The Mediating and Moderating Effects of Physical Fitness of the Relationship between Adherence to the Mediterranean Diet and Health-Related Quality of Life in University Students

Abstract

The aim of this study was to estimate the relationship between the adherence to the Mediterranean diet (MD) and health-related quality of life (HRQoL) in university students and to assess whether this relationship is mediated or moderated by cardiorespiratory fitness (CRF) and handgrip strength. A cross-sectional study was performed involving 310 first-year Spanish university students. Adherence to the MD was evaluated with the 14-item Mediterranean Diet Adherence Screener (MEDAS), and the HRQoL was evaluated with the Short Form-12 (SF-12) questionnaire. CRF was assessed by the 20 m shuttle run test, and the handgrip strength was determined by dynamometry. ANCOVA models showed that participants with higher CRF and handgrip strength levels had significantly higher scores in the physical component summary (PCS) and mental component summary (MCS) of the SF-12 and in the MEDAS questionnaire than those with medium and low scores (p < 0.050). Additionally, the ANCOVA models showed that students with good adherence to the MD showed higher scores in the MCS of HRQoL than those with low adherence (p = 0.044, ES = 0.013), but these results did not appear for the PCS of HRQoL (p = 0.728, ES = 0.001). In the mediation analysis, it was found that CRF and handgrip strength acted as full mediators of the relationship between adherence to the MD and the MCS of HRQoL. In the moderation analysis, it was evidenced that CRF and handgrip strength did not act as moderators in the relationship between adherence to the MD and the MCS of HRQoL. In conclusion, adherence to the MD does not seem to have a direct effect on the MCS of HRQoL because this association seems to be fully mediated by CRF and handgrip strength.

Adherence to Mediterranean Diet among Lebanese University Students

“…This should alert in applying strategies at both individual and community level to promote healthy dietary and lifestyle habits. Accordingly, the high consumption of the Mediterranean diet, which has been shown to protect from cardiovascular diseases (CVD) prognosis, diabetes, mortality, cancer, obesity, grant favorable health status, better biochemical profile, influence positively the quality of life the academic performance, the muscular fitness and mental health [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], may be a good way to implement healthy dietary habits, which would be easier to implement if they are joined to good sensory characteristics [ 42 ] and within the context of a healthy MedDiet.…”

Risky Behaviours of Spanish University Students: Association with Mediterranean Diet, Sexual Attitude and Chronotype

“…In Spain, the majority of people follow a Mediterranean diet, which is a healthy diet [7]. Previous research has revealed that the low adherence of Spanish university students to a Mediterranean diet is related to high alcohol consumption [5,8], smoking, low levels of physical activity (PA), living alone, and leading a sedentary lifestyle [5], and good adherence to the Mediterranean diet is associated with an improved quality of life related to perceived health [9] and low body weight [5].…”

Mediterranean Diet, Psychological Adjustment and Health Perception in University Students: The Mediating Effect of Healthy and Unhealthy Food Groups

“…Two instruments were used to assess dietary habits: (i) The Mediterranean Diet Adherence Screener (MEDAS) [56] to assess adherence to the MedDiet. This questionnaire has been adapted in different countries showing reasonable construct validity [57][58][59][60] and employed in the Spanish university population for the study of habits related to both physical and mental health [61][62][63]. The questionnaire is composed of 14 items that can score 0 (Does not meet criteria) or 1 (Meets criteria); 12 of the items refer to the frequency of consumption of certain foods (fruits, vegetables, olive oil, animal fats, red meat, nuts, industrial confectionery, fizzy drinks, wine, fish and seafood, and soft drinks) while two focus on dietary habits/characteristics consistent with a traditional MedDiet, such as preferential consumption of white over red meat and frequency of consumption related to pasta/rice/vegetables cooked with a sauce of tomato, onion, garlic, leeks sauteed in olive oil (Sofrito).…”