Journals / Journal of Medicine and Palliative Care / 2026 / Volume: 7 Issue: 5

Associations of nutrition literacy and Mediterranean diet adherence with healthy nutrition attitudes among young adults: a cross-sectional study

Gizem Özata Uyar(Kırıkkale Üniversitesi)0000-0002-9022-6956
Serkan Aslan(ERZURUM TECHNICAL UNIVERSITY)0000-0002-5834-5074
Burcu Deniz Güneş(AYDIN ADNAN MENDERES UNIVERSITY)0000-0002-8421-4334
Pages
—
Publication Date
2026-10-25
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Nutrition literacy and physical activity were independently associated with healthier nutrition attitudes among young adults, highlighting their relevance in the context of nutrition-related health promotion.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: Nutrition literacy and attitudes toward healthy nutrition are increasingly recognized as factors associated with dietary behavior, including adherence to the Mediterranean diet (MD).
📊
Key Findings & Data:Methods: A total of 296 young adults (aged 18-30 years) participated in this cross-sectional study and were recruited through convenience sampling from Erzurum and Kırıkkale, two provinces in Turkiye.
💡
Conclusion & Impact:Conclusion: Nutrition literacy and physical activity were independently associated with healthier nutrition attitudes among young adults, highlighting their relevance in the context of nutrition-related health promotion.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Mediterranean diet · health literacy · attitude to health

Abstract

Aims: Nutrition literacy and attitudes toward healthy nutrition are increasingly recognized as factors associated with dietary behavior, including adherence to the Mediterranean diet (MD). However, studies examining these three constructs together, particularly among young adults, remain limited. The purpose of this study was to investigate the relationships between adherence to the MD, nutrition literacy, and healthy nutrition attitudes, and to identify the factors independently associated with healthy nutrition attitudes. Methods: A total of 296 young adults (aged 18-30 years) participated in this cross-sectional study and were recruited through convenience sampling from Erzurum and Kırıkkale, two provinces in Turkiye. Data were collected using face-to-face questionnaires, including the Mediterranean Diet Adherence Screener (MEDAS), The Short Form of the Nutrition Literacy Scale for Young Adults (S-NutLit), and the Attitude Scale for Healthy Nutrition (ASHN). The statistical evaluation of the data was carried out using parametric and nonparametric tests, Chi-square tests, Pearson correlation analysis, and multiple linear regression analysis. Results: Of the participants, 62.8% had acceptable adherence to the MD, and 63.5% self-reported ≥150 minutes of physical activity per week. Male participants had significantly higher total ASHN and positive nutrition (PN) subscale scores than females (p=0.014 and p=0.004, respectively). The S-NutLit score correlated positively with both MEDAS (p<0.01) and ASHN (p<0.001) scores. In multiple linear regression analysis, S-NutLit showed the strongest independent association with ASHN scores (β=0.384, p<0.001), followed by physical activity (β=0.129, p=0.020), whereas age, gender, BMI, and MEDAS scores were not significantly associated with ASHN scores. Conclusion: Nutrition literacy and physical activity were independently associated with healthier nutrition attitudes among young adults, highlighting their relevance in the context of nutrition-related health promotion.

🔖

Cite This Article

Uyar, G. Ö., Aslan, S., Şimşek, G. N., Güneş, B. D. (2026). Associations of nutrition literacy and Mediterranean diet adherence with healthy nutrition attitudes among young adults: a cross-sectional study. Journal of Medicine and Palliative Care, Volume: 7 Issue: 5. https://ajindex.com/articles/1668093

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (42)

  1. Menotti A, Puddu PE. Ancel Keys, the Mediterranean diet, and the seven countries study: a review. J Cardiovasc Dev Dis. 2025;12(4):141. doi:10.3390/jcdd12040141
  2. Godos J, Guglielmetti M, Ferraris C, et al. Mediterranean diet and quality of life in adults: a systematic review. Nutrients. 2025;17(3):577. doi:10.3390/nu17030577
  3. Hareer LW, Lau YY, Mole F, et al. The effectiveness of the Mediterranean diet for primary and secondary prevention of cardiovascular disease: an umbrella review. Nutr Diet. 2025;82(1):8-41. doi:10.1111/1747-0080.12891
  4. Obeid CA, Gubbels JS, Jaalouk D, Kremers SP, Oenema A. Adherence to the Mediterranean diet among adults in Mediterranean countries: a systematic literature review. Eur J Nutr. 2022;61(7):3327-3344. doi:10.1007/s00394-022-02885-0
  5. Tsofliou F, Vlachos D, Appleton K. Barriers and facilitators to adoption of and adherence to a Mediterranean style diet in adults: a systematic review of observational and qualitative studies. Nutrients. 2022;14(20): 4314. doi:10.3390/nu14204314
  6. Tao Y, Wall M, Larson N, Neumark-Sztainer D, Winpenny EM. Changes in diet quality across life transitions from adolescence to early adulthood: a latent growth analysis. Am J Clin Nutr. 2024;120(5):1215-1224. doi:10.1016/j.ajcnut.2024.08.017
  7. Pendergast FJ, Livingstone KM, Worsley A, McNaughton SA. Correlates of meal skipping in young adults: a systematic review. Int J Behav Nutr Phys Act. 2016;13(1):125. doi:10.1186/s12966-016-0451-1
  8. İbiş R, Öztürk A. Üniversite öğrencilerinde beslenme okuryazarlığı durumu ve obezite ile ilişkisi: Yozgat örneği. Gümüşhane Üniv Sağlık Bil Derg. 2023;12(2):700-712. doi:10.37989/gumussagbil.1097718
  9. Groufh-Jacobsen S, Medin AC. Food literacy competencies in youth–a mini-review. Front Public Health. 2023;11:1185410. doi:10.3389/fpubh.2023.1185410
  10. Helvacı G, Tayhan F, Özbey Yücel Ü. Gender and healthy eating attitude strongly predict sustainable food literacy among Turkish young adults, while Mediterranean diet adherence shows only weak correlation. Front Public Health. 2025;13:1606495. doi:10.3389/fpubh.2025.1606495
  11. Aydilek OH, Arslantaş D, Ünsal A, Kavlu E, Yücel E. Bir üniversite hastanesine başvuranlarda sağlıklı beslenmeye ilişkin tutum ve algılanan gıda okuryazarlığının değerlendirilmesi (ESOGÜ SUAH örneği). Osmangazi Tıp Derg. 2025;47(4):582-592. doi:10.20515/otd.1639257
  12. Iskender H, Yildiz N, Dokumacioglu E. Investigation of the healthy nutrition attitude and nutritional literacy level of university students receiving health education. Mediterranean J Nutr Metab. 2024;17(1):35-42. doi:10.3233/MNM-230050
  13. Lorini C, Buresta D, Marini C, et al. Nutrition literacy and adherence to the Mediterranean diet in women aged 45–70 years: a cross-sectional analysis from the Ophelia Study in Florence. Nutrients. 2026;18(8):1238. doi:10.3390/nu18081238
  14. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:1-253.
  15. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-1462. doi:10.1136/bjsports-2020-102955
  16. Tcymbal A, Messing S, Mait R, et al. Validity, reliability, and readability of single-item and short physical activity questionnaires for use in surveillance: a systematic review. PLoS One. 2024;19(3):e0300003. doi:10.1371/journal.pone.0300003
  17. Vrinten J, Van Royen K, Pabian S, De Backer C, Matthys C. Development and validation of a short nutrition literacy scale for young adults. Front Nutr. 2023;10:1008971. doi:10.3389/fnut.2023.1008971
  18. Koc MC, Yildirim E, Isik O, Aksen P, Talaghir L-G, Zanfir C. Turkish version of a short nutrition literacy scale for young adults: cultural adaptation and validation. Front Nutr. 2024;11:1422738. doi:10.3389/fnut.2024.1422738
  19. Demir GT, Cicioğlu Hİ. Sağlıklı beslenmeye ilişkin tutum ölçeği (SBİTÖ): geçerlik ve güvenirlik çalışması. Gaziantep Üniv Spor Bil Derg. 2019;4(2):256-274. doi:10.31680/gaunjss.559462
  20. Schröder H, Fitó M, Estruch R, et al. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J Nutr. 2011;141(6):1140-1145. doi:10.3945/jn.110.135566
  21. Özkan Pehlivanoğlu EF, Balcıoğlu H, Ünlüoğlu İ. Akdeniz Diyeti Bağlılık Ölçeği’nin Türkçe’ye uyarlanması geçerlilik ve güvenilirliği. Osmangazi Tıp Derg. 2020;42(2):160-164.
  22. Yılmaz G, Şengür E, Turasan İ. Spor bilimleri fakültesinde okuyan öğrencilerin sağlıklı beslenme tutum puanlarının incelenmesi. Türk Spor Bil Derg. 2022;5(2):64-70. doi:10.46385/tsbd.1111714
  23. Mengi Çelik Ö, Ekici EM, Yılmaz S, Metin ZE. Evaluation of the relationship between nutrition literacy, Mediterranean diet compliance, ecological footprint and sustainable environmental attitudes in adolescents. BMC Public Health. 2025;25(1):130. doi:10.1186/s12889-024-20910-1
  24. Falakacılar ÇP, Terzi M, Kütük MÖ. Adherence to the Mediterranean diet and sustainable nutrition: the role of nutrition literacy across generations. Sustainability. 2025;18(1):61. doi:10.3390/su18010061
  25. Uzdil Z, Macit Çelebi MS, Ertaş Öztürk Y, Kaya PS. Effect of food literacy on adherence to Mediterranean diet and anthropometric measurements in adults. Revista de Nutrição. 2024;37:e230034. doi:10.1590/1678-9865202437e230034
  26. Abreu F, Hernando A, Goulão LF, et al. Mediterranean diet adherence and nutritional literacy: an observational cross-sectional study of the reality of university students in a COVID-19 pandemic context. BMJ Nutr Prev Health. 2023;6(2):221. doi:10.1136/bmjnph-2023-000659
  27. Eroğlu FE, Açıkalın Göktürk B, Kalyoncu Atasoy ZB, Mengi Çelik Ö. The relationship between sustainable dietary behaviors, sustainable food literacy, healthy life awareness, and social media addiction in adults: a cross-sectional study in Türkiye. J Health Popul Nutr. 2025;45(1):27. doi:10.1186/s41043-025-01190-w
  28. Xu B, Hwang J-Y. How food literacy levels shape healthy eating intentions: a cross-sectional study of adults in Shandong Province, China, using the theory of planned behavior. Nutr Res Pract. 2025;19(4):566-576. doi:10.4162/nrp.2025.19.4.566
  29. Lai I-J, Chang L-C, Lee C-K, Liao L-L. Nutrition literacy mediates the relationships between multi-level factors and college students’ healthy eating behavior: evidence from a cross-sectional study. Nutrients. 2021; 13(10):3451. doi:10.3390/nu13103451
  30. Effert A, Eichin KN, Sproesser G. Gendered eating: can gender role orientations explain gender differences in healthy eating? J Health Psychol. 2026;31(7):2905-2927. doi:10.1177/13591053251388269
  31. Feraco A, Armani A, Amoah I, et al. Assessing gender differences in food preferences and physical activity: a population-based survey. Front Nutr. 2024;11:1348456. doi:10.3389/fnut.2024.1348456
  32. Fernandes V, Rodrigues F, Jacinto M, et al. How does the level of physical activity influence eating behavior? A self-determination theory approach. Life. 2023;13(2):298. doi:10.3390/life13020298
  33. Orhan BE, Alkasasbeh WJ, Karaçam A, Canlı U, Adıgüzel NS, Amawi AT. Nutrition knowledge and healthy-eating attitudes: the role of physical activity and lifestyle factors in adults. Front Nutr. 2026;13: 1754963. doi:10.3389/fnut.2026.1754963
  34. Biggi C, Biasini B, Ogrinc N, et al. Drivers and barriers influencing adherence to the Mediterranean diet: a comparative study across five countries. Nutrients. 2024;16(15):2405. doi:10.3390/nu16152405
  35. Costa-Camilo E, Cardoso F, Duarte I, et al. Mediterranean diet as a nutraceutical and sustainable model for health and environmental wellbeing. Gastronomy. 2025;3(4):17. doi:10.3390/gastronomy3040017
  36. Demirbaş-Bilen AB, Metin EH, Alınlı Fİ, et al. Obesity and hedonic hunger: associations with healthy eating attitudes and nutrition knowledge. İstanbul Gelişim Üniv Sağlık Bil Derg. 2026;28:330-344. doi:10.38079/igusabder.1647891
  37. Ljubičić M, Sorić T, Gusar I, et al. Association between attitude toward a healthy lifestyle, lifestyle behaviors, sociodemographic characteristics, and body-mass index: a cross-sectional study. Nutrients. 2026;18(3):500. doi:10.3390/nu18030500
  38. Yusni A, Vanoh D, Salleh NSAM. The relationship between nutrition knowledge, attitude and practice (NKAP), self-efficacy of healthy eating with body mass index (BMI) status among undergraduate students in USM Kubang Kerian, Kelantan: a cross-sectional study. Asian J Med Biomed. 2023;7(2):121-130. doi:10.37231/ajmb.2023.7.2.612
  39. Yusni Y, Rahman S, Naufal I. Positive correlation between body weight and body mass index with blood pressure in young adults. Narra J. 2024; 4(1):e533. doi:10.52225/narra.v4i1.533
  40. Caglayan-Akay E, Ertok-Onurlu M, Komuryakan F. What factors drive gender differences in the body mass index? Evidence from Turkish adults. J Biosoc Sci. 2023;55(3):538-563. doi:10.1017/S0021932022000190
  41. Kayantaş İ, Özdemir M, Buyrukoğlu E. Fiziksel aktivite düzeyinin cinsiyet özelliği açısından incelenmesi (bir meta-analiz çalışması). Mediterranean J Sport Sci. 2022;5(Özel Sayı 1):687-696. doi:10.38021/asbid.1207249
  42. Bahadır E, Özkan A. Üniversitede yer alan öğrencilerin VKI, sağlıklı yaşam biçimi davranışları ve fiziksel aktivite düzeylerinin belirlenmesi. Uluslararası Bozok Spor Bil Derg. 2024;5(2):113-125.