The Mediterranean diet in a university student population: a cross-sectional study on adherence and perceived knowledge, barriers, and benefits

Abstract

The Dietary Guidelines for Americans recommend incorporating the Mediterranean diet (MD) into one's eating habits. Nevertheless, it is uncertain if university students have increased their adoption of this diet from 2018 to 2023. A survey was conducted among students to investigate adherence to the MD, and perceived benefits and barriers to its consumption. The survey received 761 responses from university students in three different years: 2018 (n = 254), 2020 (n = 216), and 2022 (n = 291). For the data analysis, linear and multivariable linear regression analysis were utilized. The unadjusted model showed that the Mediterranean Diet Adherence Screener (MEDAS) scores were lower for the 2022 group (p = 0.004), but not for the 2020 group, when compared to the 2018 group. In the adjusted model, a significant group effect (p = 0.021) was observed. In the adjusted and unadjusted models, the 2020 and 2022 groups perceived fewer MD knowledge barriers (p<0.001; p<0.001, respectively), and the 2022 group perceived fewer MD health barriers in the adjusted model (p<0.001), maintaining in the unadjusted model for 2020 (p=0.037) and 2022 (p<0.001). The 2020 group perceived greater MD health benefits (p=0.005), weight loss (p=0.036), ethical concerns (p=0.015), natural content (p=0.006), and sensory appeal (p=0.002), while the 2022 group perceived less of these benefits (all p<0.001). MEDAS score was higher in females (p<0.001), participants aged 25-34 (p=0.016) and aged 35-44 (p<0.001), and respondents with health-related qualifications (p<0.001). Our findings highlight key barriers and benefits of the MD in university students, which could inform targeted interventions.