Mediterranean Diet Adherence and Screening Indicators of Gambling-Related Problems in a Sample of Young Adults: An...

Background/Objectives: Gambling disorder is recognized as a behavioral addiction, and gambling-related problems represent an important public health concern among young adults. However, evidence regarding their association with overall diet quality, particularly adherence to the Mediterranean diet (MedDiet), remains scarce. This exploratory secondary analysis examined whether screening indicators of gambling-related problems were associated with MedDiet adherence in young adults. Methods: We conducted a cross-sectional analysis of 496 participants aged 18-34 years from the EVA-Adic study. MedDiet adherence was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14). Gambling-related indicators were assessed using the Short Pathological Gambling Questionnaire (CBJP), the Lie/Bet Questionnaire, and their six individual items. Independent multiple linear regression models were fitted for each indicator. The fully adjusted Model 2 included age, sex, alcohol consumption, sleep quality, sitting time, marital status, and educational level. Given the secondary nature of the analysis, the absence of an a priori sample-size calculation for the present research question, and the limited number of participants with positive gambling-related indicators, the analyses were considered exploratory and hypothesis-generating rather than confirmatory. Results: The mean age was 26.60 ± 4.41 years; 276 participants (55.6%) were women, and 157 (31.7%) had high MedDiet adherence. In the fully adjusted Model 2, feeling guilty about gambling (Q2) was nominally associated with a lower MEDAS-14 score (B = -1.10; 95% CI, -1.97 to -0.22; p = 0.015). However, this association did not remain statistically significant after Benjamini-Hochberg correction (q = 0.116), and none of the eight primary Model 2 associations met the FDR-adjusted significance threshold. Conclusions: Several gambling-related screening indicators showed nominal inverse associations with MedDiet adherence, with gambling-related guilt showing the most consistent estimate across sensitivity analyses. However, no association remained statistically significant in the fully adjusted model after correction for multiple testing, and formal interaction analyses provided no robust evidence of effect modification by sex. Given the small number of positive screens and the cross-sectional design, these findings should be considered exploratory and hypothesis-generating.