Culture and Adherence to the Mediterranean Diet: An Island’s Scope

Main Article Content

Taygun Dayi
Adile Oniz


MEDAS, Cyprus, Mediterranean diet, culture, Mediterranean region


Introduction: The Mediterranean diet is a nutritional model which is known with the Mediterranean countries. It is based on the nutritional habits and lifestyles of people from the region incorporating nutrition, physical activity, food production etc. The island of Cyprus is centrally located in the eastern part of the region. There are cultural differences between the northern and southern sides. Besides native islanders there are latecomers who have migrated to the for education, work or retirement.

Objective: This study is aimed to determine locals -from each side- and latecomers’ adherence to the Mediterranean diet and relation between food production and the Mediterranean diet adaptation.

Methods: Participation was voluntary in this presented study. General background and food production were determined with questionnaire developed by researchers. Overall, adherence to the Mediterranean diet was conducted by Mediterranean Diet Adherence Screener (MEDAS).

Results: The mean MEDAS score was 7.46 ± 2.23 points, while the Southern side of the island had a higher adaptation (due to more red wine and white meat consumption). According to results as latecomers’ duration in the island increased, their MEDAS scores improved (i.e. who lived in this island more than ten years had the highest MEDAS in latecomers subgroup). Strikingly, participants -who produced their own foods- had higher score in proportion to production volume.

Conclusion: Consequently, modification of current Mediterranean Diet Pyramid with locally available and traditional foods promotes an ideal adherence.


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1. Altomare R, Cacciabaudo R, Damiano G et al. The Mediterranean diet: A history of health. Iranian J of Publ Health 2013; 42(5): 449-57.
2. Lăcătusu CM, Grigorescu ED, Floria M, Onofriescu M, Mihai BM. The Mediterranean diet: From an environment-driven food culture to an emerging medical prescription. Int J Environ Res Public Health 2019; 16(6): 1-16.
3. George ES, Kucianski T, Mayr HL, Moschonis G, Tierney AC, Itsiopoulos C. A Mediterranean diet model in Australia: Strategies for translating the traditional Mediterranean diet into a multicultural setting. Nutrients 2018; 10(4): 1-20.
4. Bach-Faig A, Berry EM, Lairon D et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr 2011; 14(12A): 2274-84.
5. Naja F, Itani L, Hamade R, Chamieh MC, Hwalla N. Mediterranean diet and its environmental footprints amid nutrition transition: The case of Lebanon. Sustainability 2019; 11(23): 1-18.
6. Esposito K, Maiorino MI, Bellastella G, Chiodini P, Panagiotakos D, Giugliano D. A journey into a Mediterranean diet and type 2 diabetes: A systemic review with meta-analyses. BMJ Open 2015; 5(8): 1-5.
7. Roman B, Carta L, Martínez-González MǍ, Serra-Majem L. Effectiveness of the Mediterranean diet in the elderly. Clin Interv Aging 2008; 3(1): 97-109.
8. Arós F, Estruch R. Mediterranean diet and cardiovascular prevention. Rev Esp Cardiol 2013; 66(10): 771-4.
9. Gotsis E, Anagnostis P, Mariolis A, Vlachou A, Katsiki N, Karagiannis A. Health benefits of the Mediterranean diet: An update of research over the last 5 years. Angiology 2015; 66(4): 304-18.
10. Papassotiriou I, Islam Shariful SM. Adherence to Mediterranean diet is associated with lung function in older adults: Data from the Health and Retirement Study. J Am Coll Nutr 2020; 40(2): 119-24.
11. Delipetrou P, Makhzoumi J, Dimopoulos P, Georghiou K. Chapter 9: Cyprus. In: Vogiatzakis IN, Pungetti G, Mannion AM, editors. Mediterranean island landscapes natural and cultural approaches. 1st ed. United Kingdom (UK): Springer; 2008. p. 170-202.
12. Pedi R, Kouskouvelis I. Cyprus in the Eastern Mediterranean: A small state seeking for status. In: Litsas SN, Tziampiris A, editors. The new Eastern Mediterranean. 1st ed. United Kingdom (UK): Springer; 2019. p. 151-67.
13. Kabaran S, Gezer C. Determination of the Mediterranean diet and the obesity status of children and adolescents in Turkish Republic of Northern Cyprus. Turkish J Pediatr Dis 2013; 7(1): 11-20.
14. Dayi T, Soykut G, Ozturk M, Yucecan S. Mothers and children adherence to the Mediterranean diet: Evidence from a Mediterranean country. Prog Nutr Forthcoming.
15. Demetriou CA, Hadjisavvas A, Loizidou MA, Loucaides G, Neophytou I, Sieri S, Kakouri E, Middleton N, Vineis P, Kyriacou K. The Mediterranean dietary pattern and breast cancer risk in Greek-Cypriot women: A case-control study. BMC Cancer 2012; 12: 1-12.
16. Kyriacou A, Evans JMM, Economides N, Kyriacou A. Adherence to the Mediterranean diet by Greek and Cypriot population: A systematic review. Eur J Public Health 2015; 25(6): 1012-8.
17. Lazarou C, Panagiotakos DB, Matalas A. Level of adherence to the Mediterranean diet among children from Cyprus: the CYKIDS study. Public Health Nutr 2009; 12(7): 991-1000.
18. Martínez-González MA, García-Arellano A, Toledo E et al. A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: The PREDIMED trial. PLoS One 2012; 7(8): 1-10.
19. Martínez-González MA, Fernández-Jarne E, Serrano-Martínez M, Wright M, Gomez-Gracia E. Development of a short dietary intake questionnaire for the quantitavie estimation of adherence to a cardioprotective Mediterranean diet. Eur J Clin Nutr 2004; 58(11): 1550-2.
20. Hernάndez-Galiot A, Goňi I. Adherence to the Mediterranean diet pattern, cognitive status and depressive symptoms in an elderly non-institutionalized population. Nutr Hosp 2017; 34(2): 338-44.
21. Hebestreit K, Yahiaoui-Doktor M, Engel C et al. Validation of the German version of the Mediterranean Diet Adherence Screener (MEDAS) questionnaire. BMC Cancer 2017; 17: 1-10.
22. García-Conesa MT, Philippou E, Pafilas C et al. Exploring the Validity of the 14-Item Mediterranean Diet Adherence Screener (MEDAS): A cross-national study in seven European countries around the Mediterranean region. Nutrients 2020; 12(10): 1-17.

23. Papadaki A, Johnson L, Toumpakari Z et al. Validation of the English version of the 14-Item Mediterranean Diet Adherence Screener of the PREDIMED study, in people at high cardiovascular risk in the UK. Nutrients 2018; 10(2): 1-16.
24. Pehlivanoglu EFO, Balcioglu H, Unluoglu I. Turkish validation and reliability of Mediterranean Diet Adherence Screener. Osmangazi J of Med 2020; 42(2): 160-4.
25. Andrade V, Jorge R, García-Conesa MT et al. Mediterranean diet adherence and subjective well-being in a sample of Portuguese adults. Nutrients 2020; 12(12): 1-15.
26. Muros JJ, Zabala M. Differences in Mediterranean diet adherence between cyclists and triathletes in a sample of Spanish athletes. Nutrients 2018; 10(10): 1-11.
27. Schwarzer R, Fleig L, Warner LM et al. Who benefits from a dietary online intervention? Evidence from Italy, Spain and Greece. Public Health Nutr 2017; 20(5): 938-47.
28. Phull S. The Mediterranean diet: Socio-cultural relevance for contemporary health promotion. Open Public Health J 2015; 8(1): 35-40.
29. Nemeth N, Rudnak I, Ymeri P, Fogarassy C. The role of cultural factors in sustainable food consumption – An investigation of the consumption habits among international students in Hungary. Sustainability 2019; 11(11): 1-27.
30. Tierney AC, Zabetakis I. Changing the Irish dietary guidelines to incorporate the principles of the Mediterranean diet: Proposing the MedÈire diet. Public Health Nutr 2018; 22(2): 375-81.
31. Ball K, Timperio AF, Crawford DA. Understanding environmental influences on nutrition and physical activity behaviors: Where should we look and what should we count?. Int J Behav Nutr Phys Act 2006; 3: 1-8.
32. Hoffman R, Gerber M. Evaluating and adapting the Mediterranean diet for non-Mediterranean populations: A critical appraisal. Nutr Rev 2013; 71(9): 573-84.
33. Constantinou CM, Demetriou O, Hatay M. Conflicts and uses of cultural heritage in Cyprus. JBNES 2012; 14(2): 177-98.
34. Vrontis D, Paliwoda SJ. Branding and the Cyprus wine industry. J Brand Manag 2008; 16(3): 145-59.
35. Kendirci B, Sin T, Darbaz I. TRNC economy status report. Cyprus (CY): Embassy of Turkey; 2018/02/22. Report no.: 16.
36. Akbora HD. General status and growth potential of fisheries sector in Northern Cyprus. Nat Eng Sci 2020; 5(2): 73-81.
37. Demirkol C. The analysis of red meat sector at industry and consumer level in Turkey [PhD thesis]. Turkey (TR): Namık Kemal University; 2007.
38. Food and Agriculture Organization of the United Nations (FAO). Fishery and aquaculture country profiles. 2015/11 [Accessed 2021/01/30]
39. Echeverría G, Tiboni O, Berkowitz L et al. Mediterranean lifestyle to promote physical, mental, and environmental health: The case of Chile. Int J Environ Res Public Health 2020; 17(22): 1-17.
40. Algert S, Diekmann L, Renvall M, Gray L. Community and home gardens increase vegetable intake and food security of residents in San Jose, California. Calif Agric 2016; 70(2): 77-82.
41. Benyaich A. The effects of the Mediterranean diet on chronic diseases: Cardiovascular diseases, oxidative stress, dyslipidemia, diabetes mellitus, blood pressure, cancer, neurodegenerative disease and obesity. Journal Adv Res 2017; 2(6): 333-55.
42. Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health status: An updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr 2013; 17(12): 2769-82.
43. Torrado YP, Velasco AG, Galiot AH, Cambrodón IG. A stategy for weight loss based healthy dietary habits and control of emotional response to food. Nutr Hosp 2015; 31(6): 2392-9.

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