Frontiers in Nutrition (Jul 2025)
Gender-specific insights into adherence to Mediterranean diet and lifestyle: analysis of 4,000 responses from the MEDIET4ALL project
- Mohamed Ali Boujelbane,
- Mohamed Ali Boujelbane,
- Achraf Ammar,
- Achraf Ammar,
- Achraf Ammar,
- Achraf Ammar,
- Atef Salem,
- Atef Salem,
- Mohamed Kerkeni,
- Mohamed Kerkeni,
- Khaled Trabelsi,
- Khaled Trabelsi,
- Bassem Bouaziz,
- Bassem Bouaziz,
- Liwa Masmoudi,
- Juliane Heydenreich,
- Christiana Schallhorn,
- Gabriel Müller,
- Ayse Merve Uyar,
- Hadeel Ali Ghazzawi,
- Adam Tawfiq Amawi,
- Bekir Erhan Orhan,
- Giuseppe Grosso,
- Osama Abdelkarim,
- Osama Abdelkarim,
- Tarak Driss,
- Kais El Abed,
- Kais El Abed,
- Piotr Zmijewski,
- Nasreddine Benbettaieb,
- Nasreddine Benbettaieb,
- Clément Poulain,
- Laura Reyes,
- Amparo Gamero,
- Marta Cuenca-Ortolá,
- Nicola Francesca,
- Concetta Maria Messina,
- Björn Lorenzen,
- Stefania Filice,
- Aadil Bajoub,
- El-Mehdi Ajal,
- El-Mehdi Ajal,
- El Amine Ajal,
- Majdouline Obtel,
- Sadjia Lahiani,
- Taha Khaldi,
- Nafaa Souissi,
- Omar Boukhris,
- Omar Boukhris,
- Haitham Jahrami,
- Haitham Jahrami,
- Waqar Husain,
- Walid Mahdi,
- Walid Mahdi,
- Hamdi Chtourou,
- Wolfgang I. Schöllhorn
Affiliations
- Mohamed Ali Boujelbane
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Mohamed Ali Boujelbane
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Achraf Ammar
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Achraf Ammar
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Achraf Ammar
- Department of Movement Sciences and Sports Training, School of Sport Science, The University of Jordan, Amman, Jordan
- Atef Salem
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Atef Salem
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Mohamed Kerkeni
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Mohamed Kerkeni
- Research Laboratory Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Khaled Trabelsi
- Department of Movement Sciences and Sports Training, School of Sport Science, The University of Jordan, Amman, Jordan
- Khaled Trabelsi
- Research Laboratory Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Bassem Bouaziz
- Multimedia InfoRmation systems and Advanced Computing Laboratory (MIRACL), University of Sfax, Sfax, Tunisia
- Bassem Bouaziz
- Higher Institute of Computer Science and Multimedia of Sfax (ISIMS), University of Sfax, Sfax, Tunisia
- Liwa Masmoudi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Juliane Heydenreich
- Faculty of Sports Sciences, Department of Experimental Sports Nutrition, Leipzig University, Leipzig, Germany
- Christiana Schallhorn
- Department of Sports Economics, Sociology and History, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Gabriel Müller
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Ayse Merve Uyar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Hadeel Ali Ghazzawi
- 0Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
- Adam Tawfiq Amawi
- Department of Movement Sciences and Sports Training, School of Sport Science, The University of Jordan, Amman, Jordan
- Bekir Erhan Orhan
- 1Faculty of Sports Sciences, Istanbul Aydın University, Istanbul, Türkiye
- Giuseppe Grosso
- 2Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
- Osama Abdelkarim
- 3Faculty of Sport Sciences, Assiut University, Assiut, Egypt
- Osama Abdelkarim
- 4ESLSCA University Egypt, Giza, Egypt
- Tarak Driss
- 5Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology Physical Activity, Health and Learning (LINP2), UFR STAPS, Paris Nanterre University, Nanterre, France
- Kais El Abed
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Kais El Abed
- Research Laboratory Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Piotr Zmijewski
- 6Department of Biomedical Sciences, Jozef Pilsudski University of Physical Education in Warsaw, Warsaw, Poland
- Nasreddine Benbettaieb
- 7Department BioEngineering, Institut Universitaire de Technologie IUT-Dijon-Auexrre-Nevers, University Burgundy Europe, Dijon, France
- Nasreddine Benbettaieb
- 8Joint Research Unit UMR PAM-PCAV (Physical-Chemistry of Food and Wine Laboratory), Université Bourgogne Europe/Institut AgroDijon/INRAE, Dijon, France
- Clément Poulain
- 8Joint Research Unit UMR PAM-PCAV (Physical-Chemistry of Food and Wine Laboratory), Université Bourgogne Europe/Institut AgroDijon/INRAE, Dijon, France
- Laura Reyes
- 9Vitagora Innovation Cluster, Dijon, France
- Amparo Gamero
- 0Department of Preventive Medicine and Public Health, Food Science, Toxicology and Forensic Medicine, Faculty of Pharmacy & Food Sciences, University of Valencia, Valencia, Spain
- Marta Cuenca-Ortolá
- 0Department of Preventive Medicine and Public Health, Food Science, Toxicology and Forensic Medicine, Faculty of Pharmacy & Food Sciences, University of Valencia, Valencia, Spain
- Nicola Francesca
- 1Department of Agricultural Food and Forest Sciences, University of Palermo, Palermo, Italy
- Concetta Maria Messina
- 2Laboratory of Marine Biochemistry and Ecotoxicology, Department of Earth and Marine Sciences DiSTeM, University of Palermo, Trapani, Italy
- Björn Lorenzen
- 3Microtarians Academy, Luxembourg, Luxembourg
- Stefania Filice
- 3Microtarians Academy, Luxembourg, Luxembourg
- Aadil Bajoub
- 4Laboratory of Food and Food By-Products Chemistry and Processing Technology, National School of Agriculture in Meknès, Meknès, Morocco
- El-Mehdi Ajal
- 4Laboratory of Food and Food By-Products Chemistry and Processing Technology, National School of Agriculture in Meknès, Meknès, Morocco
- El-Mehdi Ajal
- 5Laboratory of Social Medicine, Faculty of Medicine and Pharmacy of Rabat, Department of Epidemiology and Public Health, Mohammed V University, Rabat, Morocco
- El Amine Ajal
- 6UPR of Pharmacognosy, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
- Majdouline Obtel
- 5Laboratory of Social Medicine, Faculty of Medicine and Pharmacy of Rabat, Department of Epidemiology and Public Health, Mohammed V University, Rabat, Morocco
- Sadjia Lahiani
- 7VALCORE Laboratory, Faculty of Science, Department of Biology, University of M’hamed Bougara Boumerdes, Boumerdes, Algeria
- Taha Khaldi
- 8Biotechnology Research Center (C.R.Bt), Constantine, Algeria
- Nafaa Souissi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Omar Boukhris
- 9SIESTA Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Omar Boukhris
- 0Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Haitham Jahrami
- 1Government Hospitals, Manama, Bahrain
- Haitham Jahrami
- 2Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Waqar Husain
- 3Department of Humanities, COMSATS University Islamabad, Islamabad, Pakistan
- Walid Mahdi
- Multimedia InfoRmation systems and Advanced Computing Laboratory (MIRACL), University of Sfax, Sfax, Tunisia
- Walid Mahdi
- Higher Institute of Computer Science and Multimedia of Sfax (ISIMS), University of Sfax, Sfax, Tunisia
- Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Wolfgang I. Schöllhorn
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- DOI
- https://doi.org/10.3389/fnut.2025.1570904
- Journal volume & issue
-
Vol. 12
Abstract
BackgroundThe Mediterranean Diet (MedDiet) is widely recognized for its health benefits, though adherence varies across populations and is influenced by multiple lifestyle and demographic factors. This study examined MedDiet adherence patterns and their associations with lifestyle behaviors, with particular attention to gender differences in a large, multinational cohort.MethodsData were obtained via the MEDIET4ALL survey, an international cross-sectional study that included 4,010 participants (mean age: 36.04 ± 15.06 years; 59.5% female) across 10 countries. The evaluation of adherence to the MedDiet was conducted using the MedLife Index, a validated tool that assesses adherence to MedDiet patterns and lifestyle behaviors through three blocks: Mediterranean food consumption, MedDiet habits, and lifestyle behaviors. Additionally, validated instruments were used to measure associated factors, including perceived barriers to adherence, physical activity, sleep quality and disturbances, mental health, life satisfaction, social participation, and technology use behaviors.ResultsWhile total Mediterranean lifestyle (MedLife) scores showed no significant gender differences, women demonstrated better adherence to food consumption components (p < 0.001), while men showed greater physical activity and social participation. Women reported poorer sleep metrics (efficiency, latency, duration) and higher insomnia severity (all p < 0.05). Psychological distress was more prevalent among women, who also expressed greater needs for psychosocial and nutritional support (p < 0.001). The MedLifeMEDLIFE Index showed significant positive correlations with physical activity (r = 0.298), social participation (r = 0.227), and sleep satisfaction (r = 0.181), and negative correlations with mental health measures (insomnia: r = –0.137; depression: r = –0.115; stress: r = –0.089; anxiety: r = –0.076; all p < 0.001).ConclusionOur findings reveal distinct gender-specific patterns in MedDiet adherence and associated lifestyle factors. These results underscore the need for differentiated public health approaches that address the unique behavioral and psychosocial needs of men and women to promote MedLife adoption.
Keywords
