Mediterranean Diet Adherence and Cardiometabolic, Inflammatory, Hormonal, Body Composition, and Behavioral Health...

Background: The Mediterranean Diet (MD) is linked to better cardiometabolic and inflammatory health, but its relationships with appetite-related hormones, body composition, and behavioral health remain unclear in physically active young adults from understudied Arab settings. Objective: To examine associations between MD adherence and cardiometabolic, inflammatory, hormonal, body-composition, and behavioral-health profiles, including sleep quality, physical activity, perceived recovery, and health-related quality of life (HRQoL), among physically active young adults in Jordan. Methods: Eighty adults aged 18-35 years (44 men and 36 women) were recruited from fitness centers and campuses in Amman. MD adherence was assessed using the validated Moroccan Arabic version of the 14-item Mediterranean Diet Adherence Screener (MEDAS; adherent ≥ 8). Fasting lipid profile, C-reactive protein (CRP), interleukin-6 (IL-6), leptin, and ghrelin were measured using enzymatic and ELISA methods. Anthropometric and body-composition measures were assessed using stadiometry and multifrequency bioelectrical impedance analysis. Sleep quality, physical activity, perceived recovery, and HRQoL were assessed using validated questionnaires. Results: 60% of participants were non-adherent to the MD. In exploratory analyses, non-adherence was associated with higher odds of abnormal triglycerides (adjusted OR = 9.17, 95% CI: 2.08-40.38). After additional adjustment for percent body fat, the association with abnormal CRP remained significant (adjusted OR = 5.39, 95% CI: 1.34-21.61), whereas the association with abnormal leptin was attenuated and no longer statistically significant (adjusted OR = 3.47, 95% CI: 0.75-16.07). The leptin finding was sensitive to adjustment for adiposity, while residual confounding remains possible for the CRP association. Non-adherent participants had higher BMI, body fat mass, and percent body fat, and lower physical HRQoL. No statistically significant associations were detected for ghrelin, resting blood pressure, or resting heart rate. The IL-6 findings were inconclusive because 62.5% of measurements were below the assay detection limit. Conclusions: Greater MD adherence was associated with a more favorable cardiometabolic and body-composition profile in this exploratory cross-sectional sample. These hypothesis-generating findings highlight the importance of considering dietary quality alongside physical activity and require confirmation in larger prospective studies with more comprehensive confounder adjustment.