Shifting patterns of a Mediterranean lifestyle among elderly Cypriots: retrospective investigation

Abstract Background The traditional Mediterranean diet, comprising high consumption of olive oil, fresh fruits, vegetables, legumes, and fish, is linked to lower morbidity and mortality. A Mediterranean lifestyle, involving aspects like foraging in nature and own produce, the social aspect of eating, frequent physical activity, as well as ideal sleeping patterns and leading a stress-free life, is even more beneficial for health and wellbeing. A challenge faced by Mediterranean countries is the gradual abandonment of their traditional diet and lifestyle. Methods We assessed adherence to the Mediterranean diet (MEDAS questionnaire) and aforementioned aspects of the Mediterranean way of life in the households of 200 elderly Cypriots, retrospectively for the period where the participants were in their childhood and cross-sectionally for the present. We used linear mixed models to determine changes in adherence to both the Mediterranean diet and lifestyle over the decades. Results We identified significant decreases in adherence to both the Mediterranean diet and lifestyle (p-values for change over time <0.001), with the change in lifestyle being overwhelming, particularly in urban areas. Despite this, specific aspects of the Mediterranean diet (e.g. olive oil as the primary source of dietary fat, frequent consumption of fruits, vegetables, and legumes) persisted among elderly Cypriots over the decades, while traditional lifestyle aspects (e.g. taking siestas and consuming own produce) persisted only in rural settings (p-values < 0.001). Finally, we detected some beneficial shifts in dietary patterns, such as choice of low-fat over full-fat dairy and wholegrain over refined cereal products (p-values <0.001). Conclusions Our findings reveal clear changing patterns in the traditional Mediterranean lifestyle among elderly Cypriots, with an overall reduction in adherence to the Mediterranean diet and a decline in the traditional lifestyle, particularly in urban areas. Key messages • Decreased adherence to the Mediterranean diet and lifestyle is apparent in an Eastern Mediterranean elderly population, particularly in urban settings. • Public health approaches should empower individuals residing in Mediterranean regions to increase further adherence to their traditional lifestyle as a means of leading a prolonged and healthier life.