Factors associated with adherence to Mediterranean diet among Saudi non-diabetic patients attending primary health care centers: A cross-sectional study.

Objectives: To investigate the degree and factors responsible for adherence to a Mediterranean diet among non-diabetic patients attending primary health care centres (PHCCs).

Methods: A cross-sectional study was conducted in Jeddah PHCCs using a validated self-administered questionnaire which assessed adherence levels to 14 dietary aspects related to the Mediterranean diet. The questionnaire enabled calculation of an adherence score (0-14), where inadequate adherence was assumed for scores ≤7. Factors of adherence included general socio-demographic characteristics, medical history, lifestyle, and cardiovascular risk factors such as body mass index, waist-to-hip ratio, blood pressure, and fasting and 1-h postprandial blood glucose levels.

Results: Of the 265 participants (50.6% males), inadequate adherence was reported in 74.3%. Adherence scores were higher in married participants than in unmarried ones (6.68 ± 1.74 vs. 6.24 ± 1.79, p = 0.04), as well as in those who engaged in regular physical activity vs. those who did not (6.79 ± 1.90 vs. 6.30 ± 1.63, p = 0.02). Furthermore, Mediterranean diet adherence increased with age (B = 0.02, r = 0.133;  < 0.001). Interestingly, adherence scores were not associated with major cardiovascular risk factors except for a significantly higher diastolic blood pressure in participants with adequate as opposed to low adherence (77.96 ± 12.20 vs. 74.01 ± 12.24, respectively,  = 0.022).

Conclusion: One out of 4 non-diabetic patients attending PHCCs exhibited good adherence to a Mediterranean diet without considerable association with cardiovascular risk factors. Further studies are recommended to investigate awareness and knowledge regarding the Mediterranean diet among Saudi populations. Subsequently, awareness programs could be tailored accordingly.