Portuguese households' diet quality (adherence to Mediterranean food pattern and compliance with WHO population dietary goals): trends, regional disparities and socioeconomic determinants

Objective: To evaluate households' diet-quality trends and regional disparities, as well as to identify the influence of its socioeconomic determinants. Methods/Subjects: Two dietary indexes were applied: a revised Health Diet Indicator version (HDIr) and the Mediterranean Adequacy Index (MAI). The socioeconomic differences between households with low-diet quality (if their scoring in HDIr or MAI was below the national median) and the remaining ones were analysed by means of logistic regression. Representative samples of households among each region were analysed. Results: Adherence to a Mediterranean diet was poor in all Portuguese regions; the proportion of households adhering to it has diminished in the North, Centre, Libson and Tejo valley. The proportion of households with high HDlr decreased in the North, Centre, Lisbon and Tejo valley and Algarve. In multivariate analysis, households whose head had secondary or higher education, living in semi-urban or urban areas, from the Azores region, within the higher income or outside home food expenditures groups were more likely to be in low-quality diet. Conclusions: The decreasing adherence to a Mediterranean food pattern and the diminishin compliance with World Health Organization dietary goals show that Portuguese households have reduced their diet quality. The observed influence of urbanization and region on diet quality highlights the importance of considering regional nutrition strategies.