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Exploring Determinants of Mediterranean Lifestyle Adherence: Findings from the Multinational MEDIET4ALL e-Survey Across Ten Mediterranean and Neighboring Countries

Research Abstract

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations.

Research Authors
Achraf Ammar, Mohamed Ali Boujelbane, Atef Salem, Khaled Trabelsi, Bassem Bouaziz, Mohamed Kerkeni, Liwa Masmoudi, Juliane Heydenreich, Christiana Schallhorn, Gabriel Müller, Ayse Merve Uyar, Hadeel Ali Ghazzawi, Adam Tawfiq Amawi, Bekir Erhan Orhan, Gius
Research Date
Research Journal
Nutrients
Research Member
Research Year
2025

Exploring Determinants of Mediterranean Lifestyle Adherence: Findings from the Multinational MEDIET4ALL e-Survey Across Ten Mediterranean and Neighboring Countries

Research Abstract

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations.

Research Authors
Achraf Ammar, Mohamed Ali Boujelbane, Atef Salem, Khaled Trabelsi, Bassem Bouaziz, Mohamed Kerkeni, Liwa Masmoudi, Juliane Heydenreich, Christiana Schallhorn, Gabriel Müller, Ayse Merve Uyar, Hadeel Ali Ghazzawi, Adam Tawfiq Amawi, Bekir Erhan Orhan, Gius
Research Date
Research Member
Research Website
https://www.mdpi.com/2072-6643/17/14/2280
Research Year
2025

Unhealthy Ultra-Processed Food, Diet Quality and Adherence to the Mediterranean Diet in Children and Adolescents: The DELICIOUS Project

Research Abstract

Background: Western dietary patterns worldwide are increasingly dominated by energy-dense, nutrient-deficient industrial foods, often identified as ultra-processed foods (UPFs). Such products may have detrimental health implications, particularly if nutritionally inadequate. This study aimed to examine the intake of unhealthy UPFs among children and adolescents from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) involved in the DELICIOUS project and to assess the association with dietary quality indicators. Methods: A survey was conducted with a sample of 2011 parents of children and adolescents aged 6 to 17 years to evaluate their dietary habits. Diet quality was assessed using the Youth Healthy Eating Index (Y-HEI), the KIDMED index to determine adherence to the Mediterranean diet, and compliance with national dietary guidelines. Results: Increased UPF consumption was not inherently associated with healthy or unhealthy specific food groups, although children and adolescents who consumed UPF daily were less likely to exhibit high overall diet quality and adherence to the Mediterranean diet. In all five countries, greater UPF intake was associated with poorer compliance with dietary recommendations concerning fats, sweets, meat, and legumes. Conclusions: Increased UPF consumption among Mediterranean children and adolescents is associated with an unhealthy dietary pattern, possibly marked by a high intake of fats, sweets, and meat, and a low consumption of legumes.

Research Authors
Francesca Giampieri, Alice Rosi, Evelyn Frias-Toral, Osama Abdelkarim, Mohamed Aly, Achraf Ammar, Raynier Zambrano-Villacres, Juancho Pons, Laura Vázquez-Araújo, Nunzia Decembrino, Alessandro Scuderi, Alice Leonardi, Lorenzo Monasta, Fernando Maniega Lega
Research Date
Research Journal
Foods
Research Member
Research Website
https://www.mdpi.com/2304-8158/14/15/2648
Research Year
2025

Important announcement regarding online application for graduate programs for the 2025/2026 academic year.

The Faculty of Sports Sciences announces the opening of online applications for graduate programs for the 2025/2026 academic year, from September 1, 2025, to September 25, 2025, in accordance with the following terms and conditions:

? First: General Diploma Stage

?‍? Application Requirements:
1️⃣ A Bachelor's degree in Physical Education from an Egyptian university.
2️⃣ Approval from the employer if the applicant is employed.
3️⃣ Submit an application for enrollment using the forms prepared by the Faculty's Graduate Studies Department (free of charge).
4️⃣ Attend at least 75% of lectures to sit for the exam.
5️⃣ The student must submit the enrollment papers in person.

? Second: Master's Stage

? Required Documents:
? Original certificates (qualification, diploma, grades).
? Original birth certificate (computer).
? Military service status for males.
? (4) personal photos.
? Certificate of non-imposition of disciplinary penalties.
? Statement of employment status + employer approval stamped with the Republic's emblem.
? Copy of national ID card or passport for expatriates.
? Declaration of non-employment in any governmental or private entity.
? Payment of the prescribed fees (2,000 EGP + additional fees).

? Third: Doctoral stage

? Conditions and documents:
✅ Original certificates (bachelor's, diploma, master's).
✅ Original birth certificate (computer).
✅ Copy of the appointment decision as an assistant professor at the college.
✅ Military service status for males.
✅ (4) personal photos.
✅ Certificate of non-imposition of disciplinary penalties.
✅ A statement of employment status + employer approval stamped with the Egyptian Republic's emblem.
✅ A copy of the national ID card or passport for expatriates.
✅ A declaration stating that you do not work for any government or private entity.
? Payment of the required fees (2,500 EGP + additional fees).

? To apply online via the college's official website:

???
https://aun.edu.eg/physical_education/ar/hs_registration

اعلان

اعلان

Announcement of training courses at the Faculty of Sports Sciences, Assiut University

As part of the Faculty of Sports Sciences, Assiut University's commitment to enhancing the academic and practical aspects of its students and graduates, and providing distinguished training opportunities that contribute to skill development and capacity building, this initiative is under the patronage of the Ministry of Youth and Sports, His Excellency Professor Dr. Ahmed El-Minshawy, President of Assiut University, and His Excellency Professor Dr. Ahmed Abdel-Mawla, Vice President for Education and Student Affairs, and under the supervision of the Faculty of Sports Sciences, Assiut University, in cooperation with the National Youth Council, the Central Administration for Sports Performance, and the General Administration of Sports Cadres at the Ministry of Youth and Sports.

The Faculty announces the commencement of registration for specialized training courses, which will be held at the Faculty's headquarters.

Course registration fee:
Only EGP 800 per course.

Exemptions and Discounts:

Full exemption for children of martyrs of the Armed Forces and Police, and for students who have lost both parents.

50% discount for students who have lost one parent.

50% discount for students with disabilities and their children.
? Booking and Subscription Steps:
1️⃣ The student must transfer the subscription fee (or the amount after the discount) to the Vodafone Cash number: 01016017165.
2️⃣ Prepare the required documents (a copy of the transfer receipt, a copy of the national ID card, a personal photo, a copy of the college ID, and proof of eligibility for the discount in special cases).
3️⃣ Send all the above documents, along with the name of the required course(s), to the booking number: 01006174049.
4️⃣ Fill out the following information and submit it as is without any modifications:
? Training Course Subscription Request
Name:
Batch:
Governorate:
Number of Courses:
Mobile Number:
Course Name(s):
Subscription Type (Full - Discounted - Free):
Vodafone Cash Number from which the transfer is made:
5️⃣ After completing all steps, the participant will be directly added to the official course group.
? Venue: Faculty of Sports Sciences, Assiut University.
? Important Note:
Any registration that does not meet all the steps and conditions mentioned above will not be accepted.
#WhatsApp_Link_For_Inquiries

https://chat.whatsapp.com/DwaWRQPlcce9On2CPmEzbq?mode=ems_copy_c

Second term exam schedule (September term) for the second year only in the undergraduate stage for the academic year 2025.

The second-term exam schedule (September term) for the second year of undergraduate studies for the 2025 academic year has been approved.
We wish all students the best of luck ???

 

Second Year Exams - Second Round - September 2025 


Attached is the schedule ?اعلان

اعلان

Condolences on the death of the late, God willing, Dr. / Muhammad Farouk Ibrahim

With hearts that believe in God’s will and destiny, the College of Physical Education and all its affiliates, represented by Professor Dr. Imad Samir, Dean of the College, and all the faculty members, employees, and students, mourn the death of the late, God willing, Dr. Muhammad Farouk Ibrahim, a lecturer in the Department of Sports Health Sciences. They extend their sincere condolences and sympathy to the honorable family, asking God Almighty to have mercy on him and to grant him a place in His spacious gardens.

تعزيه

College Council meeting on Monday, August 18, 2025

On Monday, August 18, 2025, the College Council held its (264)th session, chaired by Professor Dr. Emad Samir, Dean of the College and Chairman of the Council, and attended by Council members from the College's vice deans and faculty members.
Professor Dr. Emad Samir, Dean of the College, began the session by welcoming the attendees. The Council then discussed a number of important topics across the College's various sectors.
In the Graduate Studies and Research Sector, the Council addressed topics related to the formation of discussion committees for researchers and the approval of registration and grant decisions. It also approved the opening of graduate studies for the current academic year and the date of the second-round exams for graduate students.
In the Education and Student Affairs Sector, His Excellency discussed matters related to the start of the new academic year and study schedules.
The Council also discussed topics related to the Community Service and Environmental Development Sector, reviewing a number of proposals related to activating the College's activities in this context. It also discussed ways to develop the university and service environment to serve the educational system.

اعلان

اعلان

اعلان

Graduation Ceremony 2025

In an atmosphere of joy and pride, the Faculty of Sports Sciences at Assiut University organized the graduation ceremony for the forty-second batch of male students and the twenty-fifth batch of female students on Thursday, July 24, 2025, at the university's Grand Nile Hall. The ceremony was attended by a distinguished group of university leaders, faculty members, and the graduates' families. The ceremony was graced by the presence of His Excellency Professor Dr. Ahmed Abdel Mawla, Vice President for Education and Student Affairs; His Excellency Professor Dr. Emad Samir, Dean of the Faculty; and the Faculty's Vice Deans: Professor Dr. Yasser Hassan, Vice Dean for Education and Student Affairs; Professor Dr. Ahmed Khedry, Vice Dean for Graduate Studies and Research; and Professor Dr. Mustafa El Sebaei, Vice Dean for Community Service and Environmental Development; as well as heads of academic departments, faculty and administrative staff, and a host of students' families. The ceremony began with the national anthem, followed by a recitation of verses from the Holy Quran. This was followed by a speech by the President of the College's Student Union, Omar Ahmed Farghali, followed by a speech by the first-place graduate, Mohamed Ahmed Khedry. Professor Dr. Yasser Hassan, Vice Dean for Education and Student Affairs, then delivered a speech in which he expressed his pride in this class, noting that their years of study at the college were a journey of building character, belonging, and professional identity. He emphasized the commitment of the education and student sector to supporting students at all levels, congratulating the graduates and their families and wishing them a bright future. This was followed by a speech by Professor Dr. Emad Samir, Dean of the College, who began his speech by extending his sincere thanks and appreciation to His Excellency Professor Dr. Ahmed El-Minshawy, President of the University, for his continuous support of the College. He emphasized that this support represents the cornerstone of the College's continued path to excellence and advancement. His Excellency also expressed his pride in this batch, which he described as one of the most committed and distinguished batches, emphasizing that the College's doors will always remain open to its sons and daughters at all stages of their professional and academic lives.
The official remarks concluded with a speech by the sponsor of the ceremony, His Excellency Professor Dr. Ahmed Abdel-Mawla, Vice President of the University, who conveyed the greetings and congratulations of His Excellency Professor Dr. Ahmed El-Minshawy, President of the University, to the graduating students, wishing them a future filled with success. His Excellency the Vice President of the University also expressed the University's pride in the College of Sports Sciences and the distinguished graduates it provides, as well as the scientific and educational efforts befitting the status and leadership of Assiut University. The ceremony honored a number of university leaders. Commemorative shields were presented to His Excellency Professor Dr. Ahmed Abdel-Mawla, Vice President of the University; Professor Dr. Emad Samir, Dean of the College; the Vice Deans; and the heads of academic departments: Professor Dr. Asim Saber, Head of the Department of Curriculum and Physical Education Teaching; Professor Dr. Hazem Kamal El-Din, Head of the Department of Sports Management and Recreation; Professor Dr. Mahmoud Farouk Sabra, Head of the Department of Sports Health Sciences; Professor Dr. Tarek Salah El-Din, Head of the Department of Sports Training and Movement Sciences; and Professor Dr. Abdullah Farghali, Head of the Department of Educational Sciences and Sports Psychology. Professor Dr. Tarek Abdel Aziz, former Dean of the College, was also honored in recognition of his outstanding efforts in supporting the College and its students. Ms. Najah Samir, Director General of Youth Care at the College, was also honored for her tireless work, dedication, and devotion. Completing the ceremony, the graduating students were honored and presented with certificates of appreciation amid an atmosphere filled with pride and joy, with tears of joy mingling with warm applause from their families and loved ones. The college administration extends its sincere thanks and appreciation to everyone who contributed to the success of this distinguished ceremony, including the organizing committee, faculty members, the Youth Welfare Department, graduating students, and parents, who were true partners in the success of this event.
The college also extends special thanks to Helm Hayat Company for its generous support and sponsorship of the ceremony and for the high-quality organization befitting leading event-planning companies.
The college congratulates its graduating sons and daughters and wishes them a promising future filled with success, prosperity, and excellence in their professional and academic lives.

The aptitude tests at the Faculty of Sports Sciences, Assiut University, continue for 2025.

The Faculty of Sports Sciences, Assiut University, continues to organize aptitude tests for students applying to the college, amidst an atmosphere of discipline, organization, and precision, and under the full supervision of faculty members and staff.
? A glimpse of the activities taking place throughout the aptitude tests to date, as seen in this video with images, which demonstrates the extent of readiness and cooperation within the college to serve high school students and facilitate procedures for them.
? This comes within the framework of the directives of His Excellency Professor Dr. Ahmed El-Minshawy, President of the University, to provide the best services to applicants, with direct supervision from Professor Dr. Emad Samir, Dean of the College, and the honorable deputies.


 

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