Mediterranean Diet, Sleep Quality, Perceived Stress, and Physical Activity: A Pilot Study Among School Teachers

<b>Background:</b> Lifestyle behaviours, such as dietary patterns, sleep quality, perceived stress, and physical activity, are closely interconnected and play a critical role in maintaining health and well-being. Among school teachers, a profession marked by high psychosocial demands, the interplay between these factors warrants further exploration. <b>Objective:</b> This pilot study aimed to explore the associations between adherence to the Mediterranean Diet (MD), sleep quality, perceived stress, and physical activity levels among Portuguese primary and secondary school teachers. <b>Methods:</b> A cross-sectional study was conducted between April and December 2023. Participants completed validated self-reported instruments, including the MD Adherence Screener (MEDAS), the Pittsburgh Sleep Quality Index (PSQI), the Perceived Stress Scale (PSS-10), and the short form of the International Physical Activity Questionnaire (IPAQ-SF). Correlational analyses and multivariable linear regression models were applied to explore the relationships among the variables. <b>Results:</b> Among the 50 teachers, 32% demonstrated high adherence to the MD, 60% reported good sleep quality, 62% experienced moderate stress, and 44% engaged in high physical activity. Women were more likely to adhere strongly to the MD (<i>p</i> = 0.012). Higher MD adherence was positively associated with physical activity (ρ = 0.343; <i>p</i> = 0.015). A positive correlation was observed between perceived stress and poorer sleep quality (ρ = 0.346, <i>p</i> = 0.014), and a negative correlation between perceived stress and physical activity levels (ρ = -0.297, <i>p</i> = 0.036). Despite reporting good sleep quality, these participants had higher perceived stress scores (<i>p</i> = 0.015). In adjusted models, sleep quality was the only significant predictor of perceived stress (B = 0.708; <i>p</i> = 0.003), and vice versa (B = 0.267; <i>p</i> = 0.003), suggesting a bidirectional relationship. <b>Conclusions:</b> The findings highlight the interrelation between dietary pattern, sleep stress, and physical activity in a professional group vulnerable to lifestyle-related health challenges. Although the sample size limits generalisability, this study provides preliminary evidence supporting the need for integrated health promotion strategies targeting stress reduction and lifestyle optimisation among educators.