Background/Objectives: Understanding the impact of dietary habits in terms of obesity, health outcomes, and functional decline is critical in Europe’s growing elderly population. This study analyzed trends in Mediterranean diet (MD) adherence, obesity prevalence, and grip strength among middle-aged and elderly Europeans using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Methods: Data from four SHARE waves (2015–2022) across 28 countries were analyzed. Dietary patterns were assessed through food frequency questionnaires classifying participants as MD-adherent or non-adherent where adherent implies daily consumption of fruits and vegetables and occasional (3–6 times/week) intake of eggs, beans, legumes, meat, fish, or poultry (an unvalidated definition of the MD pattern). Handgrip strength, a biomarker of functional capacity, was categorized into low, medium, and high groups. Body mass index (BMI), self-perceived health (SPHUS), chronic disease prevalence, and CASP-12 scores (control, autonomy, self-realization, and pleasure evaluated on the 12-item version) were also evaluated. Statistical analyses included descriptive methods, logistic regressions, and multiple imputations to address missing data. Results: A significant majority (74–77%) consumed fruits and vegetables daily, which is consistent with MD principles; however, the high daily intake of dairy products (>50%) indicates limited adherence to the MD, which advocates for moderate consumption of dairy products. Logistic regression indicated that individuals with two or more chronic diseases were more likely to follow the MD (odds ratio [OR] = 1.21, confidence interval [CI] = 1.11–1.32), as were those individuals who rated their SPHUS as very good/excellent ([OR] = 1.42, [CI] = 1.20–1.69). Medium and high maximal handgrip were also strongly and consistently associated with higher odds of MD adherence (Medium: [OR] = 1.44, [CI] = 1.18–1.74; High: [OR] = 1.27, [CI] = 1.10–1.48). Conclusions: The findings suggest that middle-aged and older adults are more likely to adhere to the MD dietary pattern if they have more than two chronic diseases, are physically active, and have a medium or high handgrip. Although an unvalidated definition of the MD dietary pattern was used, the results highlight the importance of implementing targeted dietary strategies for middle-aged and elderly adults.

This paper investigates the prevalence of obesity and its links to health and dietary habits in middle-aged and older populations in Europe (50+), with a particular focus on Croatia. In Croatia, only 33.9% of adults have a normal BMI, while almost two-thirds (64.8%) are classified as overweight or obese, placing Croatia among the EU countries with the highest prevalence of overweight. Obesity significantly increases the risk of serious health complications, including cardiovascular disease (CVD) and type 2 diabetes. Therefore, we used data from the SHARE (Survey of Health, Ageing and Retirement in Europe), for the last four waves (wave 6–wave 9). The nutritional status was investigated (using the body mass index, BMI) as well as its relationship with cardiovascular disease and dietary habits. Different BMI categorizations were used (i) for the population under and (ii) over 65 years of age, and the results show that a significant proportion of the middle-aged and older European population is overweight or obese. When it comes to dietary habits, statistically significant differences in meat, fish, or chicken consumption were noted (p < 0.001): the Croatian population, especially men, consumes them significantly more often on a daily basis compared to the EU average. Similar patterns of dairy, legumes/eggs, and fruit/vegetable consumption were observed between the EU and Croatia, although there are some statistically significant differences in daily dairy consumption among the older population and in consumption of legumes/eggs and fruit/vegetables 3–6 times a week among the older population. The prevalence of CVD generally increases with increasing BMI in both regions and age groups. However, Croatia has a statistically significantly lower prevalence of high cholesterol compared to the EU in both age groups. Also, the trend of diabetes is more pronounced in the middle-aged population in Croatia compared to the EU. These results indicate specific differences in dietary habits and the association of BMI with certain CVDs in Croatia compared to the European Union average.