Increased nutrition knowledge and adherence to the Mediterranean diet are associated with lower body mass index and better self-rated general health among university students

Background: Nutrition knowledge and adherence to the Mediterranean diet (MedDiet) have been suggested to have beneficial effects on weight status and general health. The scarcity of assessment of these effects on large samples of university students is, however, observed. Objective: To investigate the association of nutrition knowledge and adherence to the MedDiet with body mass index (BMI) and self-rated general health among university students. Methods: This was a cross-sectional study among 1776 university students aged 21.34 +/- 2.47 years. Nutrition knowledge and MedDiet adherence scores were assessed using validated questionnaires. Anthropometric measurements and general health were self-reported. Results: The prevalence of overweight and obesity was 23.1% and 4.0%, respectively. Approximately 52% of students self-rated their general health as fair or poor. MedDiet adherence score was positively correlated with nutrition knowledge scores (P < 0.001) and inversely associated with BMI (P < 0.001). Non-overweight students had significantly higher nutrition knowledge scores and MedDiet adherence scores compared to overweight/ obese peers. Similarly, non-smoking students had higher nutrition knowledge scores than their smoking counterparts (P = 0.017). Participants who self-rated their general health as fair or poor showed significantly lower nutrition knowledge and MedDiet adherence scores than other groups. Health science students had significantly lower consumption of fish, legumes, olive oil, unrefined whole grains, fruits, and vegetables compared to other students. Conclusions: Elevated levels of nutrition knowledge and adherence to the MedDiet were associated with lower BMI and better self-rated general health. Urgent interventions are needed to promote nutrition knowledge and healthy eating behavior among university students.