{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:19:44Z","timestamp":1791587984841,"version":"4.3.4"},"reference-count":102,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,4,22]],"date-time":"2023-04-22T00:00:00Z","timestamp":1682121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Background: The Mediterranean diet (MD) is a beneficial dietary pattern with strong antioxidant and anti-inflammatory properties that can promote mental and physical human health. This study aims to assess the impact of MD adherence on health-related quality of life, physical activity levels, and sleep quality in a representative Greek elderly population. Methods: This is a cross-sectional study. A total of 3254 persons \u226565 years from 14 different Greek regions, urban, rural and islands participated in this study, of which 48.4% were female and 51.6% were male. Health-Related Quality of Life (HRQOL) was evaluated utilizing a short form healthy survey, physical activity was determined by the International Physical Activity Questionnaire (IPAQ), sleep quality was assessed utilizing the Pittsburgh Sleep Quality Index (PSQI) and MD adherence was assessed via the Mediterranean Diet Score (MedDietScore). Results: Moderate adherence to the MD and an increased prevalence of poor quality of life, low physical activity levels and inadequate sleep quality among the elderly population were recorded. High MD adherence was independently associated with better quality of life (OR: 2.31, 95% CI: 2.06\u20132.68, p = 0.0008), higher physical activity (OR: 1.89, 95% CI: 1.47\u20132.35, p = 0.0141) and adequate sleep quality (OR: 2.11, 95%: 1.79\u20132.44, p = 0.0018), female sex (OR: 1.36, 95% CI: 1.02\u20131.68, p = 0.0032) and living with others (OR: 1.24, 95% CI: 0.81\u20131.76, p = 0.0375), after adjustment for potential confounding factors. In unadjusted analysis, participants\u2019 age (p &lt; 0.0001), anthropometric characteristics (p &lt; 0.005), educational (p = 0.0026) and financial status (p = 0.0005) and smoking habits (p = 0.0031) were also identified as indicators of MD adherence; however, their impact on MD adherence was considerably attenuated after adjusting for confounding factors (p &gt; 0.05). Conclusion: High MD adherence was correlated with favorable quality of life, higher levels of physical activity, and a more adequate sleep quality score. Strategies and public health policies that facilitate MD adherence and physical activity in older adults may improve sleep and quality of life, impacting overall wellbeing in this age group.<\/jats:p>","DOI":"10.3390\/antiox12050983","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T06:20:42Z","timestamp":1682317242000},"page":"983","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Mediterranean Diet Adherence Is Associated with Favorable Health-Related Quality of Life, Physical Activity, and Sleep Quality in a Community-Dwelling Greek Older Population"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2535-2841","authenticated-orcid":false,"given":"Maria","family":"Mantzorou","sequence":"first","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Mentzelou","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5152-8601","authenticated-orcid":false,"given":"Georgios K.","family":"Vasios","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7835-8246","authenticated-orcid":false,"given":"Christos","family":"Kontogiorgis","sequence":"additional","affiliation":[{"name":"Laboratory of Hygiene and Environmental Protection, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Antasouras","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Vadikolias","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Democritus University of Thrace, 68100 Alexadroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evmorfia","family":"Psara","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theofanis","family":"Vorvolakos","sequence":"additional","affiliation":[{"name":"Department of Geriatric Psychiatry, School of Medicine, Democritus University of Thrace, 68100 Alexadroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efthymios","family":"Poulios","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aspasia","family":"Serdari","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Child Psychiatry, School of Medicine, Democritus University of Thrace, 68100 Alexadroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sousana K.","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2878-4831","authenticated-orcid":false,"given":"Constantinos","family":"Giaginis","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,22]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2023, February 18). The United Nations Decade of Healthy Ageing (2021\u20132030). Available online: https:\/\/www.who.int\/initiatives\/decade-of-healthy-ageing."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1177\/0003319714532169","article-title":"Health benefits of the Mediterranean Diet: An update of research over the last 5 years","volume":"66","author":"Gotsis","year":"2015","journal-title":"Angiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s11886-017-0908-0","article-title":"A Heart-Healthy Diet: Recent Insights and Practical Recommendations","volume":"19","author":"Dinu","year":"2017","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1002\/cam4.539","article-title":"Adherence to Mediterranean diet and risk of cancer: An updated systematic review and meta-analysis of observational studies","volume":"4","author":"Schwingshackl","year":"2015","journal-title":"Cancer Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1002\/dmrr.2516","article-title":"Mediterranean diet and type 2 diabetes","volume":"30","author":"Esposito","year":"2015","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1007\/s40520-020-01608-x","article-title":"Mediterranean diet adherence is associated with better cognitive status and less depressive symptoms in a Greek elderly population","volume":"33","author":"Mantzorou","year":"2021","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"366","DOI":"10.3390\/endocrines2040034","article-title":"Mediterranean diet and physical activity for successful aging: An update for nutritionists and endocrinologists","volume":"2","author":"Chapela","year":"2021","journal-title":"Endocrines"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"104044","DOI":"10.1016\/j.archger.2020.104044","article-title":"The association between the level of adherence to the Mediterranean diet and successful aging: An analysis of the ATTICA and MEDIS (MEDiterranean Islands Study) epidemiological studies","volume":"89","author":"Foscolou","year":"2020","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Andreo-L\u00f3pez, M.C., Contreras-Bol\u00edvar, V., Mu\u00f1oz-Torres, M., Garc\u00eda-Fontana, B., and Garc\u00eda-Fontana, C. (2023). Influence of the Mediterranean Diet on Healthy Aging. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24054491"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Tsigalou, C., Konstantinidis, T., Paraschaki, A., Stavropoulou, E., Voidarou, C., and Bezirtzoglou, E. (2020). Medi-terranean Diet as a Tool to Combat Inflammation and Chronic Diseases. An Overview. Biomedicines, 8.","DOI":"10.3390\/biomedicines8070201"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Finicelli, M., Di Salle, A., Galderisi, U., and Peluso, G. (2022). The Mediterranean Diet: An Update of the Clinical Trials. Nutrients, 14.","DOI":"10.3390\/nu14142956"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gantenbein, K.V., and Kanaka-Gantenbein, C. (2021). Mediterranean Diet as an Antioxidant: The Impact on Metabolic Health and Overall Wellbeing. Nutrients, 13.","DOI":"10.3390\/nu13061951"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"371","DOI":"10.3390\/encyclopedia1020031","article-title":"Mediterranean Diet","volume":"1","author":"Sikalidis","year":"2021","journal-title":"Encyclopedia"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Maykish, A., Rex, R., and Sikalidis, A.K. (2021). Organic Winemaking and Its Subsets; Biodynamic, Natural, and Clean Wine in California. Foods, 10.","DOI":"10.3390\/foods10010127"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1080\/1028415X.2017.1411320","article-title":"A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized con-trolled trial (HELFIMED)","volume":"22","author":"Parletta","year":"2019","journal-title":"Nutr. Neurosci."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Govindaraju, T., Sahle, B.W., McCaffrey, T.A., McNeil, J.J., and Owen, A.J. (2018). Dietary Patterns and Quality of Life in Older Adults: A Systematic Review. Nutrients, 10.","DOI":"10.3390\/nu10080971"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Tasigchana, R.F., Le\u00f3n-Mu\u00f1oz, L.M., L\u00f3pez-Garc\u00eda, E., Banegas, J.R., Rodr\u00edguez-Artalejo, F., and Guallar-Castill\u00f3n, P. (2016). Mediterranean Diet and Health-Related Quality of Life in two cohorts of commu-nity-dwelling older adults. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0155171"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Galilea-Zabalza, I., Buil-Cosiales, P., Salas-Salvado, J., Toledo, E., Ortega-Azor\u00edn, C., D\u00edez-Espino, J., V\u00e1zquez-Ruiz, Z., Zome\u00f1o, M.D., Vioque, J., and Mart\u00ednez, J.A. (2018). PREDIMED-PLUS Study Investigators. Mediterranean diet and quality of life: Baseline cross-sectional analysis of the PREDIMED-PLUS trial. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0198974"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.3945\/ajcn.116.136390","article-title":"Adherence to the Mediterranean diet is associated with better quality of life: Data from the Osteoarthritis Initiative","volume":"104","author":"Veronese","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_20","unstructured":"Word Health Organization (2023, February 15). Physical Activity. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/physical-activity."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Gluchowski, A., Bilsborough, H., Mcdermott, J., Hawley-Hague, H., and Todd, C. (2022). A lot of people just go for walks, and don\u2019t do anything else\u2019: Older adults in the UK are not aware of the strength component embedded in the chief medical officers\u2019 physical activity guidelines\u2014A qualitative study. Int. J. Environ. Res. Public Health, 19.","DOI":"10.51224\/SRXIV.174"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1590\/1516-4446-2012-0895","article-title":"Association between physical activity and quality of life in the elderly: A systematic review, 2000\u20132012","volume":"36","author":"Vagetti","year":"2014","journal-title":"Braz. J. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"l2323","DOI":"10.1136\/bmj.l2323","article-title":"Physical activity trajectories and mortality: Population based cohort study","volume":"365","author":"Mok","year":"2019","journal-title":"BMJ"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1007\/s10522-016-9641-0","article-title":"Physical activity in older age: Perspectives for healthy ageing and frailty","volume":"17","author":"McPhee","year":"2016","journal-title":"Biogerontology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1136\/bjsports-2017-098963","article-title":"Do the associations of sedentary behaviour with cardiovascular disease mortality and cancer mortality differ by physical activity level? A systematic review and harmonised meta-analysis of data from 850 060 participants","volume":"53","author":"Ekelund","year":"2019","journal-title":"Br. J. Sport. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1097\/CM9.0000000000001730","article-title":"Independent and joint association of physical activity and sedentary behavior on all-cause mortality","volume":"134","author":"Zhou","year":"2021","journal-title":"Chin. Med. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.archger.2017.01.008","article-title":"The effect of physical activity on depressive symptoms and quality of life among elderly nursing home residents: Randomized controlled trial","volume":"70","author":"Lok","year":"2017","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1007\/s00198-019-05080-w","article-title":"Promoting mobility and healthy aging in men: A narrative review","volume":"30","author":"Ebeling","year":"2019","journal-title":"Osteoporos. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.chc.2018.11.010","article-title":"Promoting mental health and wellness in youth through physical activity, nutrition, and sleep","volume":"28","author":"Hosker","year":"2019","journal-title":"Child Adolesc. Psychiatr. Clin. N. Am."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1503\/cmaj.060792","article-title":"Sleep and aging: 1. Sleep disorders commonly found in older people","volume":"176","author":"Wolkove","year":"2007","journal-title":"CMAJ"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s40675-015-0030-z","article-title":"The relationships among sleep, nutrition, and obesity","volume":"1","author":"Arora","year":"2015","journal-title":"Curr. Sleep Med. Rep."},{"key":"ref_32","first-page":"367","article-title":"Sleep duration and quality: Impact on lifestyle behaviors and cardiometabolic health: A scientific statement from the American Heart Association","volume":"134","author":"Grandner","year":"2016","journal-title":"Circulation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/jhn.12813","article-title":"The influence of sleep health on dietary intake: A systematic review and meta-analysis of intervention studies","volume":"34","author":"Fenton","year":"2021","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1530\/JOE-21-0155","article-title":"The links between sleep duration, obesity and type 2 diabetes mellitus","volume":"252","author":"Antza","year":"2021","journal-title":"J. Endocrinol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"435","DOI":"10.7326\/0003-4819-153-7-201010050-00006","article-title":"Insufficient sleep undermines dietary efforts to reduce adiposity","volume":"153","author":"Nedeltcheva","year":"2010","journal-title":"Ann. Intern. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.sleep.2017.01.023","article-title":"Sleep quality is associated with weight loss maintenance status: The MedWeight study","volume":"34","author":"Yannakoulia","year":"2017","journal-title":"Sleep Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"393","DOI":"10.3389\/fneur.2017.00393","article-title":"Diet and sleep physiology: Public health and clinical implications","volume":"8","author":"Frank","year":"2017","journal-title":"Front. Neurol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Scoditti, E., Tumolo, M.R., and Garbarino, S. (2022). Mediterranean diet on sleep: A health alliance. Nutrients, 14.","DOI":"10.3390\/nu14142998"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Ikonte, C.J., Mun, J.G., Reider, C.A., Grant, R.W., and Mitmesser, S.H. (2019). Micronutrient Inadequacy in Short Sleep: Analysis of the NHANES 2005\u20132016. Nutrients, 11.","DOI":"10.3390\/nu11102335"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/j.1532-5415.2010.03232.x","article-title":"The effect of melatonin, magnesium, and zinc on primary insomnia in long-term care facility residents in Italy: A double-blind, placebo-controlled clinical trial","volume":"59","author":"Rondanelli","year":"2011","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1089\/jmf.2009.0096","article-title":"Effects of a tart cherry juice beverage on the sleep of older adults with insomnia: A pilot study","volume":"13","author":"Pigeon","year":"2010","journal-title":"J. Med. Food"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1007\/s13668-021-00362-4","article-title":"The Relationship Between Diet and Sleep in Older Adults: A Narrative Review","volume":"10","author":"Gupta","year":"2021","journal-title":"Cur. Nutr. Rep."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.dhjo.2016.04.008","article-title":"Measurement characteristics for two health-related quality of life measures in older adults: The SF-36 and the CDC Healthy Days items","volume":"9","author":"Barile","year":"2016","journal-title":"Disabil. Health J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International physical activity questionnaire: 12-country reliability and validity","volume":"35","author":"Craig","year":"2003","journal-title":"Med. Sci. Sport Exerc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12955-017-0637-5","article-title":"Validation of the Pittsburgh sleep quality index in community dwelling Ethiopian adults","volume":"15","author":"Salahuddin","year":"2017","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.ypmed.2006.12.009","article-title":"Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; the accuracy of the MedDietScore","volume":"44","author":"Panagiotakos","year":"2007","journal-title":"Prev. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1080\/1028415X.2018.1486940","article-title":"Nutritional status is associated with the degree of cognitive impairment and depressive symptoms in a Greek elderly population","volume":"23","author":"Mantzorou","year":"2020","journal-title":"Nutr. Neurosci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.puhe.2011.03.009","article-title":"Compliance with a healthy lifestyle in a representative sample of the Greek population: Preliminary results of the Hellas Health I study","volume":"125","author":"Filippidis","year":"2011","journal-title":"Public Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1007\/s40519-019-00807-4","article-title":"Nutrition behaviour and compliance with the Mediterranean diet pyramid recommendations: An Italian survey-based study","volume":"25","author":"Bracale","year":"2020","journal-title":"Eat Weight Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"a1344","DOI":"10.1136\/bmj.a1344","article-title":"Adherence to Mediterranean diet and health status: Meta-analysis","volume":"337","author":"Sofi","year":"2008","journal-title":"BMJ"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"156","DOI":"10.2174\/1745017902016010156","article-title":"Medi-terranean 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":"ref_52","doi-asserted-by":"crossref","unstructured":"Apostolaki, I., Pepa, A., Vlassopoulos, A., and Kapsokefalou, M. (2021). Social capital and self-perceived quality of life-interrelated predictors of Mediterranean diet adherence in older adults. Nutrients, 13.","DOI":"10.3390\/nu13093100"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s12603-017-0923-2","article-title":"Relationship between adherence to the Mediterranean diet and health-related quality of life and life satisfaction among older adults","volume":"22","year":"2018","journal-title":"J. Nutr. Health Aging"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.exger.2015.01.047","article-title":"Associations of diet quality with health-related quality of life in older Australian men and women","volume":"64","author":"Milte","year":"2015","journal-title":"Exp. Gerontol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1038\/ejcn.2011.146","article-title":"Adherence to the Mediterranean diet and quality of life in the SUN Project","volume":"66","author":"Ruano","year":"2012","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Ruano, C., Henriquez, P., Mart\u00ednez-Gonz\u00e1lez, M.\u00c1., Bes-Rastrollo, M., Ruiz-Canela, M., and S\u00e1nchez-Villegas, A. (2013). Empirically derived dietary patterns and health-related quality of life in the SUN project. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0061490"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1186\/s12955-016-0572-x","article-title":"Diet and physical activity in people with intermediate cardiovascular risk and their relationship with the health-related quality of life: Results from the MARK study","volume":"14","author":"Ramos","year":"2016","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1007\/s12603-020-1327-2","article-title":"Health-Related Quality of Life and associated factors among oldest-old in China","volume":"24","author":"Chen","year":"2020","journal-title":"J. Nutr. Health Aging"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1111\/jhn.12709","article-title":"Diet and sleep health: A scoping review of intervention studies in adults","volume":"33","author":"Burrows","year":"2020","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.jagp.2014.10.001","article-title":"Sleep complaints and metabolic syndrome in an elderly population: The three-city study","volume":"23","author":"Akbaraly","year":"2015","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1093\/ajcn\/87.2.310","article-title":"Sleep duration, general and abdominal obesity, and weight change among the older adult population of Spain","volume":"87","author":"Faubel","year":"2008","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3142874","DOI":"10.1155\/2020\/3142874","article-title":"The Effects of Dietary Nutrition on Sleep and Sleep Disorders","volume":"2020","author":"Zhao","year":"2020","journal-title":"Mediat. Inflamm."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"805955","DOI":"10.3389\/fnut.2021.805955","article-title":"Adherence to the Mediterranean diet and its association with sleep quality and chronotype among youth: A cross-sectional study","volume":"8","author":"Naja","year":"2022","journal-title":"Front. Nutr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"105881","DOI":"10.1016\/j.appet.2021.105881","article-title":"Associations between sleep duration and Mediterranean diet score in Costa Rican adults","volume":"170","author":"Gupta","year":"2022","journal-title":"Appetite"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1111\/ggi.13521","article-title":"Associations between the Mediterranean diet and sleep in older adults: Results from the Hellenic longitudinal investigation of aging and diet study","volume":"11","author":"Mamalaki","year":"2018","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"zsw093","DOI":"10.1093\/sleep\/zsw083","article-title":"Mediterranean Diet and Changes in Sleep Duration and Indicators of Sleep Quality in Older Adults","volume":"40","author":"Campanini","year":"2017","journal-title":"Sleep"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Flor-Alemany, M., Nestares, T., Alemany-Arrebola, I., Mar\u00edn-Jim\u00e9nez, N., Borges-Cosic, M., and Aparicio, V.A. (2020). Influence of dietary habits and Mediterranean diet adherence on sleep quality during pregnancy. The GESTAFIT Project. Nutrients, 12.","DOI":"10.3390\/nu12113569"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Muscogiuri, G., Barrea, L., Aprano, S., Framondi, L., Di Matteo, R., Laudisio, D., Pugliese, G., Savastano, S., Colao, A., and on behalf of the OPERA PREVENTION Project (2020). Sleep quality in obesity: Does adherence to the Mediterranean diet matter?. Nutrients, 12.","DOI":"10.3390\/nu12051364"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Zuraikat, F.M., Makarem, N., St-Onge, M.P., Xi, H., Akkapeddi, A., and Aggarwal, B. (2020). A Mediterranean dietary pattern predicts better sleep quality in US women from the American Heart Association Go Red for Women Strategically Focused Research Network. Nutrients, 12.","DOI":"10.3390\/nu12092830"},{"key":"ref_70","first-page":"zsy158","article-title":"Mediterranean diet pattern and sleep duration and insomnia symptoms in the Multi-Ethnic Study of Atherosclerosis","volume":"41","author":"Wood","year":"2018","journal-title":"Sleep"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"101430","DOI":"10.1016\/j.smrv.2021.101430","article-title":"Association between diet and sleep quality: A systematic review","volume":"57","author":"Godos","year":"2021","journal-title":"Sleep Med. Rev."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"\u0160tefan, L., Radman, I., Podnar, H., and Vrgo\u010d, G. (2018). Sleep Duration and Sleep Quality Associated with Dietary Index in Free-Living Very Old Adults. Nutrients, 10.","DOI":"10.3390\/nu10111748"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Godos, J., Ferri, R., Caraci, F., Cosentino, F.I.I., Castellano, S., Shivappa, N., Hebert, J.R., Galvano, F., and Grosso, G. (2019). Dietary Inflammatory Index and Sleep Quality in Southern Italian Adults. Nutrients, 11.","DOI":"10.3390\/nu11061324"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Rostami, H., Parastouei, K., Samadi, M., Taghdir, M., and Eskandari, E. (2022). Adherence to the MIND dietary pattern and sleep quality, sleep related outcomes and mental health in male adults: A cross-sectional study. BMC Psychiatry, 22.","DOI":"10.1186\/s12888-022-03816-3"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Sejbuk, M., Miro\u0144czuk-Chodakowska, I., and Witkowska, A.M. (2022). Sleep quality: A narrative review on nutrition, stimulants, and physical activity as important factors. Nutrients, 14.","DOI":"10.3390\/nu14091912"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"938","DOI":"10.3945\/an.116.012336","article-title":"Effects of diet on sleep quality","volume":"7","author":"Mikic","year":"2016","journal-title":"Adv. Nutr. Int. Rev. J."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Binks, H., Vincent, G.E., Gupta, C., Irwin, C., and Khalesi, S. (2020). Effects of diet on sleep: A narrative review. Nutrients, 12.","DOI":"10.3390\/nu12040936"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.sleh.2017.07.013","article-title":"The epidemiology of sleep and obesity","volume":"3","author":"Ogilvie","year":"2018","journal-title":"Sleep Health"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Capurso, C., Bellanti, F., Buglio, A.L., and Vendemiale, G. (2019). The Mediterranean diet slows down the progression of aging and helps to prevent the onset of frailty: A narrative review. Nutrients, 12.","DOI":"10.3390\/nu12010035"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1111\/jgs.15251","article-title":"Adherence to Mediterranean Diet Reduces Incident Frailty Risk: Systematic Review and Meta-Analysis","volume":"66","author":"Kojima","year":"2018","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"101395","DOI":"10.1016\/j.arr.2021.101395","article-title":"Cross-sectional and longitudinal associations between adherence to Mediterranean diet with physical performance and cognitive function in older adults: A systematic review and meta-analysis","volume":"70","author":"Trichopoulou","year":"2021","journal-title":"Ageing Res. Rev."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1007\/s00394-018-1689-y","article-title":"Multiple approaches to associations of physical activity and adherence to the Mediterranean diet with all-cause mortality in older adults: The PREvenci\u00f3n con DIeta MEDiterr\u00e1nea study","volume":"58","author":"Subirana","year":"2019","journal-title":"Eur. J. Nutr."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s13668-020-00306-4","article-title":"Healthy lifestyle and cognition: Interaction between diet and physical activity","volume":"9","author":"Serra","year":"2020","journal-title":"Curr. Nutr. Rep."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1001\/jama.292.12.1433","article-title":"Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: The HALE Project","volume":"292","author":"Knoops","year":"2004","journal-title":"JAMA"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Conde-Pip\u00f3, J., Bouzas, C., Zurita-Ortega, F., Olea-Serrano, F., Tur, J.A., and Mariscal-Arcas, M. (2022). Adherence to a Mediterranean diet pattern, physical activity, and physical self-concept in Spanish older adults. Nutrients, 14.","DOI":"10.3390\/nu14122404"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1186\/s12966-021-01192-x","article-title":"Mobility and muscle strength trajectories in old age: The beneficial effect of Mediterranean diet in combination with physical activity and social support","volume":"18","author":"Saadeh","year":"2021","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Yu, T., Oguma, Y., Asakura, K., Takayama, M., Abe, Y., and Arai, Y. (2022). Relationship between dietary patterns and subjectively measured physical activity in Japanese individuals 85 years and older: A cross-sectional study. Nutrients, 14.","DOI":"10.3390\/nu14142924"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Jezewska-Zychowicz, M., G\u0119bski, J., Guzek, D., \u015awi\u0105tkowska, M., Stangierska, D., Plichta, M., and Wasilewska, M. (2018). The Associations between dietary patterns and sedentary behaviors in Polish adults (LifeStyle Study). Nutrients, 10.","DOI":"10.3390\/nu10081004"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.maturitas.2020.05.018","article-title":"The World Health Organization (WHO) approach to healthy ageing","volume":"139","author":"Rudnicka","year":"2020","journal-title":"Maturitas"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1080\/10408398.2019.1631752","article-title":"Adherence to the Mediterranean diet and healthy ageing: Current evidence, biological pathways, and future directions","volume":"60","author":"Critselis","year":"2020","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/1479-5868-8-121","article-title":"Barriers to physical activity in older adults in Germany: A cross-sectional study","volume":"8","author":"Moschny","year":"2011","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1089\/rej.2017.1921","article-title":"Nordic Walking Can Be Incorporated in the Exercise Prescription to In-crease Aerobic Capacity, Strength, and Quality of Life for Elderly: A Systematic Review and Meta-Analysis","volume":"21","author":"Bullo","year":"2018","journal-title":"Rejuvenation Res."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Granado-Casas, M., Martin, M., Mart\u00ednez-Alonso, M., Alcubierre, N., Hern\u00e1ndez, M., Alonso, N., Castelblanco, E., and Mauricio, D. (2020). The Mediterranean Diet is Associated with an Improved Quality of Life in Adults with Type 1 Diabetes. Nutrients, 12.","DOI":"10.3390\/nu12010131"},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Klonizakis, M., Grammatikopoulou, M.G., Theodoridis, X., Milner, M., Liu, Y., and Chourdakis, M. (2019). Effects of Long-Versus Short-Term Exposure to the Mediterranean Diet on Skin Microvascular Function and Quality of Life of Healthy Adults in Greece and the UK. Nutrients, 11.","DOI":"10.3390\/nu11102487"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"330","DOI":"10.5409\/wjcp.v11.i4.330","article-title":"Effects of adherence to the Mediterranean diet in children and adolescents with irritable bowel syndrome","volume":"11","author":"Maher","year":"2022","journal-title":"World J. Clin. Pediatr."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1093\/ajcn\/nqac106","article-title":"The effect of a Mediterranean diet on the symptoms of depression in young males (the \u201cAMMEND: A Mediterranean Diet in MEN with Depression\u201d study): A randomized controlled trial","volume":"116","author":"Bayes","year":"2022","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Santulli, G., Pascale, V., Finelli, R., Visco, V., Giannotti, R., Massari, A., Morisco, C., Ciccarelli, M., Illario, M., and Iaccarino, G. (2019). We are What We Eat: Impact of Food from Short Supply Chain on Metabolic Syndrome. J. Clin. Med., 8.","DOI":"10.3390\/jcm8122061"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Grace-Farfaglia, P. (2021). Self-Reported Diet and Health Outcomes of Participants of the CCSVI-Tracking Survey Study. Nutrients, 13.","DOI":"10.3390\/nu13061891"},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Zelicha, H., Kloting, N., Kaplan, A., Meir, A.Y., Rinott, E., Tsaban, G., Chassidim, Y., Bluher, M., Ceglarek, U., and Isermann, B. (2022). The effect of high-polyphenol Mediterranean diet on visceral adiposity: The DIRECT PLUS randomized controlled trial. BMC Med., 20.","DOI":"10.1186\/s12916-022-02525-8"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Dragun, R., Ve\u010dek, N.N., Marendi\u0107, M., Pribisali\u0107, A., \u0110ivi\u0107, G., Cena, A., Pola\u0161ek, O., and Kol\u010di\u0107, I. (2020). Have Lifestyle Habits and Psychological Well-Being Changed among Adolescents and Medical Students Due to COVID-19 Lockdown in Croatia?. Nutrients, 13.","DOI":"10.3390\/nu13010097"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"e005784","DOI":"10.1161\/JAHA.117.005784","article-title":"Gut-Derived Serum Lipopolysaccharide is Associated with Enhanced Risk of Major Adverse Cardiovascular Events in Atrial Fibrillation: Effect of Adherence to Mediterranean Diet","volume":"6","author":"Pastori","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Hidalgo-Liberona, N., Mero\u00f1o, T., Zamora-Ros, R., Rabassa, M., Semba, R., Toshiko, T., Bandinelli, S., Ferrucci, L., Andres-Lacueva, C., and Cherubini, A. (2021). Adherence to the Mediterranean diet assessed by a novel dietary biomarker score and mortality in older adults: The InCHIANTI cohort study. BMC Med., 19.","DOI":"10.1186\/s12916-021-02154-7"}],"container-title":["Antioxidants"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3921\/12\/5\/983\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:21:22Z","timestamp":1760124082000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3921\/12\/5\/983"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,22]]},"references-count":102,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["antiox12050983"],"URL":"https:\/\/doi.org\/10.3390\/antiox12050983","relation":{},"ISSN":["2076-3921"],"issn-type":[{"value":"2076-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,22]]}}}