Objective: To examine the trend of food and nutrient intake from 1960 to 1991 of the subjects of two rural Italian cohorts of the Seven Countries Study. Design: Longitudinal study of dietary patterns from 1960 to 1991. Setting: Two rural Italian cohorts of Seven Countries Study: Crevalcore in the North near Bologna and Montegiorgio in the Centre near Ancona. Subjects: Men aged 40-59 y in 1960 examined every 5 or 10 y until 1991. Methods: Food intake was assessed by the dietary history method on all available subjects and by the weighed record method in a statistically selected subsample. Results: A marked decrease of energy intake was observed, due not only to the aging process but also to a remarkable reduction of working activities and life habits. The trend of food group intake as percentage of energy shows an increase for milk, cheese, meat, vegetables, fruit, sweet beverages and cakes, pies and cookies and a decrease for bread and alcoholic beverages, which were more marked in Montegiorgio. The evaluation of the above changes by a Mediterranean Adequacy Index provided the following values: in Crevalcore in 1965 2.9 and in 1991 2.2; in Montegiorgio the corresponding values are 5.6 and 3.9. The Mediterranean Adequacy Index of diet of men from Nicotera (the third rural cohort examined only in 1960), considered the Reference Italian-Mediterranean Diet, is 7.5. Accordingly, in both cohorts dietary habits, different at baseline and rather far from the Reference Italian-Mediterranean type (especially in Crevalcore) became worse with time, particularly in Montegiorgio. Conclusions: The changes observed in 31 y in the diet of men from Crevalcore and Montegiorgio suggest the necessity in the longitudinal nutritional epidemiology studies particularly in rapidly changing societies to assess the trend of food intakes and the factors related to it. This is in view of the promotion of nutrition intervention programs. Sponsorship: Italian Ministry of Health, US Public Health Service from the National Heart Institute, Italian National Research Council. | 
