Background: A follow-up analysis of cohorts surveyed in the "Seven Countries Study" has provided increasing evidence of an association between diet and morbidity or mortality from coronary heart disease (CHD) and cancer. The effects of the "Mediterranean diet" on mortality is still evident in Italy, where food patterns differ significantly in different geographical areas.
Objective: To examine differences in food habits in Nicotera, one of the Italian rural areas of the Seven Countries Study, between 1960 and 1996.
Methods: In 1996, 80 subjects, 37 females and 43 males, aged 40-59 years, were examined in Nicotera assessing food intake by means of a semiquantitative questionnaire of food frequency, validated for the Italian population. In 1960, food intake of a sample of Nicotera subjects was assessed by weighed record method for three seasons.
Results: Food choices differed markedly between 1960 and 1996. Consumption of animal foods increased, as did that of cakes, pies and cookies and sweet beverages in both male and female groups; an increase of alcoholic beverages was observed only in females.
Conclusions: In 1960, Nicotera inhabitants were following a diet defined as a "reference Italian Mediterranean diet", but by 1996 the Nicotera diet approached that of an average Italian diet, whose characteristics fall short of a true Mediterranean diet. This change in dietary habits may be responsible for an increased risk of CHD and cancer in the general population in the absence of other factors.