The Relationship Between Socio-Demographic and Behavioral Characteristics and Adherence to the Mediterranean Diet: The UniFoodWaste Study Among University Students in Italy

Background: Adherence to the Mediterranean diet (MD) is associated with improved health outcomes, however limited evidence exists on the socio-demographic and behavioral determinants of MD adherence among university students, a population at risk of developing unhealthy habits during a critical life stage. Methods: A cross-sectional study was conducted among 2697 students (70.6% female) enrolled at a university in Northern Italy. MD adherence was measured using the validated Medi-Lite score. Multivariable logistic and linear regression models were used to identify socio-demographic and behavioral associations with high adherence to the MD (score ≥12). Principal component analysis was performed to explore multivariate patterns across dietary components and participant characteristics. Results: Overall, 25.6% of participants were classified as having high adherence to the MD. Higher adherence was more frequent among women, non-smokers, older students, and those living with their families. Students in health sciences showed greater adherence compared to those in other fields of study. Conversely, frequent users of mobile food ordering applications and smokers were less likely to adhere to the MD. These associations remained consistent after adjusting for age and sex. Conclusions: Adherence to the MD is suboptimal among university students and influenced by socio-demographic and behavioral factors. Targeted interventions should prioritize younger males, smokers, and convenience food users, while promoting sustainability and social support as facilitators of healthier dietary patterns.