Mediterranean diet adherence and its associations with hedonic hunger, diet quality, and obesity in Turkish adults: a cross-sectional study

The Mediterranean diet is a mainly plant-based dietary pattern associated with reduced risk of chronic diseases and improved overall health. This study examined the associations between Mediterranean diet adherence, hedonic hunger, diet quality, and anthropometric measures among adults attending a diet clinic in Istanbul, Türkiye. In this cross-sectional study, participants were recruited consecutively using convenience sampling from a municipal dietitian polyclinic. Anthropometry, diet quality (Healthy Eating Index-2020), and hedonic hunger (Power of Food Scale) were assessed. Adherence was measured using the 14-item MEDAS. Statistical analyses included t-tests, correlations, and logistic regression. Higher adherence was significantly associated with older age, better diet quality, female gender, and normal weight (p < 0.05). Participants with lower adherence had higher hedonic hunger and lower HEI scores; however, hedonic hunger was not an independent predictor in multivariable models. Mediterranean diet adherence was associated with age, gender, diet quality, and weight status. These findings support the development of tailored strategies to promote healthy eating behaviors. Higher Mediterranean diet adherence was associated with older age and better diet quality. Females showed greater adherence to the Mediterranean diet compared with males. Overweight/obese individuals exhibited lower adherence to the Mediterranean diet. Higher hedonic hunger was linked to poorer diet quality but did not independently predict Mediterranean diet adherence. Findings support the need for tailored dietary strategies based on demographic and behavioral factors.