Comprehensive monitoring of the characteristics of Mediterranean food environments related to obesity and NCDs is needed to allow comparisons, and to timely evaluate the impact of initiatives to improve food environments. Despite a growing literature on the influence of different aspects of the food environment on diet in Anglo-Saxon countries, there is little evidence for Mediterranean urban settings. Spain) regarding the shape and distribution of the food environment. Īlthough these urbanization and economic processes are rapidly changing the food supply and distribution systems, many cultural and social differences still exist between the U.S and Southern-European countries (e.g. In conclusion, during the last decades demographic, economic and social changes have changed traditional food patterns into Western food patterns. Greece), traditionally adhered to Mediterranean diets (high in legumes, fruits and vegetables, and whole grains), which are gradually moving towards a ‘Westernised/Americanised’ diet. These changes have transformed dietary patterns of Mediterranean countries (e.g. These population diet determinants differ between countries and cultures and have changed over time. Īt the population level, diet is driven by upstream determinants including food availability, food accessibility and food affordability, which in turn are influenced by agriculture and production policies, marketing and media, urbanization, or culture and social norms. Therefore, it is essential to shift paradigms around the causes of obesity towards a socio-ecological perspective, in which individual dietary behaviors are embedded within broader contextual determinants. Historically, strategies to prevent obesity have targeted high-risk individuals, showing poor results or lack of improved outcomes. In Spain, the prevalence of obesity in adults nearly doubled between 1987 (8.0%) and 2012 (16.5%). Obesity is associated with an increased risk for non-communicable diseases (NCDs), including diabetes, cardiovascular disease and cancer. The rising obesity pandemic is a public health priority worldwide.
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