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Keywords = Mediterranean diet adherence screener

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19 pages, 1271 KB  
Article
Adherence to the Mediterranean Diet and Metabolic Gene Expression in Smokers: An Integrative Transcriptomic Approach
by İlayda Öztürk Altuncevahir, Ayşe Büşranur Çelik, Kezban Uçar Çifçi, Mervenur Uslu, Meltem Vural, Alev Kural, Ezgi Nurdan Yenilmez Tunoğlu and Yusuf Tutar
Nutrients 2026, 18(2), 276; https://doi.org/10.3390/nu18020276 - 15 Jan 2026
Viewed by 340
Abstract
Background: Cigarette smoking disrupts cellular energy metabolism and remains a major global health problem. The Mediterranean diet, characterized by antioxidant and anti-inflammatory properties, has been implicated in the regulation of metabolic pathways. Objective: This study aimed to examine the association between adherence to [...] Read more.
Background: Cigarette smoking disrupts cellular energy metabolism and remains a major global health problem. The Mediterranean diet, characterized by antioxidant and anti-inflammatory properties, has been implicated in the regulation of metabolic pathways. Objective: This study aimed to examine the association between adherence to the Mediterranean diet and the expression of energy metabolism-related genes in smokers aged 18–55 years. Methods: Smokers were classified according to their Mediterranean Diet Adherence Screener (MEDAS) scores into an adhering group (n = 24) and a non-adhering group (n = 24). Participant characteristics were recorded, blood samples were collected, and total RNA was isolated. Gene expression analysis was performed using a custom RT-qPCR array targeting energy metabolism-related genes. Pathway enrichment analysis was conducted using EnrichR Reactome 2024, and gene–metabolite relationships were explored using MetaboAnalyst 6.0 to support pathway-level interpretation. Results: Smoking was associated with coordinated upregulation of genes involved in glycolysis, glucose transport, lipid metabolism, amino acid metabolism, the pentose phosphate pathway, and redox regulation, consistent with a metabolically stressed state. In contrast, adherence to the Mediterranean diet was associated with lower expression of genes related to glycolytic flux, lipid β-oxidation, and amino acid turnover, alongside relatively higher engagement of tricarboxylic acid cycle-related pathways and reduced activation of redox-associated processes. Conclusions: Adherence to the Mediterranean diet was associated with differences in the expression of genes involved in cellular energy metabolism among smokers, suggesting a potential modulatory role of dietary patterns in smoking-related metabolic alterations. Full article
(This article belongs to the Section Nutritional Epidemiology)
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14 pages, 306 KB  
Article
Challenging the Wine Component in Mediterranean Diet Scores: Cognitive Outcomes in Portuguese Adults at High Risk of Dementia
by Andreia Mesquita, Daniela de Sousa, Patrícia Padrão, Ana Rute Costa and Pedro Moreira
Nutrients 2025, 17(22), 3576; https://doi.org/10.3390/nu17223576 - 15 Nov 2025
Viewed by 841
Abstract
Introduction: The Mediterranean diet (MD) has been linked to better cognition, but evidence in older adults at high dementia risk is limited. Moreover, the traditional Mediterranean Diet Adherence Screener (MEDAS) counts daily wine consumption as a beneficial component, which may distort genuine diet–cognition [...] Read more.
Introduction: The Mediterranean diet (MD) has been linked to better cognition, but evidence in older adults at high dementia risk is limited. Moreover, the traditional Mediterranean Diet Adherence Screener (MEDAS) counts daily wine consumption as a beneficial component, which may distort genuine diet–cognition relationships. Objective: Evaluate whether MD adherence, as measured with the original MEDAS (MEDAS-O) versus a version that reverses the wine item (MEDAS-R), is associated with cognitive function in Portuguese adults aged 55–85 years at increased dementia risk. Methodology: The sample comprised 75 participants from the NUTRIMIND randomised controlled trial (mean age 70.5 ± 7.0 years). MD adherence was evaluated using the original version of MEDAS (MEDAS-O) and an adapted version with a reverse score in the wine question (MEDAS-R). Cognitive function was assessed via the Montreal Cognitive Assessment (MoCA), Addenbrooke’s Cognitive Examination Revised (ACE-R) and Mini-Mental State Examination (MMSE). Statistical analysis was performed using Analysis of Covariance (ANCOVA) models adjusted for age, sex, BMI, education, and physical activity. Results: MEDAS-R was positively associated with better MMSE performance (p = 0.043) and showed a borderline association with the MoCA (p = 0.051), but not with the ACE-R score (p = 0.356). No association was found between MEDAS-O and cognitive function. Better cognitive scores were more frequently observed among participants with higher education (p < 0.001). Conclusions: Reversing the wine item changes how MEDAS relates to cognitive function. These findings support re-evaluating how wine is scored in MD adherence measures. Full article
17 pages, 757 KB  
Article
Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences
by José Luis Ribes Valles, Pedro Juan Tárraga López, Ángel Arturo López González, Irene Coll Campayo, Carla Busquets-Cortés and José Ignacio Ramírez-Manent
Med. Sci. 2025, 13(4), 271; https://doi.org/10.3390/medsci13040271 - 14 Nov 2025
Viewed by 627
Abstract
Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in [...] Read more.
Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95% CI 1.14–1.25, p < 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p < 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p < 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p < 0.001). Lower physical activity (OR = 5.70; 95% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95% CI 2.88–3.70), smoking (OR = 1.29; 95% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences. Full article
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13 pages, 778 KB  
Article
Nutritionist-Guided Video Intervention Improves Adherence to Mediterranean Diet and Reduces the Rate of Gestational Diabetes Mellitus: A Randomized Clinical Trial
by Rocío Martín-O’Connor, Ana M. Ramos-Levi, Ricardo Saviron-Cornudella, Bricia López-Plaza, Angélica Larrad-Sainz, Ana Barabash, Clara Marcuello-Foncillas, Inés Jiménez-Varas, Angel Diaz-Perez, Paz de Miguel, Miguel A. Rubio-Herrera, Pilar Matía-Martín and Alfonso L. Calle-Pascual
Nutrients 2025, 17(22), 3533; https://doi.org/10.3390/nu17223533 - 12 Nov 2025
Viewed by 841
Abstract
Aims: Gestational diabetes mellitus (GDM) represents an increasing global challenge. Mediterranean diet interventions have proven benefits, but their implementation is limited by the absence of nutritionists in many public health systems. This study aimed to evaluate whether a video intervention guided by a [...] Read more.
Aims: Gestational diabetes mellitus (GDM) represents an increasing global challenge. Mediterranean diet interventions have proven benefits, but their implementation is limited by the absence of nutritionists in many public health systems. This study aimed to evaluate whether a video intervention guided by a nutritionist could increase compliance to Mediterranean diet and reduce the incidence of GDM and adverse maternal–neonatal outcomes. Methods: In this randomized controlled trial, 1750 consecutive pregnant women were allocated (1:1) to standard care (verbal, printed advice) or to a video designed by a nutritionist promoting a Mediterranean and physical activity. The primary outcome was the incidence of GDM; secondary outcomes included other pregnancy-related complications. Dietary adherence was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS) score. Results: The experimental group increased their MEDAS score from baseline to GDM screening (mean difference (95% CI) 0.41 (0.23; 0.60); p < 0.001), mainly through greater extra virgin olive oil and nut intake and lower consumption of juices and confectionery. GDM incidence declined from 25.1% to 20.7% (p = 0.025), with significant reductions in gestational hypertension, episiotomy and neonatal intensive care unit admissions. Conclusions: Nutritionist-guided video intervention improves adherence to Mediterranean diet and reduces GDM incidence and adverse outcomes. This low-cost, scalable approach may help overcome structural limitations in public health systems. Full article
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12 pages, 469 KB  
Article
Mediterranean Diet Adherence and One-Year Metabolic Changes in Patients with Papillary Thyroid Cancer: An Observational Study
by Jinyoung Shin, Seok-Jae Heo, Yae-Ji Lee, Sang-Wook Kang, Yu-Jin Kwon and Ji-Won Lee
Nutrients 2025, 17(21), 3420; https://doi.org/10.3390/nu17213420 - 30 Oct 2025
Viewed by 858
Abstract
Background/Objectives: The Mediterranean diet (MD) has been associated with favorable metabolic outcomes in the general population. However, evidence of these associations among thyroid cancer survivors remains limited. This study examined whether higher MD adherence at diagnosis is associated with longitudinal changes in insulin [...] Read more.
Background/Objectives: The Mediterranean diet (MD) has been associated with favorable metabolic outcomes in the general population. However, evidence of these associations among thyroid cancer survivors remains limited. This study examined whether higher MD adherence at diagnosis is associated with longitudinal changes in insulin resistance and lipid profiles in patients with papillary thyroid cancer (PTC). Methods: We analyzed 345 Korean patients aged ≥20 years with histologically confirmed PTC at a tertiary hospital between April 2023 and March 2024. MD adherence at baseline (diagnosis) was assessed using the Korean Mediterranean Diet Adherence Screener and categorized into tertiles. Changes in body mass index (BMI), hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), metabolic score for insulin resistance (METS-IR), homeostasis model assessment of β-cell function (HOMA-β), and triglyceride-glucose (TyG) index were evaluated between baseline and one year post-diagnosis. A stratified analysis was conducted according to BMI (<25 vs. ≥25 kg/m2). Results: During the one-year follow-up, patients with PTC experienced significant reductions in BMI, HbA1c, METS-IR, HOMA-β, triglycerides, LDL-cholesterol, and the TyG index, whereas HDL-cholesterol levels increased. Patients in the high MD adherence group showed decreased HOMA-IR and increased HDL-cholesterol levels compared to those in the low adherence groups. In BMI-stratified analyses, reductions in insulin and HOMA-IR were observed only among patients with obesity in the high MD adherence group. Conclusions: Higher adherence to the MD at diagnosis was associated with decreases in insulin resistance markers and an increase in HDL-cholesterol levels among patients with PTC during the first year after diagnosis. Full article
(This article belongs to the Special Issue Dietary Patterns and Cancer: Risks and Survival Outcomes)
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16 pages, 552 KB  
Article
Association Between Mediterranean Diet Consumption and the Physical and Mental Components of HRQL in Community-Dwelling Older Adults in Valencia
by Pilar Pérez-Ros, Ayde Rios-Corral and Omar Cauli
Nutrients 2025, 17(20), 3243; https://doi.org/10.3390/nu17203243 - 15 Oct 2025
Viewed by 1199
Abstract
Background/Objectives: The relationship between health-related quality of life (HRQL) in community-dwelling older adults and the consumption of foods typical of the Mediterranean diet (MD) has not been studied. The main objective of this study was to determine which MD foods, as well as [...] Read more.
Background/Objectives: The relationship between health-related quality of life (HRQL) in community-dwelling older adults and the consumption of foods typical of the Mediterranean diet (MD) has not been studied. The main objective of this study was to determine which MD foods, as well as overall MD adherence, are associated with HRQL in community-dwelling older adults, taking into account both physical and mental components. Methods: A cross-sectional study was conducted including community-dwelling older adults aged 60 years or over. Sociodemographic variables, the Spanish version of the SF-12v2 quality-of-life questionnaire (physical and mental component scores), and data on the consumption of MD foods and adherence to the Mediterranean Diet Adherence Screener (MEDAS) were collected. Two binary logistic regression models, adjusted for age and sex, were fitted to analyse which food types included in the MEDAS questionnaire were significantly associated with a higher probability of having good physical and mental components of HRQL. Results: A total of 285 participants were recruited, with a mean age of 74.97 (SD 5.75) years, predominantly female (87.7%, n = 250) and 36.3% (n = 104) lived alone. The sample showed low physical quality of life [PCS-12: 42.88 IQR (33.61–51.09)], moderately good mental quality of life [MCS-12: 51.09 (39.97–57.42)] and good adherence to the Mediterranean diet [MEDAS: 9 (8–10)]. Binary logistic regression for PCS-12 showed that younger age, the joint consumption of less than one serving of butter per day, less than one cup of sugar-sweetened beverages per day and two or more servings of vegetables per day were significantly (p < 0.05) associated with good physical quality of life. Similarly, living alone, four or more tablespoons of olive oil per day and less than 2 servings of desserts per week were associated with good mental quality of life (MCS-12). Conclusions: The Mediterranean diet is related to physical and mental quality of life in older adults, with the consumption of specific foods within the MD showing significant associations in multivariate analyses. Identifying the items that are most closely related to good physical and mental health is key to promoting healthy lifestyle habits that are directly linked to improving quality of life from a holistic perspective. Understanding the associations between quality of life and consumption or avoidance of certain foods could help inform future nutritional interventions aimed at improving both physical and mental health in older adults. Full article
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17 pages, 463 KB  
Article
Adherence to Three Mediterranean Dietary Indexes and All-Cause, Cardiovascular, and Cancer Mortality in an Older Mediterranean Population
by Carolina Ojeda-Belokon, Sandra González-Palacios, Laura María Compañ-Gabucio, Alejandro Oncina-Cánovas, Manuela García-de-la-Hera, Jesús Vioque and Laura Torres-Collado
Nutrients 2025, 17(18), 2956; https://doi.org/10.3390/nu17182956 - 13 Sep 2025
Viewed by 2558
Abstract
Background/Objectives: A higher adherence to the Mediterranean diet (MedDiet) has been associated with a lower risk of death in different populations, but this association has been insufficiently investigated in the elderly Spanish population. In this study, we assess the association between adherence [...] Read more.
Background/Objectives: A higher adherence to the Mediterranean diet (MedDiet) has been associated with a lower risk of death in different populations, but this association has been insufficiently investigated in the elderly Spanish population. In this study, we assess the association between adherence to three MedDiet indexes and all-cause, cardiovascular disease (CVD), and cancer mortality in a population aged 65 years and older in Spain. Methods: The population included 903 participants from two population-based surveys. Diet was assessed at baseline by using validated food-frequency questionnaires (FFQ). We calculated scores of adherence to the MedDiet for three indexes: alternate Mediterranean Diet Score (aMED), relative Mediterranean Diet Score (rMED) and 17-item energy-restricted Mediterranean Diet Adherence Screener (erMEDAS). Deaths were ascertained through the National Death Index of Spain and the Mortality Registry in the Valencian Region during a 12 year follow-up period. Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI), adjusting for relevant confounders. Results: During the 12 years of follow-up, 403 deaths occurred: 160 due to CVD and 90 to cancer. Compared to participants in the lowest tertile of adherence to aMED, those in the highest tertile showed a 30% lower risk of all-cause mortality, HR = 0.70 (95% CI 0.51–0.96). In addition, per two-point increase in aMED, we observed a 17% lower risk of all-cause mortality, HR = 0.83 (95% CI 0.73–0.95), and a 21% lower risk of CVD mortality, HR = 0.79 (95% CI 0.64–0.99). A 9% lower risk of all-cause mortality was also observed per two-point increase in the rMED score, HR = 0.91 (95% CI 0.84–0.99). Compared to participants in the lowest tertile of adherence to rMED, those in the highest tertile showed evidence of a marginally significant, lower risk of cancer mortality, HR = 0.55 (95% CI 0.29–1.04). No association was observed between the erMEDAS index and mortality for any cause. Conclusions: High adherence to the MedDiet, as measured by aMED and rMED indexes, was associated with lower all-cause, CVD, and cancer mortality in an older Mediterranean population after 12 years of follow-up. Full article
(This article belongs to the Section Geriatric Nutrition)
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20 pages, 314 KB  
Article
Mediterranean Diet Adherence and Sleep Quality Among Primary and Secondary School Teachers in Portugal: An Exploratory Cross-Sectional Study
by Leandro Oliveira, António Raposo, Thamer Alslamah, Hani A. Alfheeaid, Nada Alqarawi and Marta Esgalhado
Nutrients 2025, 17(18), 2948; https://doi.org/10.3390/nu17182948 - 12 Sep 2025
Viewed by 1458
Abstract
Background: Diet and sleep are modifiable lifestyle factors that influence health and well-being. While adherence to the Mediterranean diet has been associated with improved sleep quality, this relationship remains understudied in high-stress occupational groups such as school teachers. Objective: To examine the association [...] Read more.
Background: Diet and sleep are modifiable lifestyle factors that influence health and well-being. While adherence to the Mediterranean diet has been associated with improved sleep quality, this relationship remains understudied in high-stress occupational groups such as school teachers. Objective: To examine the association between adherence to the Mediterranean diet and self-reported sleep quality among primary and secondary school teachers in Portugal. Methods: A cross-sectional study was conducted with 113 teachers who completed a self-administered digital questionnaire. Adherence to the Mediterranean diet was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS) and sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Results: Of the 113 participants, 58% reported poor sleep quality (PSQI > 5), and the median PSQI score was 6.0 (IQR 4.0–8.8). The median MEDAS score was 9.0 (IQR 8.0–10.0), with 34% classified as having high adherence. When stratified by dietary adherence, there were no statistically significant differences in global PSQI or its components, and multivariable linear regression showed no association between MEDAS and PSQI. Patterns varied by teaching level: poor sleep predominated in most levels except the 2nd Cycle; high adherence was most prevalent in the 1st Cycle, moderate adherence predominated in the 3rd Cycle and secondary education, and the 2nd Cycle showed similar shares of moderate and high adherence. Conclusions: In this occupational group, poor sleep was common and varied across teaching levels, while Mediterranean diet adherence showed no detectable association with overall sleep quality in this study. Larger, longitudinal studies using objective assessments of diet and sleep, and accounting for factors such as stress and chronotype, are warranted to clarify potential links in educational settings. Full article
(This article belongs to the Special Issue Sleep and Diet: Exploring Interactive Associations on Human Health)
18 pages, 485 KB  
Article
Mediterranean Diet, Sleep Quality, Perceived Stress, and Physical Activity: A Pilot Study Among School Teachers
by Marta Esgalhado, António Raposo, Najla A. Albaridi, Thamer Alslamah, Nada Alqarawi and Leandro Oliveira
Nutrients 2025, 17(17), 2745; https://doi.org/10.3390/nu17172745 - 25 Aug 2025
Cited by 1 | Viewed by 3017
Abstract
Background: Lifestyle behaviours, such as dietary patterns, sleep quality, perceived stress, and physical activity, are closely interconnected and play a critical role in maintaining health and well-being. Among school teachers, a profession marked by high psychosocial demands, the interplay between these factors warrants [...] Read more.
Background: Lifestyle behaviours, such as dietary patterns, sleep quality, perceived stress, and physical activity, are closely interconnected and play a critical role in maintaining health and well-being. Among school teachers, a profession marked by high psychosocial demands, the interplay between these factors warrants further exploration. Objective: This pilot study aimed to explore the associations between adherence to the Mediterranean Diet (MD), sleep quality, perceived stress, and physical activity levels among Portuguese primary and secondary school teachers. Methods: A cross-sectional study was conducted between April and December 2023. Participants completed validated self-reported instruments, including the MD Adherence Screener (MEDAS), the Pittsburgh Sleep Quality Index (PSQI), the Perceived Stress Scale (PSS-10), and the short form of the International Physical Activity Questionnaire (IPAQ-SF). Correlational analyses and multivariable linear regression models were applied to explore the relationships among the variables. Results: Among the 50 teachers, 32% demonstrated high adherence to the MD, 60% reported good sleep quality, 62% experienced moderate stress, and 44% engaged in high physical activity. Women were more likely to adhere strongly to the MD (p = 0.012). Higher MD adherence was positively associated with physical activity (ρ = 0.343; p = 0.015). A positive correlation was observed between perceived stress and poorer sleep quality (ρ = 0.346, p = 0.014), and a negative correlation between perceived stress and physical activity levels (ρ = −0.297, p = 0.036). Despite reporting good sleep quality, these participants had higher perceived stress scores (p = 0.015). In adjusted models, sleep quality was the only significant predictor of perceived stress (B = 0.708; p = 0.003), and vice versa (B = 0.267; p = 0.003), suggesting a bidirectional relationship. Conclusions: The findings highlight the interrelation between dietary pattern, sleep stress, and physical activity in a professional group vulnerable to lifestyle-related health challenges. Although the sample size limits generalisability, this study provides preliminary evidence supporting the need for integrated health promotion strategies targeting stress reduction and lifestyle optimisation among educators. Full article
(This article belongs to the Special Issue Diet, Physical Activity and Exercise and Sleep Quality)
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17 pages, 1663 KB  
Article
Role of Mediterranean Diet and Ultra-Processed Foods on Sperm Parameters: Data from a Cross-Sectional Study
by Gabriel Cosmin Petre, Francesco Francini-Pesenti, Luca De Toni, Andrea Di Nisio, Asia Mingardi, Ilaria Cosci, Nicola Passerin, Alberto Ferlin and Andrea Garolla
Nutrients 2025, 17(13), 2066; https://doi.org/10.3390/nu17132066 - 21 Jun 2025
Cited by 2 | Viewed by 8494
Abstract
Background/Objectives: Male infertility is multifactorial, involving genetic, environmental, lifestyle, and medical factors. Recent research has underscored the influence of lifestyle choices, such as dietary habits, smoking, alcohol abuse, and metabolic disturbances, on sperm quality. In this context, nutrition plays a pivotal role: adherence [...] Read more.
Background/Objectives: Male infertility is multifactorial, involving genetic, environmental, lifestyle, and medical factors. Recent research has underscored the influence of lifestyle choices, such as dietary habits, smoking, alcohol abuse, and metabolic disturbances, on sperm quality. In this context, nutrition plays a pivotal role: adherence to a healthy diet like the Mediterranean Diet (MD), which emphasizes seasonal, fresh, and whole foods, has been linked to improved sperm performance. Conversely, a high intake of ultra-processed foods (UPFs), characterized by additives, high levels of sugars, fats, and salt, and a nutrient-poor profile, may impair sperm quality. Methods: Based on data supporting the reproductive health benefits of the MD, this observational cross-sectional study aimed at evaluating the possible relationship between MD adherence, assessed using the 14-point a priori Mediterranean Diet Adherence Screener (MEDAS) and intake of ultra-processed foods (UPFs), based on the NOVA classification, and sperm quality in 358 individuals (mean age 34.6 ± 9.3 years) who spontaneously referred to our center of reproductive medicine. Semen analyses were performed according to the WHO 2021 criteria. Hormonal profiles (FSH, LH, testosterone, SHBG, bioavailable testosterone, and calculated free testosterone) were also determined. Results: MD adherence score was significantly and positively correlated with semen parameters, whilst negatively correlated with FSH and LH levels. In contrast, UPF intake was correlated with poor semen parameters, whilst no association was observed with hormonal levels. Multivariate analyses confirmed these associations and showed the independency from age and BMI. Notably, among men with FSH levels < 8 IU/mL, higher quartiles of UPF intake had lower markers of sperm quality, particularly for viability and typical morphology. Differently, high MD adherence scores were associated with high quality sperm parameters even when FSH levels were >8 IU/mL. Conclusions: This study provides evidence that the adherence to MD, and conversely reduced intake of ultra-processed foods, is associates with a better semen profile. These findings suggest the possible role of dietary interventions as a modifiable factor in the management of male infertility. Full article
(This article belongs to the Section Nutrition and Public Health)
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15 pages, 328 KB  
Article
Prevalence of Metabolic Syndrome Among Students: Associations with Dietary Habits, Physical Activity, and Sociodemographic Factors
by Ema Dejhalla, Tina Zavidić, Branislava Popović and Tatjana Čulina
J. Clin. Med. 2025, 14(13), 4389; https://doi.org/10.3390/jcm14134389 - 20 Jun 2025
Cited by 1 | Viewed by 2397
Abstract
Background/Objectives: The prevalence of metabolic syndrome (MetS) among youth is rising, and the increase is closely linked to unhealthy lifestyle patterns. This study aimed to determine the prevalence of MetS among University of Rijeka students and investigate its associations with dietary habits, [...] Read more.
Background/Objectives: The prevalence of metabolic syndrome (MetS) among youth is rising, and the increase is closely linked to unhealthy lifestyle patterns. This study aimed to determine the prevalence of MetS among University of Rijeka students and investigate its associations with dietary habits, physical activity, gender, and faculty type (health and non-health faculties). Methods: A cross-sectional study conducted from September 2024 to March 2025 involved 217 randomly selected students from 16 faculties. The validated questionnaires Mediterranean Diet Adherence Screener (MEDAS) and International Physical Activity Questionnaire Short Form (IPAQ-SF), as well as a general data questionnaire, were used alongside anthropometric (height, weight, waist circumference) and biochemical measurements (fasting plasma glucose, triglycerides, HDL cholesterol). MetS was diagnosed using a combination of International Diabetes Federation (IDF) criteria and Polish Experts Consensus (2022) criteria. Statistical analyses included descriptive statistics, t-tests, ANOVA, Spearman’s correlation, and multivariate logistic regression. Results: MetS was identified in 5.5% of students. Significant risk factors included obesity (body mass index, BMI, p < 0.05), low physical activity (IPAQ-SF, p < 0.05), elevated blood pressure (p < 0.01), high triglyceride levels (p < 0.05), and increased waist-to-height ratio (WHtR, p < 0.01). Female students reported lower physical activity than males (p < 0.05), while students from non-health faculties had lower adherence to the Mediterranean diet (MEDAS, p < 0.05) and reduced physical activity (p < 0.05). Higher adherence to the Mediterranean diet correlated with lower BMI and triglyceride levels (p < 0.05), whereas lower adherence was associated with reduced physical activity (Spearman’s r = −0.35, p < 0.01). Logistic regression with WHR as the dependent variable showed waist circumference (WC) as the strongest predictor (OR = 45.925, 95% CI: 5.238–402.666, p = 0.001), followed by triglycerides (OR = 3.395, 95% CI: 1.322–8.718, p = 0.011). BMI was inversely associated with WHR (OR = 0.068, 95% CI: 0.006–0.780, p = 0.031). HDL cholesterol, systolic and diastolic blood pressure, and fasting glucose were not significant predictors (p > 0.05), indicating limited predictive power in this model. Conclusions: The 5.5% MetS prevalence underscores the need for targeted interventions promoting Mediterranean diet adherence and physical activity, particularly among non-health faculty students and females. Longitudinal studies are warranted to assess intervention efficacy. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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17 pages, 548 KB  
Article
Mediterranean Diet Patterns Are Positively Associated with Maximal Fat Oxidation and VO2max in Young Adults: The Mediating Role of Leptin
by Pablo Santiago-Arriaza, Juan Corral-Pérez, Daniel Velázquez-Díaz, Alejandro Pérez-Bey, María Rebollo-Ramos, Alberto Marín-Galindo, Adrián Montes-de-Oca-García, Miguel Ángel Rosety-Rodríguez, Cristina Casals and Jesús G. Ponce-González
Nutrients 2025, 17(11), 1901; https://doi.org/10.3390/nu17111901 - 31 May 2025
Viewed by 2251
Abstract
Background: Adherence to the Mediterranean diet (MedDiet) offers multiple metabolic benefits. However, its relationship with maximal fat oxidation (MFO) and cardiorespiratory fitness (VO2max), alongside the potential mediating role of leptin, remains underexplored in young adults. Objective: The objective was to investigate [...] Read more.
Background: Adherence to the Mediterranean diet (MedDiet) offers multiple metabolic benefits. However, its relationship with maximal fat oxidation (MFO) and cardiorespiratory fitness (VO2max), alongside the potential mediating role of leptin, remains underexplored in young adults. Objective: The objective was to investigate the associations between MedDiet adherence and the body mass index (BMI), MFO, and VO2max and to evaluate whether leptin mediates these relationships. Methods: Sixty-five young adults (n = 23 women), aged 18–38, were assessed for body composition, MedDiet adherence (14-Item Mediterranean Diet Adherence Screener), MFO, and VO2max through indirect calorimetry. Plasma leptin concentrations were measured in fasting conditions. Multiple linear regression models were performed, adjusting for sex, age, and both. Mediation analyses were conducted. Results: Higher MedDiet adherence was significantly associated with lower BMI (β = −0.339, p = 0.006) and leptin values (β = 0.284, p = 0.022) and higher absolute MFO (β = 0.338, p = 0.006) and VO2max values (β = 0.462, p < 0.001). These associations remained significant in all models except BMI and leptin when adjusted for sex and sex and age. Leptin was positively associated with the BMI (β = 0.550, p < 0.001) and inversely associated with absolute MFO (β = −0.650, p < 0.001) in all models. There was a trend in the association between leptin and VO2max (β = −0.233, p = 0.061) only in the unadjusted model. Mediation analysis revealed that the leptin levels significantly mediated the associations between MedDiet adherence and BMI (β = −0.358, 95% CI [−0.677, −0.077]) and VO2max (β = 1.043, 95% CI [0.280, 1.833]). Conclusions: MedDiet adherence is associated with a lower BMI and higher MFO and VO2max in young adults. Our findings further suggest that leptin plays a mediating role in how MedDiet adherence influences the BMI and VO2max. Full article
(This article belongs to the Special Issue Exercise and Fat Metabolism)
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17 pages, 484 KB  
Article
Adherence to Mediterranean Diet Among Prediabetic Patients in East Jerusalem
by Aya Zuaiter, Vered Kaufman-Shriqui, Samir Zuaiter, Dima Bitar, Lina Zuaiter, Orly Manor, Ora Paltiel and Amnon Lahad
Nutrients 2025, 17(11), 1777; https://doi.org/10.3390/nu17111777 - 23 May 2025
Viewed by 1390
Abstract
Background: Prediabetes, a precursor state to type 2 diabetes mellitus (T2DM), is characterized by elevated glucose levels that are not yet in the diabetic range. It is often associated with comorbidities such as obesity, hypertension, and dyslipidemia, driven by unhealthy lifestyle factors. This [...] Read more.
Background: Prediabetes, a precursor state to type 2 diabetes mellitus (T2DM), is characterized by elevated glucose levels that are not yet in the diabetic range. It is often associated with comorbidities such as obesity, hypertension, and dyslipidemia, driven by unhealthy lifestyle factors. This study aims to assess the relationship between adherence to the Mediterranean diet and anthropometric measures, such as body mass index and waist circumference, in Arab adults with prediabetes, considering other lifestyle patterns, including smoking, socioeconomic status, and physical activity. Methods: We performed baseline data analysis among a sample of prediabetic participants of a clinical trial aimed at improving physical activity and healthy lifestyle behaviors. Patients were recruited from the Sheikh Jarrah Clalit Health Services clinic in East Jerusalem. Eligible participants were identified via medical record review and invited by their primary physician. After providing informed consent, participants completed interviewer-administered questionnaires covering sociodemographic data, physical activity, and dietary habits. Physical measurements, including height, weight, and waist circumference, were taken using standardized protocols. Adherence to the Mediterranean diet was assessed using the locally adapted Israeli Mediterranean Diet Adherence Screener (I-MEDAS). Results: A total of 172 prediabetic adults aged 40–69.9 years were recruited. The majority of participants exhibited high adherence to the Mediterranean diet, with 80.2% achieving a high adherence score. However, no significant associations were found between Mediterranean diet adherence and BMI or waist circumference. Active smokers were 70.6% less likely to adhere to the Mediterranean diet compared to nonsmokers, and participants with equal-to-average income had lower odds of adhering to the diet compared to those with below-average income. Conclusions: These findings underscore the need for tailored public health strategies that address local cultural, economic, and environmental factors influencing dietary habits. Improving adherence to the Mediterranean diet in this population will require a multifaceted approach, with further research needed to understand the complex relationship between diet, lifestyle, and chronic disease prevention. Full article
(This article belongs to the Section Nutrition and Diabetes)
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12 pages, 638 KB  
Article
Adherence to Mediterranean Diet and Ocular Dryness Severity in Sjögren’s Syndrome: A Cross-Sectional Study
by Celine Chaaya, Elie Raad, Francesca Kahale, Elias Chelala, Nelly Ziade and Georges Maalouly
Med. Sci. 2025, 13(2), 64; https://doi.org/10.3390/medsci13020064 - 23 May 2025
Cited by 4 | Viewed by 1578
Abstract
Background: Sjögren’s syndrome (SS) is a multifaceted clinical condition characterized by various features, including ocular dryness (OD), which plays a substantial role in shaping the clinical presentation of the disease and has detrimental effects on quality of life. Recent research has acknowledged [...] Read more.
Background: Sjögren’s syndrome (SS) is a multifaceted clinical condition characterized by various features, including ocular dryness (OD), which plays a substantial role in shaping the clinical presentation of the disease and has detrimental effects on quality of life. Recent research has acknowledged the advantages of the Mediterranean diet (MD) for its positive impact on various autoimmune diseases. This study aims to investigate the correlation between the severity of ocular symptoms in individuals with SS and adherence to the MD. Methods: This was a cross-sectional observational study of previously diagnosed SS patients recruited from the histopathological and immunological archives of a university hospital. The data were collected through a telephone questionnaire, including demographic and disease data, the Ocular Surface Disease Index (OSDI) score to evaluate the OD severity, and the Mediterranean Diet Adherence Screener (MEDAS) score to determine adherence to the MD. The primary outcome of the study, the correlation between OSDI and MEDAS scores, was evaluated using Spearman’s correlation coefficient. Results: The study included 114 patients, with a mean age of 51 (±13.4) years and a female proportion of 86%. OD was documented in 80.7% of the patients. The median OSDI and MEDAS scores were 23 (IQR 10–40) and 8 (IQR 5–11), respectively. A strong negative correlation was observed between the MEDAS and the OSDI scores (ρ = −0.73, p < 0.01). Additionally, there was a significant negative relationship between the richness of diet in fatty acids and the OSDI score (ρ = −0.67, p < 0.01). Conclusions: The study results suggest an association between lower OD severity in patients with SS and adherence to the MD, particularly the components related to polyunsaturated fatty acids consumption. This approach may serve as a complementary strategy with multiple health benefits, alongside conventional treatment options. Full article
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15 pages, 991 KB  
Article
A Greater Adherence to the Mediterranean Diet Supplemented with Extra Virgin Olive Oil and Nuts During Pregnancy Is Associated with Improved Offspring Health at Six Years of Age
by Laura del Valle, Verónica Melero, Andrés Bodas, Rocío Martín O’Connor, Ana Ramos-Levi, Ana Barabash, Johanna Valerio, Paz de Miguel, José Ángel Díaz Pérez, Cristina Familiar Casado, Inmaculada Moraga Guerrero, Inés Jiménez-Varas, Clara Marcuello Foncillas, Mario Pazos, Miguel A. Rubio-Herrera, Bricia López-Plaza, Isabelle Runkle, Pilar Matía-Martín and Alfonso L. Calle-Pascual
Nutrients 2025, 17(10), 1719; https://doi.org/10.3390/nu17101719 - 19 May 2025
Cited by 1 | Viewed by 2259
Abstract
Background/Objectives: Children’s health may be influenced by maternal eating habits during pregnancy. A Mediterranean diet (MedDiet)-based pattern has been associated with benefits in infectious disease and allergies in children. Methods: From a total 2228 pregnant women evaluated between 2015 and 2017 in the [...] Read more.
Background/Objectives: Children’s health may be influenced by maternal eating habits during pregnancy. A Mediterranean diet (MedDiet)-based pattern has been associated with benefits in infectious disease and allergies in children. Methods: From a total 2228 pregnant women evaluated between 2015 and 2017 in the St. Carlos cohort, 1292 women belonging to the intervention group (IG) undertook a MedDiet supplemented with extra virgin olive oil (EVOO) and nuts from early on in pregnancy. The control group (CG) consisted of 516 pregnant women who were advised to follow a fat-restricted MedDiet. The modified 12-point Mediterranean diet adherence screener (MEDAS) was applied. A total of 1808 (81.2%) children were analyzed at 6 years postpartum. All women from both groups received the same postpartum nutritional recommendations as the IG had during pregnancy. Results: Children from the IG showed lower rates of bronchiolitis and atopic eczema compared to the CG. Children whose mother’s MEDAS score was ≥6 at 24–28 GW vs. MEDAS scores < 6 presented lower rates of bronchiolitis [222/695 (28.8%) vs. 441/1113 (39.6%); p = 0.022] and atopic eczema [311/695 (39.0%) vs. 564/1113 (50.7%); p = 0.039]. The offspring of mothers with MEDAS scores ≥ 8 (n = 176) vs. MEDAS scores ≤ 3 (n = 564) showed a lower relative risk (RR) (95% CI) for developing bronchiolitis [0.75 (0.58–0.97)] and atopic eczema [0.82 (0.69–0.98)], with both having a p < 0.001 trend. Conclusions: A higher adherence to a MedDiet supplemented with EVOO and nuts during pregnancy is associated with health benefits in offspring at 6 years of age. Full article
(This article belongs to the Section Nutrition in Women)
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