Income, education, adherence to a Mediterranean diet pattern and obesity prevalence

In a study published on British Medical Journal a research team has examined cross-sectional associations of income and education with an adherence to a Mediterranean dietary pattern and obesity prevalence on a sample of 13262 subjects (mean age 53±11, 50% men) out of 24 318 citizens (citizens of Molise, a region placed between Central and Southern Italy) randomly enrolled in the Moli-sani Project, a population based cohort study.
Household net income categories were considered as:

  • high (>40000 Euro/year);
  • medium–high (>25000 <40000 Euro/year);
  • low–medium (>10000<25000 Euro/year);
  • low (< 10000 Euro/year).

Education level was divided into three categories:

  • ≤8 (low) years of studies;
  • >8 and ≤13 (medium) years of studies;
  • >13 (high) years of studies.

Household higher income were significantly associated with greater adherence to a Mediterranean diet and to olive oil and vegetables dietary pattern, with odds of having the highest adherence to a Mediterranean diet clearly increased according to income levels (diet quality showed a continued improvement across the relatively small range of economic strata). Obesity prevalence was higher in the lowest-income group in comparison with the highest-income category.
Education was positively associated with adherence to Mediterranean diet and lower prevalence of obesity.

The study showed that a higher income and education are independently associated with a greater adherence to Mediterranean diet-like eating patterns and a lower prevalence of obesity.


Bonaccio M., Bonanni A.E., Di Castelnuovo A., De Lucia F.,Donati M.B.,de Gaetano G.,Iacoviello L., on behalf of the Moli-sani Project Investigators. Low income is associated with poor adherence to a Mediterranean diet and a higher prevalence of obesity: cross-sectional results from the Moli-sani study. BMJ Open 2012;2:e001685. doi:10.1136/bmjopen-2012-001685