{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:05:22Z","timestamp":1789707922007,"version":"4.0.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Mediterranean Diet (MedDiet) has been linked to lower breast cancer incidence through anti-inflammatory and antioxidant effects. This study evaluated adherence to the MedDiet among women undergoing mammographic screening provided by mobile units in Italy and explored its association with breast cancer risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A cross-sectional study was carried out between January and December 2023 as part of the mobile \u201cPrevention Caravan programme.\u201d Eligible participants included women aged 18\u202fyears or older who underwent breast ultrasound or mammography and completed the 14-item \u201cMediterranean Diet Adherence Screener (MEDAS).\u201d Descriptive analyses and differences across groups defined by known breast cancer risk factors, stratified by MedDiet adherence levels, were performed, and a multivariable logistic regression analysis was conducted to further explore these patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 7,492 women were included, most of whom were \u226445\u202fyears of age (69%) and from Central Italy (59%). The mean MEDAS score was 7.0 (SD 1.6), with 62% categorized as having low adherence to the MedDiet. Only 1.21% of participants achieved an excellent level of adherence to the MedDiet. MEDAS score increased with increasing age (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.036), women aged 46\u201374\u202fyears and postmenopausal women were also overrepresented among those with excellent adherence (37 and 27% of the excellent-adherence group, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.022 and\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). A significant association emerged with family history of breast conditions (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), particularly benign lesions, which was associated with lower adherence. These findings were broadly supported by the multivariable analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mobile programmes like the \u201cPrevention Caravan programme\u201d may help promote healthy lifestyles and improve access to prevention services. Future studies should confirm these results in larger, more diverse populations and explore associations with lesion type and severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1932170","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:33:55Z","timestamp":1789706035000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mediterranean diet adherence among women attending mobile breast cancer prevention programme: results of a cross-sectional study in Italy"],"prefix":"10.3389","volume":"14","author":[{"given":"Alessandra","family":"Maio","sequence":"first","affiliation":[{"name":"Section of Hygiene, University Department of Life Science and Public Health, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Di Leone","sequence":"additional","affiliation":[{"name":"Multidisciplinary Breast Center, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Di Grande","sequence":"additional","affiliation":[{"name":"Section of Hygiene, University Department of Life Science and Public Health, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Franceschini","sequence":"additional","affiliation":[{"name":"Multidisciplinary Breast Center, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Magno","sequence":"additional","affiliation":[{"name":"Multidisciplinary Breast Center, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Castagnetta","sequence":"additional","affiliation":[{"name":"Multidisciplinary Breast Center, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Masetti","sequence":"additional","affiliation":[{"name":"Multidisciplinary Breast Center, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Boccia","sequence":"additional","affiliation":[{"name":"Section of Hygiene, University Department of Life Science and Public Health, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]},{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Pastorino","sequence":"additional","affiliation":[{"name":"Section of Hygiene, University Department of Life Science and Public Health, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]},{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"ref1","year":""},{"key":"ref2","year":""},{"key":"ref3","year":""},{"key":"ref4","year":""},{"key":"ref5","doi-asserted-by":"publisher","first-page":"326","DOI":"10.3390\/nu10030326","article-title":"Mediterranean diet and breast cancer risk","volume":"10","author":"Turati","year":"2018","journal-title":"Nutrients"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1016\/j.clnu.2023.02.012","article-title":"Mediterranean diet and risk of breast cancer: an umbrella review","volume":"42","author":"Gonz\u00e1lez-Palacios Torres","year":"2023","journal-title":"Clin Nutr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1001\/jamainternmed.2015.4838","article-title":"Mediterranean diet and invasive breast cancer risk among women at high cardiovascular risk in the PREDIMED trial: a randomized clinical trial","volume":"175","author":"Toledo","year":"2015","journal-title":"JAMA Intern Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s12967-023-04814-z","article-title":"Sex-differences in Mediterranean diet: a key piece to explain sex-related cardiovascular risk in obesity? A cross-sectional study","volume":"22","author":"Barrea","year":"2024","journal-title":"J Transl Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/j.jand.2013.07.038","article-title":"Factors associated with adherence to the Mediterranean diet in the adult population","volume":"114","author":"Patino-Alonso","year":"2014","journal-title":"J Acad Nutr Diet"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1093\/eurpub\/cky127","article-title":"Socioeconomic and psychosocial determinants of adherence to the Mediterranean diet in a general adult Italian population","volume":"29","author":"Ruggiero","year":"2019","journal-title":"Eur J Pub Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2963","DOI":"10.3390\/ijerph16162963","article-title":"Determinants of adherence to the Mediterranean diet: findings from a cross-sectional study in women from southern Italy","volume":"16","author":"Maugeri","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/j.numecd.2019.11.003","article-title":"Trends in adherence to the Mediterranean diet in South Italy: a cross sectional study","volume":"30","author":"Veronese","year":"2020","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"734","DOI":"10.3390\/nu9070734","article-title":"Trends of adherence to the Mediterranean dietary pattern in northern Italy from 2010 to 2016","volume":"9","author":"Leone","year":"2017","journal-title":"Nutrients"},{"key":"ref14","year":"2026"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.3945\/jn.110.135566","article-title":"A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women","volume":"141","author":"Schr\u00f6der","year":"2011","journal-title":"J Nutr"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1186\/s12885-017-3337-y","article-title":"Validation of the German version of the Mediterranean diet adherence screener (MEDAS) questionnaire","volume":"17","author":"Hebestreit","year":"2017","journal-title":"BMC Cancer"},{"key":"ref17","year":"2025"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1016\/j.jacr.2024.05.005","article-title":"The association between food security and mammography screening: cross-sectional survey results from the National Health Interview Survey","volume":"21","author":"Watts","year":"2024","journal-title":"J Am Coll Radiol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"351","DOI":"10.15585\/mmwr.mm7315e1","article-title":"Vital signs: mammography use and association with social determinants of health and health-related social needs among women\u2014United States, 2022","volume":"73","author":"Miller","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"3282","DOI":"10.3390\/nu13093282","article-title":"Adherence to the Mediterranean diet in association with self-perception of diet sustainability, anthropometric and sociodemographic factors: a cross-sectional study in Italian adults","volume":"13","author":"Biasini","year":"2021","journal-title":"Nutrients"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"110813","DOI":"10.1016\/j.nut.2020.110813","article-title":"Evaluation of adherence to Mediterranean diet and association with clinical and biological markers in an Italian population","volume":"77","author":"Barnaba","year":"2020","journal-title":"Nutrition"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1346455","DOI":"10.3389\/fnut.2024.1346455","article-title":"Adherence to Mediterranean diet and its main determinants in a sample of Italian adults: results from the ARIANNA cross-sectional survey","volume":"11","author":"Cardamone","year":"2024","journal-title":"Front Nutr"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1623827","DOI":"10.3389\/fnut.2025.1623827","article-title":"The 15-year trend in adherence to dietary recommendations and ultra-processed food consumption in Italy","volume":"12","author":"Di Veroli","year":"2025","journal-title":"Front Nutr"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1016\/j.numecd.2014.02.014","article-title":"Decline of the Mediterranean diet at a time of economic crisis. Results from the Moli-sani study","volume":"24","author":"Bonaccio","year":"2014","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"3893","DOI":"10.3390\/nu15183893","article-title":"Inequalities in childhood nutrition, physical activity, sedentary behaviour and obesity in Italy","volume":"15","author":"Spinelli","year":"2023","journal-title":"Nutrients"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"11360","DOI":"10.3390\/ijerph191811360","article-title":"Ultra-processed food consumption and relation with diet quality and Mediterranean diet in southern Italy","volume":"19","author":"Godos","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jadohealth.2018.07.011","article-title":"Preventative health and risk behaviors among adolescent girls with and without family histories of breast cancer","volume":"64","author":"Schwartz","year":"2019","journal-title":"J Adolesc Health"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s12529-018-9737-9","article-title":"Is a family history of the breast cancer related to women\u2019s cancer prevention behaviors?","volume":"26","author":"Bertoni","year":"2019","journal-title":"Int J Behav Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1038\/gim.2012.118","article-title":"Health behaviors and cancer screening among Californians with a family history of cancer","volume":"15","author":"Townsend","year":"2013","journal-title":"Genet Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1016\/j.ajog.2023.05.030","article-title":"Mediterranean diet and female reproductive health over lifespan: a systematic review and meta-analysis","volume":"229","author":"Yang","year":"2023","journal-title":"Am J Obstet Gynecol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"4564","DOI":"10.3390\/nu13124564","article-title":"A generation shift in Mediterranean diet adherence and its association with biological markers and health in Dalmatia, Croatia","volume":"13","author":"\u0160arac","year":"2021","journal-title":"Nutrients"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"886824","DOI":"10.3389\/fendo.2022.886824","article-title":"Mediterranean diet: what are the consequences for menopause?","volume":"13","author":"Vetrani","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.3390\/nu13041248","article-title":"Adherence to the Mediterranean diet and determinants among pregnant women: the NELA cohort","volume":"13","author":"Su\u00e1rez-Mart\u00ednez","year":"2021","journal-title":"Nutrients"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1186\/s12966-025-01823-7","article-title":"The effectiveness of mobile app-based interventions in facilitating behaviour change towards healthier and more sustainable diets: a systematic review and meta-analysis","volume":"22","author":"Curtin","year":"2025","journal-title":"Int J Behav Nutr Phys Act"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/EMBC53108.2024.10781576","article-title":"MedDietAgent: an AI-based mobile app for harmonizing individuals\u2019 dietary choices with the Mediterranean diet pattern","volume":"2024","author":"Konstantakopoulos","year":"2024","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1038\/s41416-018-0160-4","article-title":"Determinants of willingness to receive healthy lifestyle advice in the context of cancer screening","volume":"119","author":"Stevens","year":"2018","journal-title":"Br J Cancer"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e024136","DOI":"10.1136\/bmjopen-2018-024136","article-title":"Randomised controlled trial to assess the impact of a lifestyle intervention (ActWELL) in women invited to NHS breast screening","volume":"8","author":"Anderson","year":"2018","journal-title":"BMJ Open"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12966-021-01099-7","article-title":"A novel approach to increasing community capacity for weight management: a volunteer-delivered programme (ActWELL) initiated within breast screening clinics: a randomised controlled trial","volume":"18","author":"Anderson","year":"2021","journal-title":"Int J Behav Nutr Phys Act"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1007\/s10552-020-01377-4","article-title":"Effectiveness of diet and physical activity interventions amongst adults attending colorectal and breast cancer screening: a systematic review and meta-analysis","volume":"32","author":"Orange","year":"2021","journal-title":"Cancer Causes Control"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1932170\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:34:03Z","timestamp":1789706043000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1932170\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":39,"alternative-id":["10.3389\/fpubh.2026.1932170"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1932170","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"article-number":"1932170"}}