{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:09:50Z","timestamp":1775624990006,"version":"3.50.1"},"reference-count":39,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJNPH"],"accepted":{"date-parts":[[2023,10,11]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To evaluate the adherence to the Mediterranean diet (MD) and the level of nutritional literacy (NL) among university students from different academic fields of study, within the context of the COVID-19 pandemic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 1114 first-year undergraduate students at the University of Lisbon, Portugal, were included in this study. A self-administered online questionnaire was applied that included questions regarding sociodemographic information, the MD measured by the PREDIMED questionnaire (PREvenci\u00f3n con DIeta MEDiterr\u00e1nea) and NL assessed using the Newest Vital Sign questionnaire.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The average PREDIMED score revealed a low adherence (6.79\u00b12.14 points) to the MD. Notably, students in the Social Sciences and Humanities academic fields showed the highest level of adherence (U=21\u2009071; p&lt;0.05). Within the Health field, there was a greater prevalence of dietary behaviours aligned with the MD, contributing to higher overall adherence scores. Furthermore, 84.1% of the participants demonstrated adequate NL. Interestingly, students in the Exact Sciences and Engineering field demonstrated the highest levels of NL (5.07\u00b11.19), particularly in questions involving mathematical reasoning.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings suggest that university students in Lisbon do not follow a MD and are far from the recommendations of this dietary pattern. While most participants showed adequate NL, it is essential to highlight the link between knowledge and application to daily practice. Despite positive literacy levels, there remains a deficit in translating this knowledge into correct dietary practices.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjnph-2023-000659","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T12:10:20Z","timestamp":1702987820000},"page":"221-230","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Mediterranean diet adherence and nutritional literacy: an observational cross-sectional study of the reality of university students in a COVID-19 pandemic context"],"prefix":"10.1136","volume":"6","author":[{"given":"Filipa","family":"Abreu","sequence":"first","affiliation":[{"name":"Universidade de Lisboa, Faculdade de Medicina, Centro Acad\u00e9mico de Medicina de Lisboa, Laborat\u00f3rio de Nutri\u00e7\u00e3o, Lisboa, Portugal"}]},{"given":"Ana","family":"Hernando","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Faculdade de Medicina, Centro Acad\u00e9mico de Medicina de Lisboa, Laborat\u00f3rio de Nutri\u00e7\u00e3o, Lisboa, Portugal"}]},{"given":"Lu\u00eds Filipe","family":"Goul\u00e3o","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Instituto Superior de Agronomia, Linking Landscape, Environment, Agriculture and Food (LEAF), Lisboa, Portugal"}]},{"given":"Alexandra Marques","family":"Pinto","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Faculdade de Psicologia, Centro de Investiga\u00e7\u00e3o em Ci\u00eancia Psicol\u00f3gica, Lisboa, Portugal"}]},{"given":"Am\u00e9lia","family":"Branco","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, ISEG - Instituto Superior de Economia e Gest\u00e3o, GHES, Research Center \u2013 Office of Economic and Social of History, Lisboa, Portugal"}]},{"given":"Ana","family":"Cerqueira","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Faculdade de Medicina, Instituto de Sa\u00fade Ambiental, Lisboa, Portugal"},{"name":"Universidade de Lisboa, Faculdade de Motricidade Humana, Lisboa, Portugal"}]},{"given":"Cec\u00edlia","family":"Galv\u00e3o","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Instituto de Educa\u00e7\u00e3o, Lisboa, Portugal"}]},{"given":"F\u00e1bio Botelho","family":"Guedes","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Faculdade de Medicina, Instituto de Sa\u00fade Ambiental, Lisboa, Portugal"},{"name":"Universidade de Lisboa, Faculdade de Motricidade Humana, Lisboa, Portugal"}]},{"given":"Maria Ros\u00e1rio","family":"Bronze","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Faculdade de Farm\u00e1cia, Lisboa, Portugal"},{"name":"Instituto de Biologia Experimental e Tecnol\u00f3gica (iBET), Oeiras, Portugal"}]},{"given":"Wanda","family":"Viegas","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Instituto Superior de Agronomia, Linking Landscape, Environment, Agriculture and Food (LEAF), Lisboa, Portugal"}]},{"given":"Margarida Gaspar","family":"de Matos","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Faculdade de Medicina, Instituto de Sa\u00fade Ambiental, Lisboa, Portugal"},{"name":"Universidade de Lisboa, APPsyCI - Instituto Universit\u00e1rio de Ci\u00eancias Psicol\u00f3gicas, Sociais e da Vida, Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7875-0149","authenticated-orcid":false,"given":"Joana","family":"Sousa","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Faculdade de Medicina, Centro Acad\u00e9mico de Medicina de Lisboa, Laborat\u00f3rio de Nutri\u00e7\u00e3o, Lisboa, Portugal"},{"name":"Universidade de Lisboa, Faculdade de Medicina, Instituto de Sa\u00fade Ambiental, Lisboa, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"2025090109130709000_6.2.221.1","first-page":"6","article-title":"H\u00e1bitos Alimentares, De Sa\u00fade E Ades\u00e3o \u00c0 Dieta Mediterr\u00e2nica dos Jovens DA Regi\u00e3o do Algarve","volume":"20","author":"B\u00f4to","year":"2020","journal-title":"Acta Port Nutr"},{"key":"2025090109130709000_6.2.221.2","unstructured":"Socarr\u00e1s VS , Mart\u00ednez A . H\u00e1bitos Alimentarios Y Conductas Relacionadas con La Salud en una Poblaci\u00f3n Universitaria. 2015;31:449\u201357."},{"key":"2025090109130709000_6.2.221.3","doi-asserted-by":"crossref","DOI":"10.3390\/nu13061752","article-title":"The impact of nutrition on the COVID-19 pandemic and the impact of the COVID-19 pandemic on nutrition","volume":"13","author":"Rodriguez-Leyva","year":"2021","journal-title":"Nutrients"},{"key":"2025090109130709000_6.2.221.4","unstructured":"Mathieu E , Ritchie H , Rod\u00e9s-Guirao L , et al . Coronavirus pandemic (COVID-19). Available: https:\/\/ourworldindata.org\/coronavirus [Accessed 12 Oct 2022]."},{"key":"2025090109130709000_6.2.221.5","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19063494","article-title":"COVID-19 pandemic in Portugal: psychosocial and health-related factors associated with psychological discomfort","volume":"19","author":"Pais-Ribeiro","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2025090109130709000_6.2.221.6","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade . REACT-COVID Inqu\u00e9rito Sobre Alimenta\u00e7\u00e3o E Atividade F\u00edsica em Contexto de Conten\u00e7\u00e3o social; 2020. Servi\u00e7o Nacional de Sa\u00fade; Dire\u00e7\u00e3o-Geral DA Sa\u00fade"},{"key":"2025090109130709000_6.2.221.7","doi-asserted-by":"crossref","first-page":"6","DOI":"10.21011\/apn.2017.1102","article-title":"Roda DA Alimenta\u00e7\u00e3o Mediterr\u00e2nica E Pir\u00e2mide DA Dieta Mediterr\u00e2nica: compara\u00e7\u00e3o Entre os Dois Guias Alimentares","volume":"11","author":"Barbosa","year":"2017","journal-title":"Acta Port Nutr"},{"issue":"Suppl-1","key":"2025090109130709000_6.2.221.8","doi-asserted-by":"crossref","first-page":"156","DOI":"10.2174\/1745017902016010156","article-title":"Mediterranean diet and its benefits on health and mental health: a literature review","volume":"16","author":"Ventriglio","year":"2020","journal-title":"Clin Pract Epidemiol Ment Health"},{"key":"2025090109130709000_6.2.221.9","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/NT.0000000000000228","article-title":"Mediterranean diet and prevention of chronic diseases","volume":"52","author":"Romagnolo","year":"2017","journal-title":"Nutr Today"},{"key":"2025090109130709000_6.2.221.10","unstructured":"UNESCO . Decision of the intergovernmental committee: 8.COM; 2013."},{"key":"2025090109130709000_6.2.221.11","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980009990541"},{"key":"2025090109130709000_6.2.221.12","unstructured":"Instituto Nacional de Estat\u00edstica . Balan\u00e7a Alimentar Portuguesa 2016-2020. Lisboa-Portugal: Instituto Nacional de Estat\u00edstica, 2021."},{"key":"2025090109130709000_6.2.221.13","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18063177","article-title":"Nutrition literacy of Portuguese adults-a pilot study","volume":"18","author":"Monteiro","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2025090109130709000_6.2.221.14","doi-asserted-by":"crossref","first-page":"56","DOI":"10.21011\/apn.2021.2411","article-title":"Literacia Nutricional E Literacia Alimentar: uma revis\u00e3o narrativa sobre defini\u00e7\u00e3o, dom\u00ednios E ferramentas de avalia\u00e7\u00e3o","volume":"24","author":"Torres","year":"2021","journal-title":"Acta Port Nutr"},{"key":"2025090109130709000_6.2.221.15","unstructured":"Espanha R , \u00c1vila P , Veloso RM . Literacia em Sa\u00fade em Portugal: Relat\u00f3rio S\u00edntese. Fund.Cal. Gulbenkian. Lisboa; 2016. Available: http:\/\/www.gulbenkian.pt"},{"key":"2025090109130709000_6.2.221.16","first-page":"e125","article-title":"The newest vital sign: frequently asked questions","volume":"2","author":"Weiss","year":"2018","journal-title":"Health Lit Res Pract"},{"key":"2025090109130709000_6.2.221.17","doi-asserted-by":"crossref","DOI":"10.3390\/nu12051511","article-title":"Validation of the telephone-administered version of the mediterranean diet adherence Screener (MEDAS) questionnaire","volume":"12","author":"Greg\u00f3rio","year":"2020","journal-title":"Nutrients"},{"key":"2025090109130709000_6.2.221.18","doi-asserted-by":"publisher","DOI":"10.1370\/afm.405"},{"key":"2025090109130709000_6.2.221.19","doi-asserted-by":"crossref","DOI":"10.3390\/nu13041264","article-title":"Adherence to mediterranean diet among Lebanese university students","volume":"13","author":"Karam","year":"2021","journal-title":"Nutrients"},{"key":"2025090109130709000_6.2.221.20","doi-asserted-by":"crossref","DOI":"10.3390\/nu13093174","article-title":"Adherence to mediterranean diet, alcohol consumption and emotional eating in Spanish university students","volume":"13","author":"L\u00f3pez-Moreno","year":"2021","journal-title":"Nutrients"},{"key":"2025090109130709000_6.2.221.21","doi-asserted-by":"crossref","DOI":"10.3390\/nu11112830","article-title":"Adherence to the mediterranean diet and its association with body composition and physical fitness in Spanish university students","volume":"11","author":"Cobo-Cuenca","year":"2019","journal-title":"Nutrients"},{"key":"2025090109130709000_6.2.221.22","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/0260106020945076","article-title":"Eating behavior: the influence of age, nutrition knowledge, and mediterranean diet","volume":"26","author":"Ferreira-P\u00eago","year":"2020","journal-title":"Nutr Health"},{"key":"2025090109130709000_6.2.221.23","unstructured":"Lopes C , Torres D , Oliveira A , et al . Inqu\u00e9rito Alimentar Nacional E de Atividade F\u00edsica, IAN-AF 500 2015-2016: relat\u00f3rio de resultados. n.d. Available: www.ian-af.up.pt"},{"key":"2025090109130709000_6.2.221.24","unstructured":"World Health Organization . Diet, nutrition and the prevention of chronic diseases. report of a joint WHO\/FAO expert consultation. WHO technical report series 916. Geneva World Health Organization; 2003."},{"key":"2025090109130709000_6.2.221.25","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade . COVID-19 E Alimenta\u00e7\u00e3o; 2020."},{"key":"2025090109130709000_6.2.221.26","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade . REACT-COVID 2.0 Inqu\u00e9rito Sobre Alimenta\u00e7\u00e3o E Atividade F\u00edsica em Contexto DA Pandemia COVID-19; 2021."},{"key":"2025090109130709000_6.2.221.27","unstructured":"World cancer research fund\/American Institute for cancer research . Diet, nutrition, physical activity and cancer: a global perspective. Continuous Update Project Expert Report; 2018. Available: http:\/\/gco.iarc.fr\/today%0Adietandcancerreport.org"},{"key":"2025090109130709000_6.2.221.28","unstructured":"Greg\u00f3rio MJ , Sousa R , Teixeira D , et al . Programa Nacional para a Promo\u00e7\u00e3o DA Alimenta\u00e7\u00e3o Saud\u00e1vel 2020. Lisboa: Dire\u00e7\u00e3o-Geral da Sa\u00fade, 2020. Available: https:\/\/www.dgs.pt\/documentos-e-publicacoes\/programa-nacional-para-a-promocao-da-alimentacao-saudavel-relatorio-20205.aspx"},{"key":"2025090109130709000_6.2.221.29","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1007\/s40615-018-0512-z","article-title":"A preliminary study of health literacy in an ethnically diverse University sample","volume":"6","author":"Avci","year":"2019","journal-title":"J Racial Ethn Health Disparities"},{"key":"2025090109130709000_6.2.221.30","doi-asserted-by":"crossref","first-page":"861","DOI":"10.20344\/amp.9135","article-title":"Limited health literacy in Portugal assessed with the newest vital sign","volume":"30","author":"Paiva","year":"2017","journal-title":"Acta Med Port"},{"key":"2025090109130709000_6.2.221.31","unstructured":"Benavente A , Rosa A , Costa A , et al . A Literacia em Portugal: resultados de Uma Pesquisa Extensiva E Monogr\u00e1fica. 1996:396\u2013410."},{"key":"2025090109130709000_6.2.221.32","unstructured":"Miranda PRR . Os Conhecimentos Nutricionais Dos Alunos Do Mestrado Integrado Em Medicina Da Faculdade De Medicina Da Universidade De Coimbra E a Sua Associa\u00e7\u00e3o Com Os H\u00e1bitos Alimentares E N\u00edvel De Actividade F\u00edsica Praticados. Universidade de Coimbra, 2015."},{"key":"2025090109130709000_6.2.221.33","doi-asserted-by":"crossref","first-page":"2181","DOI":"10.36740\/WLek202209201","article-title":"Is there an association between health literacy and adherence to the Mediterranean diet? a cross-sectional study in Greece","volume":"75","author":"Albani","year":"2022","journal-title":"Wiad Lek"},{"key":"2025090109130709000_6.2.221.34","unstructured":"Lu\u00eds L . Literacia em Sa\u00fade E Alimenta\u00e7\u00e3o Saud\u00e1vel: os Novos Produtos E a Escolha dos Alimentos [Tese de Doutoramento]. Universidade Nova de Lisboa, 2010."},{"key":"2025090109130709000_6.2.221.35","unstructured":"HLS-EU Consortium HLS-EU . Comparative Report on Health Literacy in Eight EU Member States. The European Health Literacy Survey HLS-EU, 2014. Available: http:\/\/www.health-literacy.eu"},{"key":"2025090109130709000_6.2.221.36","doi-asserted-by":"crossref","first-page":"75","DOI":"10.12707\/RIII1399","article-title":"Adapta\u00e7\u00e3o cultural E Valida\u00e7\u00e3o DA Vers\u00e3o Portuguesa de newest vital sign","volume":"IV S\u00e9rie","author":"Martins","year":"2014","journal-title":"Rev Enf Ref"},{"key":"2025090109130709000_6.2.221.37","unstructured":"Lopes H . Perfil de Compet\u00eancias dos Licenciados em Engenharia. Instituto Superior T\u00e9cnico, 2002."},{"key":"2025090109130709000_6.2.221.38","unstructured":"Sobral MMJ . Literacia em Sa\u00fade E H\u00e1bitos, Atitudes E Comportamentos de Sa\u00fade em Estudantes Universit\u00e1rios: um Estudo Explorat\u00f3rio; 2018. Universidade DA Beira interior"},{"key":"2025090109130709000_6.2.221.39","unstructured":"Ma\u00efga EWH . The impact of mother\u2019s education on child health and nutrition in developing countries: evidence from a natural experiment in Burkina Faso. ACET 2015:1\u201353."}],"container-title":["BMJ Nutrition, Prevention &amp; Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjnph-2023-000659","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T16:13:21Z","timestamp":1756743201000},"score":1,"resource":{"primary":{"URL":"https:\/\/nutrition.bmj.com\/lookup\/doi\/10.1136\/bmjnph-2023-000659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":39,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,12,29]]},"published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1136\/bmjnph-2023-000659"],"URL":"https:\/\/doi.org\/10.1136\/bmjnph-2023-000659","relation":{},"ISSN":["2516-5542"],"issn-type":[{"value":"2516-5542","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12]]}}}