Habitual Dietary Patterns and Nutrient Intakes and selection of Mediterranean food items among New Zealanders (NZ MED)

Abstract

Background: The Mediterranean Diet (MD) has come into research focus as increasing evidence has identified benefits of the MD in diet-related diseases. To date, the habitual dietary intake of New Zealand (NZ) adults has not been examined in relation to the MD. The potential of adapting the MD in a NZ context remains unexplored. Aim: This study aims to define the habitual dietary patterns (DPs), nutrient intakes, and overall diet quality from a sample of NZ adults who have a low-intermediate or high diabetes risk defined by Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Methods: A cross-sectional study of 1,012 NZ adults was conducted. A validated semi-quantitative food frequency questionnaire (FFQ) was used to collect dietary information. The risk of Type 2 diabetes (T2DM) was assessed using the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). DPs were identified through Principal Component Analysis. Reported intake from the FFQ was used in conjunction with the Health Dietary Habits Index (HDHI) and the Mediterranean- Style Dietary Pattern Score (MSDPS) to determine diet quality. Mixed linear models with covariates age, sex, and ethnicity were used to analyse the association between DP and diet quality scores with demographic and health factors and dietary intake. Results: No significant difference was found in total energy or macronutrient and micronutrient intake between those with low-intermediate or high risk of T2DM. Two distinct DPs across the whole cohort were identified: Discretionary and Guideline. Adherence to DP and diet quality was associated with age and ethnicity. DP was also associated with sex. Diet quality as defined by HDHI was significantly higher (p<0.001) than diet quality defined by MSDPS. Conclusions: This study provides evidence that the current dietary habits of NZ adults can be depicted as two distinct DP: ‘Discretionary’ and ‘Guideline’. Diet quality defined by HDHI and MSDPS was found to be relatively poor. No difference was established in DP or diet quality in those with low-intermediate and high risk of T2DM as defined by AUSDRISK. Further research using food preference data will be used to develop a community-based intervention to explore the potential of implementing the MD in a NZ context.