Adherence to the Mediterranean diet and mental health among university students in Lebanon

Introduction: University students are particularly susceptible to mental health issues. The association between adherence to the Mediterranean Diet and mental health in this population remains inconclusive. To address this gap, we studied the association between adherence to the Mediterranean diet and mental health aspects: depression, anxiety, and stress, among a sample of university students in Lebanon. Methods: This was a cross-sectional study using an online survey. The survey included the Patient Health Questionnaire-4 (PHQ-4) to evaluate symptoms of depression and anxiety, the Perceived Stress Score (PSS) to assess stress levels, and the Mediterranean Diet Adherence Screener (MEDAS) to measure adherence to the Mediterranean diet. Socio-demographic and lifestyle-related questions were also assessed. Descriptive, bivariate, and multivariate analyses were conducted. Results: 200 students were included: 64 % being females, 58.5 % studying in private universities, and 69.5 % being seniors. The mean PHQ4-anxiety subscale was 3.61 (out of a total of 6) and 71.5 % of the sample met the criteria for anxiety diagnosis; the mean PHQ4-depression subscale was 4.04 (out of a total of 6) and 77 % of the sample met the criteria for depression diagnosis, and mean PSS was 21.18 (out of a total of 39). The mean MEDAS was 6.42 (out of a total of 14). There was a significant inverse association between MEDAS scores and anxiety (3=-0.110, 95 %CI: -0.196; -0.024) and between MEDAS and PSS (3=-0.327, 95 %CI: -0.546; -0.107). There was no association between MEDAS and depression. Conclusion: We found poor mental health and low adherence to the Mediterranean Diet among university students. Higher adherence to the Mediterranean Diet was associated with lower anxiety and stress levels. Randomized trials are needed to confirm our findings.