Mediterranean diet adherence, social media use, and anxiety symptoms: an exploratory cross-sectional pilot survey

Anxiety and depressive symptoms are common, and dietary patterns have been proposed as a modifiable influence on them. The majority of the evidence rests on composite adherence indices such as the Mediterranean Diet Adherence Screener (MEDAS), which sums its components as if they all contributed equally and addresses depression more often than anxiety. Whether individual dietary components relate to symptoms independently of the composite index has rarely been tested, and rarely alongside social media use, a further exposure proposed to shape both diet and mood.

An anonymous online survey in English, Spanish, and Russian was completed by 115 adults aged 18 to 65 years with no previous diagnosis of mental illness, comprising a 14-item modified Mediterranean Diet Score (mMEDS), the Hospital Anxiety and Depression Scale (HADS), and questions on daily time spent on Instagram, Facebook, and Twitter/X. Four primary hypotheses tested the associations of olive oil intake and red and processed meat intake with each HADS subscale; all other comparisons were exploratory. The Benjamini-Hochberg correction was applied within each family. Effect sizes are reported with bootstrap 95% confidence intervals. The primary comparisons were additionally adjusted for sex, age band, and educational level.

All four primary estimates lay in the hypothesized direction. Higher olive oil intake was associated with lower anxiety scores (r = -0.249, 95% CI - 0.448 to -0.050, p = 0.021), and restricted red and processed meat intake was associated with lower anxiety and depression scores after adjustment (β = -2.12, p = 0.021; β = -1.62, p = 0.032). None survived correction for multiple testing. The mMEDS total did not appear to be related to either subscale (ρ = -0.045 and -0.141), while item-level associations differed in direction across food groups.

Component-level signals appeared where the composite showed none, which may indicate that summing adherence items can obscure relationships running in opposite directions between foods. For studies using MEDAS-type indices, testing components alongside the total score could be worthwhile. Olive oil quantity and red and processed meat intake may be candidates for confirmatory work.