Maternal nutrition and lifestyle in pregnancy are important modifiable factors for both maternal and offspring’s health. Although the Mediterranean diet has beneficial effects on health, recent studies have shown low adherence in Europe. This study aimed to assess the Mediterranean diet adherence in 266 pregnant women from Dalmatia, Croatia and to investigate their lifestyle habits and regional differences. Adherence to the Mediterranean diet was assessed through two Mediterranean diet scores. Differences in maternal characteristics (diet, education, income, parity, smoking, pre-pregnancy body mass index (BMI), physical activity, contraception) with regards to location and dietary habits were analyzed using the non-parametric Mann–Whitney U test. The machine learning approach was used to reveal other potential non-linear relationships. The results showed that adherence to the Mediterranean diet was low to moderate among the pregnant women in this study, with no significant mainland–island differences. The highest adherence was observed among wealthier women with generally healthier lifestyle choices. The most significant mainland–island differences were observed for lifestyle and socioeconomic factors (income, education, physical activity). The machine learning approach confirmed the findings of the conventional statistical method. We can conclude that adverse socioeconomic and lifestyle conditions were more pronounced in the island population, which, together with the observed non-Mediterranean dietary pattern, calls for more effective intervention strategies.

Natalija Novokmet PhD, is Assistant director and senior scientific associate in field of biomedicine and health sciences, biology sciences and humanities (anthropology) at the Institute for Anthropological Research in Zagreb, Croatia. She is assistant professor at the Faculty of Science, and School of Medicine, University of Zagreb. She graduated in Biology at the Faculty of Science at the University of Zagreb and defended her M.Sc. thesis (2007), and Ph.D. thesis (2011). Her research interests involve molecular anthropological genetics of complex diseases, evolutionary biology and population genetics. The recent focus of her interest is population and medical genetics as well as biomedical (candidate genes) and epidemiological aspect of general and isolated populations. She has been involved in 15 national and international funded projects with near field point on population genetic (sub)structure and biomedical research of Croatian Adriatic island populations, Croatian mainland populations and numerous other isolated (Roma population) and general populations from South-eastern Europe. Some of mentioned projects are as follows: international: "Integrated GWAS and EWAS of Cradiometabolic Traits in an Island Population" (National Institutes of Health – NIH, USA); "Genetic and environmental factors of insulin resistance syndrome and its long term complication in immigrant Mediterranean populations – MEDIGENE" (European Commission (FP7); "Genetics of Metabolic Syndrome in an Adriatic Island Population" (NIH, National Institute of Health, SAD); "Mapping genes underlying complex quantitative traits in Croatian isolate population"; "Unravelling Data for Rapid Evidence – Based Response to COVID – 19" (unCoVer) (HORIZON 2020) and national: Croatian Islands’ Birth Cohort Study – CRIBS (Croatian Science Foundation). She has 95 autorships: published scientific papers, journal articles, conference abstracts, university textbook, theses and a scientific dictionary. She is the mentor of many graduate and doctoral theses (dissertation). She participated in the organization of more than 20 congresses and international courses and 6 national and international holistic interdisciplinary fieldwork.