Mediterranean Diet adherence among medical students in southern Italy

Background: The Mediterranean Diet (MD) is characterized by high consumption of plant-based foods, extra virgin olive oil as the main fat source, regular fish intake, limited red meat intake, and moderate wine intake with meals. Despite it being recognized worldwide for its health benefits and it having an intrinsic cultural role in Italy, recent lifestyle changes have led to more Westernized diets. This study aimed to assess MD adherence among medical students, a group presumed to be health-conscious due to their education.

Methods: We evaluated MD adherence using the 14-item PREDIMED questionnaire in 300 medical students from the University of Bari “Aldo Moro”, equally distributed across six academic years. Anthropometric data (BMI for all; waist circumference for a subset) were collected.

Results: Their adherence was generally moderate, aligning with the national averages. No significant differences emerged between academic years, though the highest adherence was seen in sixth-year students (14%) and the lowest was seen in first-years (2%). Third-year students had the lowest adherence rate (28%). While adherence was not significantly linked to BMI or waist-to-height ratio, no obese students belonged to the high-adherence group, and only six were overweight. Females showed higher adherence and a lower prevalence of overweight (18% vs. 34%) compared to these values in males. Local and non-local students showed no differences. The weakest points were low fruit and vegetable intakes, while over half consumed processed foods regularly.

Conclusions: Adherence varied by sex and year, with better adherence in the final-year students, possibly due to their cumulative nutritional knowledge. Introducing nutrition education earlier may foster healthier habits. Improving campus access to fruits and vegetables while reducing processed foods could support MD adherence further. As future physicians, medical students must both practice and promote healthy lifestyles, highlighting the need for stronger nutritional training and supportive food environments.