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Authors = Kais El Abed

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31 pages, 799 KiB  
Article
Exploring Determinants of Mediterranean Lifestyle Adherence: Findings from the Multinational MEDIET4ALL e-Survey Across Ten Mediterranean and Neighboring Countries
by Achraf Ammar, Mohamed Ali Boujelbane, Atef Salem, Khaled Trabelsi, Bassem Bouaziz, Mohamed Kerkeni, Liwa Masmoudi, Juliane Heydenreich, Christiana Schallhorn, Gabriel Müller, Ayse Merve Uyar, Hadeel Ali Ghazzawi, Adam Tawfiq Amawi, Bekir Erhan Orhan, Giuseppe Grosso, Osama Abdelkarim, Mohamed Aly, Tarak Driss, Kais El Abed, Wassim Moalla, Piotr Zmijewski, Frédéric Debeaufort, Nasreddine Benbettaieb, Clément Poulain, Laura Reyes, Amparo Gamero, Marta Cuenca-Ortolá, Antonio Cilla, Nicola Francesca, Concetta Maria Messina, Enrico Viola, Björn Lorenzen, Stefania Filice, Aadil Bajoub, El-Mehdi Ajal, El Amine Ajal, Majdouline Obtel, Sadjia Lahiani, Taha Khaldi, Nafaa Souissi, Omar Boukhris, Waqar Husain, Evelyn Frias-Toral, Walid Mahdi, Hamdi Chtourou, Haitham Jahrami and Wolfgang I. Schöllhornadd Show full author list remove Hide full author list
Nutrients 2025, 17(14), 2280; https://doi.org/10.3390/nu17142280 - 10 Jul 2025
Viewed by 618
Abstract
Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and [...] Read more.
Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations. Full article
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18 pages, 798 KiB  
Article
Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown: ECLB COVID-19 International Online Survey
by Khaled Trabelsi, Achraf Ammar, Liwa Masmoudi, Omar Boukhris, Hamdi Chtourou, Bassem Bouaziz, Michael Brach, Ellen Bentlage, Daniella How, Mona Ahmed, Patrick Mueller, Notger Mueller, Hsen Hsouna, Yousri Elghoul, Mohamed Romdhani, Omar Hammouda, Laisa Liane Paineiras-Domingos, Annemarie Braakman-Jansen, Christian Wrede, Sofia Bastoni, Carlos Soares Pernambuco, Leonardo Jose Mataruna-Dos-Santos, Morteza Taheri, Khadijeh Irandoust, Nicola L. Bragazzi, Jana Strahler, Jad Adrian Washif, Albina Andreeva, Stephen J. Bailey, Jarred Acton, Emma Mitchell, Nicholas T. Bott, Faiez Gargouri, Lotfi Chaari, Hadj Batatia, Samira C. Khoshnami, Evangelia Samara, Vasiliki Zisi, Parasanth Sankar, Waseem N. Ahmed, Gamal Mohamed Ali, Osama Abdelkarim, Mohamed Jarraya, Kais El Abed, Wassim Moalla, Nafaa Souissi, Asma Aloui, Nizar Souissi, Lisette Van Gemert-Pijnen, Bryan L. Riemann, Laurel Riemann, Jan Delhey, Jonathan Gómez-Raja, Monique Epstein, Robbert Sanderman, Sebastian Schulz, Achim Jerg, Ramzi Al-Horani, Taysir Mansi, Ismail Dergaa, Mohamed Jmail, Fernando Barbosa, Fernando Ferreira-Santos, Boštjan Šimunič, Rado Pišot, Saša Pišot, Andrea Gaggioli, Jürgen Steinacker, Piotr Zmijewski, Christian Apfelbacher, Jordan M. Glenn, Aïmen Khacharem, Cain C.T. Clark, Helmi Ben Saad, Karim Chamari, Tarak Driss, Anita Hoekelmann and on behalf of the ECLB-COVID19 Consortiumadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2021, 18(8), 4329; https://doi.org/10.3390/ijerph18084329 - 19 Apr 2021
Cited by 109 | Viewed by 13385
Abstract
Background. The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing [...] Read more.
Background. The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults. Methods. A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses “pre” and “during” the lockdown period. Participants responded to the Short Warwick–Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire. Results. Replies from older adults (aged >55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p < 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F(2, 514) = 66.41 p < 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p < 0.001, R2: 0.20). Conclusion. COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing. Full article
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17 pages, 400 KiB  
Article
COVID-19 Home Confinement Negatively Impacts Social Participation and Life Satisfaction: A Worldwide Multicenter Study
by Achraf Ammar, Hamdi Chtourou, Omar Boukhris, Khaled Trabelsi, Liwa Masmoudi, Michael Brach, Bassem Bouaziz, Ellen Bentlage, Daniella How, Mona Ahmed, Patrick Mueller, Notger Mueller, Hsen Hsouna, Asma Aloui, Omar Hammouda, Laisa Liane Paineiras-Domingos, Annemarie Braakman-Jansen, Christian Wrede, Sophia Bastoni, Carlos Soares Pernambuco, Leonardo Jose Mataruna-Dos-Santos, Morteza Taheri, Khadijeh Irandoust, Aïmen Khacharem, Nicola L. Bragazzi, Jana Strahler, Jad Adrian Washif, Albina Andreeva, Samira C. khoshnami, Evangelia Samara, Vasiliki Zisi, Parasanth Sankar, Waseem N. Ahmed, Mohamed Romdhani, Jan Delhey, Stephen J. Bailey, Nicholas T. Bott, Faiez Gargouri, Lotfi Chaari, Hadj Batatia, Gamal Mohamed Ali, Osama Abdelkarim, Mohamed Jarraya, Kais El Abed, Nizar Souissi, Lisette Van Gemert-Pijnen, Bryan L. Riemann, Laurel Riemann, Wassim Moalla, Jonathan Gómez-Raja, Monique Epstein, Robbert Sanderman, Sebastian Schulz, Achim Jerg, Ramzi Al-Horani, Taiysir Mansi, Mohamed Jmail, Fernando Barbosa, Fernando Ferreira-Santos, Boštjan Šimunič, Rado Pišot, Saša Pišot, Andrea Gaggioli, Piotr Zmijewski, Christian Apfelbacher, Jürgen Steinacker, Helmi Ben Saad, Jordan M. Glenn, Karim Chamari, Tarak Driss, Anita Hoekelmann and on behalf of the ECLB-COVID19 Consortiumadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2020, 17(17), 6237; https://doi.org/10.3390/ijerph17176237 - 27 Aug 2020
Cited by 330 | Viewed by 28546
Abstract
Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on [...] Read more.
Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction. Methods: Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses “before” and “during” confinement conditions. Results: 1047 participations (54% women) from Asia (36%), Africa (40%), Europe (21%), and others (3%) were included in the analysis. Findings revealed psychosocial strain during the enforced COVID-19 home confinement. Large decreases (p < 0.001) in the amount of social activity through family (−58%), friends/neighbors (−44.9%), or entertainment (−46.7%) were triggered by the enforced confinement. These negative effects on social participation were also associated with lower life satisfaction (−30.5%) during the confinement period. Conversely, the social contact score through digital technologies significantly increased (p < 0.001) during the confinement period with more individuals (+24.8%) being socially connected through digital technology. Conclusion: These preliminary findings elucidate the risk of psychosocial strain during the early COVID-19 home confinement period in 2020. Therefore, in order to mitigate the negative psychosocial effects of home confinement, implementation of national strategies focused on promoting social inclusion through a technology-based solution is strongly suggested. Full article
14 pages, 705 KiB  
Article
Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey
by Achraf Ammar, Michael Brach, Khaled Trabelsi, Hamdi Chtourou, Omar Boukhris, Liwa Masmoudi, Bassem Bouaziz, Ellen Bentlage, Daniella How, Mona Ahmed, Patrick Müller, Notger Müller, Asma Aloui, Omar Hammouda, Laisa Liane Paineiras-Domingos, Annemarie Braakman-Jansen, Christian Wrede, Sofia Bastoni, Carlos Soares Pernambuco, Leonardo Mataruna, Morteza Taheri, Khadijeh Irandoust, Aïmen Khacharem, Nicola L. Bragazzi, Karim Chamari, Jordan M. Glenn, Nicholas T. Bott, Faiez Gargouri, Lotfi Chaari, Hadj Batatia, Gamal Mohamed Ali, Osama Abdelkarim, Mohamed Jarraya, Kais El Abed, Nizar Souissi, Lisette Van Gemert-Pijnen, Bryan L. Riemann, Laurel Riemann, Wassim Moalla, Jonathan Gómez-Raja, Monique Epstein, Robbert Sanderman, Sebastian V. W. Schulz, Achim Jerg, Ramzi Al-Horani, Taiysir Mansi, Mohamed Jmail, Fernando Barbosa, Fernando Ferreira-Santos, Boštjan Šimunič, Rado Pišot, Andrea Gaggioli, Stephen J. Bailey, Jürgen M. Steinacker, Tarak Driss, Anita Hoekelmann and On Behalf of the ECLB-COVID19 Consortiumadd Show full author list remove Hide full author list
Nutrients 2020, 12(6), 1583; https://doi.org/10.3390/nu12061583 - 28 May 2020
Cited by 1567 | Viewed by 91032
Abstract
Background: Public health recommendations and governmental measures during the COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on [...] Read more.
Background: Public health recommendations and governmental measures during the COVID-19 pandemic have resulted in numerous restrictions on daily living including social distancing, isolation and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on health behaviours and lifestyles at home is undefined. Therefore, an international online survey was launched in April 2020, in seven languages, to elucidate the behavioural and lifestyle consequences of COVID-19 restrictions. This report presents the results from the first thousand responders on physical activity (PA) and nutrition behaviours. Methods: Following a structured review of the literature, the “Effects of home Confinement on multiple Lifestyle Behaviours during the COVID-19 outbreak (ECLB-COVID19)” Electronic survey was designed by a steering group of multidisciplinary scientists and academics. The survey was uploaded and shared on the Google online survey platform. Thirty-five research organisations from Europe, North-Africa, Western Asia and the Americas promoted the survey in English, German, French, Arabic, Spanish, Portuguese and Slovenian languages. Questions were presented in a differential format, with questions related to responses “before” and “during” confinement conditions. Results: 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%) were included in the analysis. The COVID-19 home confinement had a negative effect on all PA intensity levels (vigorous, moderate, walking and overall). Additionally, daily sitting time increased from 5 to 8 h per day. Food consumption and meal patterns (the type of food, eating out of control, snacks between meals, number of main meals) were more unhealthy during confinement, with only alcohol binge drinking decreasing significantly. Conclusion: While isolation is a necessary measure to protect public health, results indicate that it alters physical activity and eating behaviours in a health compromising direction. A more detailed analysis of survey data will allow for a segregation of these responses in different age groups, countries and other subgroups, which will help develop interventions to mitigate the negative lifestyle behaviours that have manifested during the COVID-19 confinement. Full article
(This article belongs to the Special Issue Eating Behaviors and Human Health)
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12 pages, 1027 KiB  
Article
Effects of Aerobic-, Anaerobic- and Combined-Based Exercises on Plasma Oxidative Stress Biomarkers in Healthy Untrained Young Adults
by Achraf Ammar, Khaled Trabelsi, Omar Boukhris, Jordan M Glenn, Nick Bott, Liwa Masmoudi, Ahmed Hakim, Hamdi Chtourou, Tarak Driss, Anita Hoekelmann and Kais El Abed
Int. J. Environ. Res. Public Health 2020, 17(7), 2601; https://doi.org/10.3390/ijerph17072601 - 10 Apr 2020
Cited by 42 | Viewed by 7081
Abstract
Currently, it is well accepted that physical exercise-induced oxidative stress may damage biological structures and impair cellular functions. However, it is still unclear which type of exercise results in the greatest oxidative stress responses among a healthy untrained population. The aim of the [...] Read more.
Currently, it is well accepted that physical exercise-induced oxidative stress may damage biological structures and impair cellular functions. However, it is still unclear which type of exercise results in the greatest oxidative stress responses among a healthy untrained population. The aim of the present study was to compare the acute oxidative stress response (i.e., 0 to 20 min) following different types of exercise (anaerobic, aerobic, and combined). Ten healthy, untrained males (19.5 ± 1.7 years) performed three randomized exercise bouts: anaerobic (30 s Wingate test), aerobic (30 min at 60% maximal aerobic power (MAP)) or combined (anaerobic and aerobic). Venous blood samples were collected before, as well as at 0 (P0), 5 (P5), 10 (P10), and 20 (P20) min after each session. Rates of malondialdehyde (MDA) and antioxidant activities (i.e., glutathione peroxidase (GPX), superoxide dismutase (SOD), glutathione reductase (GR), α-tocopherol, and total antioxidant status (TAS)) were assessed. Independent of exercise type, plasma MDA, GPX, SOD, and GR contents increased above baseline, whereas plasma α-tocopherol decreased under baseline after the test sessions (p < 0.05). Aerobic and anaerobic exercises generated faster responses (at P0) when compared to the combined exercise (P5 to P10) for the majority of the tested parameters. Plasma TAS content only increased following the aerobic exercise at P10 (p = 0.03). Five to twenty-minutes post exercise, the highest MDA response was registered in the aerobic condition, and the highest GPX and SOD responses were recorded in the anaerobic (at P5) and aerobic (at P20) conditions (p < 0.05). In conclusion, aerobic, anaerobic, or combined exercises have the potential to acutely increase oxidative stress and antioxidant activities, but with different responses magnitude. These findings confirm that oxidative stress response seems to be dependent on the intensity and the duration of the physical exercise and may help in understanding how varying exercise bouts influence the degree of oxidative stress among healthy untrained young adults. Full article
(This article belongs to the Special Issue Sports and Health)
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