Does adherence to a Mediterranean diet affect health-related quality of life during the coronavirus disease 2019 pandemic?

Abstract

Objectives

This study aimed to determine the effects of the coronavirus disease 2019 (COVID-19) pandemic on dietary patterns, adherence to the Mediterranean diet (MedDiet), and health-related quality of life (HRQoL), as well as establish the factors affecting adherence to the MedDiet and the relationship between MedDiet compliance and HRQoL during the pandemic period.

Methods

We conducted this cross-sectional study (n = 1689) using a self-administered online questionnaire featuring anthropometric measurements, sociodemographic characteristics, nutritional habits, dietary supplement usage, and three scales. We applied the Beck Depression Inventory, Short-Form 12-item Questionnaire, and MedDiet Adherence Screener to evaluate participants' mental health, HRQoL, and diet quality, respectively.

Results

During the COVID-19 pandemic, adherence to the MedDiet increased significantly (6.1±2.2 vs. 6.3±2.4; p < 0.001). However, mental health scores declined significantly (46.1±7.3 vs. 40.6±6.8; p < 0.001). Females (p = 0.020), those with high education levels (p < 0.05), and those with chronic diseases (p = 0.022) had a lower risk of poor adherence to MedDiet, whereas those with a higher body mass index (BMI) had a higher risk (p = 0.023). Greater adherence to the MedDiet was associated with an increased mental health score (β = 0.220, 95 % CI: 0.088, 0.352, p = 0.001). This positive association was observed (p < 0.05) among both genders (male: β = 0.263, 95 % CI: 0.023, 0.503 and female: β = 0.198, 95 % CI: 0.040, 0.356), individuals without chronic diseases (β = 0.226, 95 % CI: 0.080, 0.372), those aged ≥40 years (β = 0.430, 95 % CI: 0.119, 0.741), and those whose income was less than (β = 0.342, 95 % CI: 0.082, 0.602) or equal to their expenses (β = 0.222, 95 % CI: 0.046, 0.399).

Conclusions

Given the strong impact of the COVID-19 pandemic on people's HRQoL and evidence for an improvement in HRQoL through healthy eating, these findings shed light on the relevance of developing strategies to promote MedDiet compliance in this population.