Exploring the Association Between Mediterranean Diet Adherence and Health-related Quality of Life: A Cross-sectional study in Active Older Adults
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Palavras-chave

SF-36
Mediterranean diet
Older people; healthy aging; ageing in place; age-friendly communities; quality of life.
Longevity
Demographic ageing; Population longevity; Chronological age; Prospective age; Life expectancy

Como Citar

Exploring the Association Between Mediterranean Diet Adherence and Health-related Quality of Life: A Cross-sectional study in Active Older Adults. (2025). RIAGE - Revista Ibero-Americana De Gerontologia, 8(8), 49-63. https://doi.org/10.61415/riage.360

Resumo

Introduction: The Mediterranean diet is associated with lower mortality rates and reduced heart disease and cancer risks. As populations age, the importance of health-related quality of life is growing. Research on dietary patterns and quality of life in older adults is limited, but higher diet quality is linked to better well-being. Objective: This study investigates whether adherence to the Mediterranean diet is associated with health-related quality of life in adults aged 60 and older, focusing on medication use, comorbidities, and other factors.

Methodology: A cross-sectional study was employed. Self-administered questionnaires were used to collect data from participants. Health-related quality of life was assessed using the MOS SF-36, while diet adherence was evaluated through PREDIMED instrument. Statistical analyses were conducted using SPSS with a 95% confidence interval and significance at p < 0.05. Results: Thirty participants were involved; 20 showed low/moderate adherence and ten with high diet adherence. Interestingly, the results showed no statistically significant differences among the three adherence groups for most dimensions, apart from the Role-Emotional dimension (p=0.039). However, a significant association was identified between adherence to the Mediterranean diet and medication use (p < 0.001), as well as between adherence levels and the presence of comorbidities (p < 0.001).  Conclusion: While this study did not find a clear link between adherence to the Mediterranean diet and health-related quality of life, these findings underscore the need for further research with larger sample sizes to understand these relationships better. Dietary interventions and lifestyle modifications remain critical for promoting healthy aging and improving overall quality of life among older adults.

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Referências

Afonso, L., Moreira, T., & Oliveira, A. (2014). Índices de adesão ao padrão alimentar mediterrânico - a base metodológica para estudar a sua relação com a saúde. Revista Factores de Risco, Jan-Mar(31), 48–55.

Amarantos, E., Martinez, A., & Dwyer, J. (2001). Nutrition and quality of life in older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 56 Spec No 2, 54–64. https://doi.org/10.1093/GERONA/56.SUPPL_2.54

Apostolaki, I., Pepa, A., Vlassopoulos, A., & Kapsokefalou, M. (2021). Social capital and self-perceived quality of life-interrelated predictors of mediterranean diet adherence in older adults. Nutrients, 13(9), 3100. https://doi.org/10.3390/NU13093100/S1

Bountziouka, V., Polychronopoulos, E., Zeimbekis, A., Papavenetiou, E., Ladoukaki, E., Papairakleous, N., Gotsis, E., Metallinos, G., Lionis, C., & Panagiotakos, D. (2009). Long-term fish intake is associated with less severe depressive symptoms among elderly men and women: the MEDIS (MEDiterranean ISlands Elderly) epidemiological study. Journal of Aging and Health, 21(6), 864–880. https://doi.org/10.1177/0898264309340693

Bowling, A., & Dieppe, P. (2005). What is successful ageing and who should define it? BMJ, 331(7531), 1548–1551. https://doi.org/10.1136/BMJ.331.7531.1548

Brehm, B. A., DeFrank, S., & Swartz, R. (2021). Mediterranean Diet. Encyclopedia 2021, Vol. 1, Pages 371-387, 1(2), 371–387. https://doi.org/10.3390/ENCYCLOPEDIA1020031

Carlos, S., De La Fuente-Arrillaga, C., Bes-Rastrollo, M., Razquin, C., Rico-Campà, A., Martínez-González, M. A., & Ruiz-Canela, M. (2018). Mediterranean Diet and Health Outcomes in the SUN Cohort. Nutrients, 10(4), 439. https://doi.org/10.3390/NU10040439

Costarelli, V., Koretsi, E., & Georgitsogianni, E. (2013). Health-related quality of life of Greek adolescents: The role of the Mediterranean diet. Quality of Life Research, 22(5), 951–956. https://doi.org/10.1007/S11136-012-0219-2/TABLES/3

Critselis, E., & Panagiotakos, D. (2020). Adherence to the Mediterranean diet and healthy ageing: Current evidence, biological pathways, and future directions. Critical Reviews in Food Science and Nutrition, 60(13), 2148–2157. https://doi.org/10.1080/10408398.2019.1631752

Da Cunha, D., Ramires, N., Tibana, A., Ferreira De Melo, G., & Prestes, J. (2015). TESTES DE NORMALIDADE EM ANÁLISES ESTATÍSTICAS: UMA ORIENTAÇÃO PARA PRATICANTES EM CIÊNCIAS DA SAÚDE E ATIVIDADE FÍSICA. Revista Mackenzie de Educação Física e Esporte, 14(2), 73–77. https://editorarevistas.mackenzie.br/index.php/remef/article/view/6583

Dominguez, L. J., Di Bella, G., Veronese, N., & Barbagallo, M. (2021). Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity. Nutrients, 13(6), 2028. https://doi.org/10.3390/NU13062028

Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.-I., Corella, D., Arós, F., Gómez-Gracia, E., Ruiz-Gutiérrez, V., Fiol, M., Lapetra, J., Lamuela-Raventos, R. M., Serra-Majem, L., Pintó, X., Basora, J., Muñoz, M. A., Sorlí, J. V., Martínez, J. A., Fitó, M., Gea, A., … Martínez-González, M. A. (2018). Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. New England Journal of Medicine, 378(25). https://doi.org/10.1056/NEJMOA1800389/SUPPL_FILE/NEJMOA1800389_DISCLOSURES.PDF

Ferreira, P. L. (2000). Criação da Versão Portuguesa do MOS SF-36 Parte I - Adaptação Cultural e Linguística. Acta Medica Portuguesa, 13, 55–66. https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1760/1337

Fitó, M., Guxens, M., Corella, D., Sáez, G., Estruch, R., De La Torre, R., Francés, F., Cabezas, C., López-Sabater, M. D. C., Marrugat, J., García-Arellano, A., Arós, F., Ruiz-Gutierrez, V., Ros, E., Salas-Salvadó, J., Fiol, M., Solá, R., & Covas, M. I. (2007). Effect of a traditional Mediterranean diet on lipoprotein oxidation: a randomized controlled trial. Archives of Internal Medicine, 167(11), 1195–1203. https://doi.org/10.1001/ARCHINTE.167.11.1195

Fond, G., Young, A. H., Godin, O., Messiaen, M., Lançon, C., Auquier, P., & Boyer, L. (2020). Improving diet for psychiatric patients : High potential benefits and evidence for safety. Journal of Affective Disorders, 265, 567–569. https://doi.org/10.1016/J.JAD.2019.11.092

Galilea-Zabalza, I., Buil-Cosiales, P., Salas-Salvadó, J., Toledo, E., Ortega-Azorín, C., Díez-Espino, J., Vázquez-Ruiz, Z., Zomeño, M. D., Vioque, J., Martínez, J. A., Romaguera, D., Perez-Farinos, N., López-Miranda, J., Estruch, R., Bueno-Cavanillas, A., Arós, F., Tur, J. A., Tinahones, F., Serra-Majem, L., … Muñoz Bravo, C. (2018). Mediterranean diet and quality of life: Baseline cross-sectional analysis of the PREDIMED-PLUS trial. PLOS ONE, 13(6), e0198974. https://doi.org/10.1371/JOURNAL.PONE.0198974

Godos, J., Guglielmetti, M., Ferraris, C., Frias-Toral, E., Domínguez Azpíroz, I., Lipari, V., Di Mauro, A., Furnari, F., Castellano, S., Galvano, F., Iacoviello, L., Bonaccio, M., & Grosso, G. (2025). Mediterranean Diet and Quality of Life in Adults: A Systematic Review. Nutrients , 17(3), 577. https://doi.org/10.3390/NU17030577/S1

Hébert, J. R., Shivappa, N., Wirth, M. D., Hussey, J. R., & Hurley, T. G. (2019). Perspective: The Dietary Inflammatory Index (DII)—Lessons Learned, Improvements Made, and Future Directions. Advances in Nutrition, 10(2), 185. https://doi.org/10.1093/ADVANCES/NMY071

Hodge, A. M., Bassett, J. K., Dugué, P. A., Shivappa, N., Hébert, J. R., Milne, R. L., English, D. R., & Giles, G. G. (2018). Dietary inflammatory index or Mediterranean diet score as risk factors for total and cardiovascular mortality. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 28(5), 461–469. https://doi.org/10.1016/J.NUMECD.2018.01.010

Jivraj, S., Goodman, A., Pongiglione, B., & Ploubidis, G. B. (2020). Living longer but not necessarily healthier: The joint progress of health and mortality in the working-age population of England. Population Studies, 399–414. https://doi.org/10.1080/00324728.2020.1767297

López-Olivares, M., Fernández-Gómez, E., Mohatar-Barba, M., Luque-Vara, T., Nestares, T., López-Bueno, M., & Enrique-Mirón, C. (2023). Adherence to the Mediterranean Diet Is Associated with Health-Related Quality of Life and Anthropometric Measurements in University Professors. Healthcare 2023, Vol. 11, Page 1928, 11(13), 1928. https://doi.org/10.3390/HEALTHCARE11131928

Mantzorou, M., Mentzelou, M., Vasios, G. K., Kontogiorgis, C., Antasouras, G., Vadikolias, K., Psara, E., Vorvolakos, T., Poulios, E., Serdari, A., Papadopoulou, S. K., & Giaginis, C. (2023). Mediterranean Diet Adherence Is Associated with Favorable Health-Related Quality of Life, Physical Activity, and Sleep Quality in a Community-Dwelling Greek Older Population. Antioxidants 2023, Vol. 12, Page 983, 12(5), 983. https://doi.org/10.3390/ANTIOX12050983

Martínez-González, M. Á., De La Fuente-Arrillaga, C., Nunez-Cordoba, J. M., Basterra-Gortari, F. J., Beunza, J. J., Vazquez, Z., Benito, S., Tortosa, A., & Bes-Rastrollo, M. (2008). Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ (Clinical Research Ed.), 336(7657), 1348–1351. https://doi.org/10.1136/BMJ.39561.501007.BE

Martínez-Lapiscina, E. H., Clavero, P., Toledo, E., Estruch, R., Salas-Salvadó, J., San Julián, B., Sanchez-Tainta, A., Ros, E., Valls-Pedret, C., & Martinez-Gonzalez, M. Á. (2013). Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial. Journal of Neurology, Neurosurgery, and Psychiatry, 84(12), 1318–1325. https://doi.org/10.1136/JNNP-2012-304792

Mattei, J., Sotres-Alvarez, D., Gellman, M., Castañeda, S. F., Hu, F. B., Tucker, K. L., Siega-Riz, A. M., & Kaplan, R. C. (2018). Diet quality, inflammation, and the ankle brachial index in adults with or without cardiometabolic conditions. Clinical Nutrition (Edinburgh, Scotland), 37(4), 1332–1339. https://doi.org/10.1016/J.CLNU.2017.06.003

Maykish, A., Rex, R., & Sikalidis, A. K. (2021). Organic Winemaking and Its Subsets; Biodynamic, Natural, and Clean Wine in California. Foods 2021, Vol. 10, Page 127, 10(1), 127. https://doi.org/10.3390/FOODS10010127

Olshansky, S. J. (2018). From Lifespan to Healthspan. JAMA, 320(13), 1323–1324. https://doi.org/10.1001/JAMA.2018.12621

Pérez-Tasigchana, R. F., León-Muñoz, L. M., López-García, E., Banegas, J. R., Rodríguez-Artalejo, F., & Guallar-Castillón, P. (2016). Mediterranean Diet and Health-Related Quality of Life in Two Cohorts of Community-Dwelling Older Adults. PLOS ONE, 11(3), e0151596. https://doi.org/10.1371/JOURNAL.PONE.0151596

Quirk, S. E., Williams, L. J., O’Neil, A., Pasco, J. A., Jacka, F. N., Housden, S., Berk, M., & Brennan, S. L. (2013). The association between diet quality, dietary patterns and depression in adults: a systematic review. BMC Psychiatry, 13. https://doi.org/10.1186/1471-244X-13-175

Ruano-Rodríguez, C., Serra-Majem, L., & Dubois, D. (2015). Assessing the impact of dietary habits on health-related quality of life requires contextual measurement tools. Frontiers in Pharmacology, 6(MAY). https://doi.org/10.3389/FPHAR.2015.00101

Salas-Salvadó, J., Bulló, M., Babio, N., Martínez-González, M. Á., Ibarrola-Jurado, N., Basora, J., Estruch, R., Covas, M. I., Corella, D., Arós, F., Ruiz-Gutiérrez, V., & Ros, E. (2011). Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care, 34(1), 14–19. https://doi.org/10.2337/DC10-1288

Salas-Salvadó, J., Fernández-Ballart, J., Ros, E., Martínez-González, M. A., Fitó, M., Estruch, R., Corella, D., Fiol, M., Gómez-Gracia, E., Arós, F., Flores, G., Lapetra, J., Lamuela-Raventós, R., Ruiz-Gutiérrez, V., Bulló, M., Basora, J., & Covas, M. I. (2008). Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Archives of Internal Medicine, 168(22), 2449–2458. https://doi.org/10.1001/ARCHINTE.168.22.2449

Schwingshackl, L., Morze, J., & Hoffmann, G. (2019). Mediterranean diet and health status: Active ingredients and pharmacological mechanisms. British Journal of Pharmacology, 177(6), 1241. https://doi.org/10.1111/BPH.14778

Schwingshackl, L., Morze, J., & Hoffmann, G. (2020). Mediterranean diet and health status: Active ingredients and pharmacological mechanisms. British Journal of Pharmacology, 177(6), 1241–1257. https://doi.org/10.1111/BPH.14778

Sköldstam, L., Hagfors, L., & Johansson, G. (2003). An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis. Annals of the Rheumatic Diseases, 62(3), 208–214. https://doi.org/10.1136/ARD.62.3.208

Tanaka, T., Talegawkar, S. A., Jin, Y., Bandinelli, S., & Ferrucci, L. (2021). Association of adherence to the mediterranean-style diet with lower frailty index in older adults. Nutrients, 13(4), 1129. https://doi.org/10.3390/NU13041129/S1

Valls-Pedret, C., Sala-Vila, A., Serra-Mir, M., Corella, D., De La Torre, R., Martínez-González, M. Á., Martínez-Lapiscina, E. H., Fitó, M., Pérez-Heras, A., Salas-Salvadó, J., Estruch, R., & Ros, E. (2015). Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial. JAMA Internal Medicine, 175(7), 1094–1103. https://doi.org/10.1001/JAMAINTERNMED.2015.1668

Veronese, N., Stubbs, B., Noale, M., Solmi, M., Luchini, C., & Maggi, S. (2016). Adherence to the Mediterranean diet is associated with better quality of life: data from the Osteoarthritis Initiative. The American Journal of Clinical Nutrition, 104(5), 1403–1409. https://doi.org/10.3945/AJCN.116.136390

Victoria-Montesinos, D., Tárraga-Marcos, A., Brazo-Sayavera, J., Jiménez-López, E., Gutiérrez-Espinoza, H., Panisello Royo, J. M., Tárraga-López, P. J., & López-Gil, J. F. (2023). Adherence to the Mediterranean Diet and Health-Related Quality of Life during the COVID-19 Lockdown: A Cross-Sectional Study including Preschoolers, Children, and Adolescents from Brazil and Spain. Nutrients, 15(3), 677. https://doi.org/10.3390/NU15030677/S1

Ware, J. E., JR, & Sherbourne, C. D. (1992). The MOS SD-36 item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.

Yeung, S. S. Y., Kwan, M., Woo, J., Barchitta, M., Cicero, A., Fogacci, F., & Borghi, C. (2021). Healthy Diet for Healthy Aging. Nutrients 2021, Vol. 13, Page 4310, 13(12), 4310. https://doi.org/10.3390/NU13124310

Zaragoza-Martí, A., Ferrer-Cascales, R., Hurtado-Sánchez, J. A., Laguna-Pérez, A., & Cabañero-Martínez, M. J. (2018). Relationship Between Adherence to the Mediterranean Diet and Health-Related Quality of Life and Life Satisfaction Among Older Adults. The Journal of Nutrition, Health and Aging, 22(1), 89–96. https://doi.org/10.1007/S12603-017-0923-2

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Direitos de Autor (c) 2025 Sara Brás Alves, Samuel Encarnação, Carla Agradém, Ana Pereira, Miguel Monteiro, Olívia Pereira, Adília Fernandes, Hélder Fernandes