Mediterranean diet adherence and nutritional literacy: an observational cross-sectional study of the reality of university students in a COVID-19 pandemic context.

Aim: To evaluate the adherence to the Mediterranean diet (MD) and the level of nutritional literacy (NL) among university students from different academic fields of study, within the context of the COVID-19 pandemic. Methods: A total of 1114 first-year undergraduate students at the University of Lisbon, Portugal, were included in this study. A self-administered online questionnaire was applied that included questions regarding sociodemographic information, the MD measured by the PREDIMED questionnaire (PREvención con DIeta MEDiterránea) and NL assessed using the Newest Vital Sign questionnaire. Results: The average PREDIMED score revealed a low adherence (6.79±2.14 points) to the MD. Notably, students in the Social Sciences and Humanities academic fields showed the highest level of adherence (U=21 071; p<0.05). Within the Health field, there was a greater prevalence of dietary behaviours aligned with the MD, contributing to higher overall adherence scores. Furthermore, 84.1% of the participants demonstrated adequate NL. Interestingly, students in the Exact Sciences and Engineering field demonstrated the highest levels of NL (5.07±1.19), particularly in questions involving mathematical reasoning. Conclusions: Our findings suggest that university students in Lisbon do not follow a MD and are far from the recommendations of this dietary pattern. While most participants showed adequate NL, it is essential to highlight the link between knowledge and application to daily practice. Despite positive literacy levels, there remains a deficit in translating this knowledge into correct dietary practices.