The association between diet adherence, perceived diet adherence and nutritional status in a Scottish student population

Background: A stark contrast exists between the westernized population of Scotland and the traditional Mediterranean countries, both, in terms of dietary composition and lifestyle behaviours. There is evidence to support the cardioprotective effects of the Mediterranean diet (MD), which may explain the low cardiovascular disease (CVD) mortality rates in Mediterranean countries. It has been suggested that, not only does the MD diet encourage a protective effect against CVD, but a higher adherence and increased physical activity may also encourage beneficial effects on CVD risk factors such as a high BMI and a high waist circumference (WC). Furthermore, limited data exists on the psychosocial aspect of diet adherence, whereby one’s perception on how well they adhere to a diet may influence objective diet adherence. Thus, the aim of this study was to look at the associations between diet adherence and perceived diet adherence to a Mediterranean diet and nutrition status in a Scottish student population. Methods: Recruited participants were asked to fill out a series of questionnaires which reflected their perception on their current diet adherence, their objective diet adherence and their physical activity level. Anthropometric measurements were carried out according to the Anthropometry Procedures Manual to assess BMI (kg/m2) and waist circumference (cm). IBM SPSS version 23.0 was used for statistical analyses which was displayed in terms of mean and interquartile ranges (IQR) and associations were carried out by Mann-Whitney U test. Results: 74% of the 19 recruited participants (males=4, females=15) had high adherence to the MD, whilst 68% of participants perceived themselves to be adhering to a MD. On average a healthy BMI was seen with both, high adherence (23.7kg/m2) and low adherence (23.1kg/m2) alongside high perception (23.5kg/m2) and low perception (23.6kg/m2). A lower waist circumference was seen with both high adherence (72.5cm) and high perception (72.5cm) in comparison to low adherence (72.9cm) and low perception (81.9cm). Physical activity levels were also higher with high adherence and high perception. Overweight individuals tended to adhere more to the MD and had a higher activity level compared with healthy weight individuals. Females had a significantly higher perceived diet adherence compared with males (p=0.041), although males had slightly higher diet adherence. Conclusions: Those participants who adhered most to the Mediterranean diet exhibited a healthy BMI, lower waist circumference and had a higher physical activity level. Whereas, those who had low adherence, although still exhibiting a healthy BMI, had a higher waist circumference and lower physical activity level. Similarly, having a high perception of diet adherence was associated with a lower waist circumference and higher physical activity level. Overweight individuals were more likely to adhere to the Mediterranean diet and less likely to perceive themselves to be adhering in comparison to healthy weight individuals. Although most of these findings were not statistically significant they correlate highly with other studies mentioned in this dissertation and help add to the pool of health benefits associated with high adherence to the Mediterranean diet