Adherence to Mediterranean Diet and its Effect on Obesity among Healthy Saudi Adults

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Obesity, Mediterranean diet, nutrition, healthy, macronutrient, BMI, physical activity


Obesity is considered as a global burden disease and its prevalence is increased worldwide. Physical inactivity and excessive calorie consumption are associated with increased obesity risk. Therefore, strategies for losing weight involved increased physical activity and reduced calorie and macronutrient diet. Also, recent studies showed that higher adherence to Mediterranean diet is associated with lower risk of obesity. This study investigated association between adherence to Mediterranean diet and obesity among healthy Saudi adults. The sample size of 127 participants (50 men and 77 women) from Jeddah city with mean age 38.2 ± 13.3 years and Body Mass Index (BMI) 26.5 ± 5.2. Adherence to Mediterranean Diet (Med-diet) was measured using a validated 14-item questionnaire of Mediterranean diet adherence. Independent t-test was used to examine significant differences between groups. Results showed that lower adherence to Med-diet among the participants was with mean 5.7 ± 1.9. The analysis of 14-item Med-diet questionnaire showed that around 45% of participants used olive oil in cooking and only 35% of participants consumed more than 4 tablespoons of olive oil daily. The consumption from vegetable, fruit and fish was below recommendation from Med-diet, however, the consumption of red meat was high. Individuals with great adherence to Med-diet had lower BMI, however, values were not statistically significant compared to lower adherence to Med-diet. In conclusion, study showed lower adherence to Med-diet among Saudis and adherence to Med-diet was not associated with reduced risk of obesity.


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How to Cite

Shatwan, M. M., & Al-Zahrani, M. H. (2020). Adherence to Mediterranean Diet and its Effect on Obesity among Healthy Saudi Adults. The Indian Journal of Nutrition and Dietetics, 57(1), 1–9.



Original Articles
Received 2019-08-04
Accepted 2019-11-01
Published 2020-01-03



Finkelstein, E.A., Khavjou, O.A., Thompson, H., Trogdon, J.G., Pan, L., Sherry, B. and Dietz, W. Obesity and severe obesity forecasts through 2030. Am. J. Prev. Med., 2012, 42, 563-570.

Fruh, S.M. Obesity: Risk factors, complications and strategies for sustainable long-term weight management. J. Am. Assoc. Nurse. Pract., 2017, 29, 3-14.

Azzeh, F.S., Bukhari, H.M., Header, E.A., Ghabashi, M.A., Al-Mashi, S.S. and Noorwali, N.M. Trends in overweight or obesity and other anthropometric indices in adults aged 18-60 years in Western Saudi Arabia. Ann. Saudi Med., 2017, 37, 106-113.

Al-Ghamdi, S., Shubair, M.M., Aldiab, A., Al-Zahrani, J.M., Aldossari, K.K., Househ, M., Nooruddin, S., Razzak, H.A. and El-Metwally, A. Prevalence of overweight and obesity based on the body mass index; a cross-sectional study in Alkharj. Saudi Arabia. Lipids Health Dis., 2018, 17, 134.

Stafford, M., Cummins, S., Ellaway, A., Sacker, A., Wiggins, R.D. and Macintyre, S. Pathways to obesity: identifying local, modifiable determinants of physical activity and diet. Soc. Sci. Med., 2007, 65, 1882-1897.

Willemijn A. van Gemert, Petra H. Peeters, Anne M. May, Adriaan J. H. Doornbos Sjoerd G. Elias, Job van der Palen, Wouter Veldhuis, Maaike Stapper, Jantine A. Schuit and Evelyn M. Monninkhof. Effect of diet with or without exercise on abdominal fat in postmenopausal women - a randomised trial. BMC Public Health, 2019, 19, 174.

Dombrowski, S.U., Knittle, K., Avenell, A., Araújo-Soares, V. and Sniehotta, F.F. Long term maintenance of weight loss with non-surgical interventions in obese adults: Systematic review and meta-analyses of randomised controlled trials. BMJ., 2014, 348, 2646.

Bach-Faig, A., Berry, E.M., Lairon, D., Reguant, J., Trichopoulou, A., Dernini, S., Medina, F.X., Battino, M., Belahsen, R., Miranda, G. and Serra-Majem, L. Mediterranean diet pyramid today, science and cultural updates. Public Health Nutr., 2011, 14, 2274-2284.

D'Innocenzo, S., Biagi, C. and Lanari, M. Obesity and the Mediterranean diet: A review of evidence of the role and sustainability of the Mediterranean diet. Nutr., 2019, 11.

Agnoli, C., Sieri, S., Ricceri, F., Giraudo, M.T., Masala, G., Assedi, M., Panico, S., Mattiello, A., Tumino, R., Giurdanella, M.C. and Krogh, V. Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort. Nutr. Diabet., 2018, 8, 22.

Beunza, J.J., Toledo, E., Hu, F.B., Bes-Rastrollo, M., Serrano-Martí­nez, M., Sánchez-Villegas, A., Martí­nez, J.A. and Martí­nez-González, M.A. Adherence to the Mediterranean diet, long-term weight change, and incident overweight or obesity: The Seguimiento Universidad de Navarra (SUN) cohort. Am. J. Clin. Nutr., 2010, 92, 1484-1493.

Aljabri, M., Al-Raddadi, R., Bahijri, S.M., Al Ahmadi, J., Ajabnoor, G. and Jambi, H.A. Factors associated with adherence to Mediterranean diet among Saudi non-diabetic patients attending primary health care centers: A cross-sectional study. J. Taibah University Med. Sci., 2019, 14, 139-148. 13.Bendall, C.L., Mayr, H.L., Opie, R.S., Bes-Rastrollo, M., Itsiopoulos, C. and Thomas, C.J. Central obesity and the Mediterranean diet: A systematic review of intervention trials. Crit. Rev. Fd. Sci. Nutr., 2018, 58, 3070-3084.

Huo, R., Du, T., Xu, Y., Xu, W., Chen, X., Sun, K. and Yu, X. Effects of Mediterranean-style diet on glycemic control, weight loss and cardiovascular risk factors among type 2 diabetes individuals: A meta-analysis. Eur. J. Clin. Nutr., 2015, 69, 1200-1208.

Estruch, R., Martí­nez-González, M.A., Corella, D., Salas-Salvadó, J., Fitó, M., Chiva-Blanch, G., Fiol, M., Gómez-Gracia, E., Arós, F., Lapetra, J., Serra-Majem, L., Pintó, X., Buil-Cosiales, P., Sorlí­, J.V., Muñoz, M.A., Basora-Gallisá, J., Lamuela-Raventós, R.M., Serra-Mir, M. and Ros, E. Effect of a high-fat Mediterranean diet on body weight and waist circumference: a prespecified secondary outcomes analysis of the PREDIMED randomised controlled trial. Lancet Diabet. Endocrinol., 2019, 7, 6-17.

Martinez-Gonzalez, M.A., Garcí­a-Arellano, A., Toledo, E., Salas-Salvadó, J., Buil-Cosiales, P., Corella, D., Covas, M.I., Schröder, H., Arós, F., Gómez-Gracia, E., Fiol, M., Ruiz-Gutiérrez, V., Lapetra, J., Lamuela-Raventos, R.M., Serra-Majem, L., Pintó, X., Muñoz, M.A., Wärnberg, J., Ros, E. and Estruch, R. A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: The PREDIMED trial. PLoS One, 2012, 7, 43134.

Stefler, D., Malyutina, S., Kubinova, R., Pajak, A., Peasey, A., Pikhart, H., Brunner, E.J. and Bobak, M. Mediterranean diet score and total and cardiovascular mortality in Eastern Europe: the HAPIEE study. Eur. J. Nutr., 2017, 56, 421-429.

Adam, A., Osama, S. and Muhammad, K.I. Nutrition and food consumption patterns in the Kingdom of Saudi Arabia. Pak. J. Nutr., 2014, 13, 181.

Moradi-Lakeh, M., El Bcheraoui, C., Afshin, A., Daoud, F., AlMazroa, M.A., Al Saeedi, M., Basulaiman, M., Memish, Z.A., Al Rabeeah, A.A. and Mokdad, A.H. Diet in Saudi Arabia: Findings from a nationally representative survey. Public Health Nutr., 2017, 20, 1075-1081.

Al-Otaibi, H.H. The pattern of fruit and vegetable consumption among Saudi university students. Glob. J. Health Sci., 2013, 6, 155-162.

Mokdad, A., Basulaiman, M., AlMazroa, M., Tuffaha, M., Daoud, F., Wilson, S., Al Saeedi, M., Alanazi, F., Ibrahim, M., Ahmed, E., Hussain, S., Salloum, RM., Abid, O., Al-Dossary, M., Memish, Z., Al Rabeeah, A. and Mokdad, A. Fruit and vegetable consumption among adults in Saudi Arabia, Nutrition and Dietary Supplements, 2013, 7, 41-49.

Burger, J., Gochfeld, M., Batang, Z., Alikunhi, N., Al-Jahdali, R., Al-Jebreen, D., Aziz, M.A. and Al-Suwailem, A. Fish consumption behavior and rates in native and non-native people in Saudi Arabia. Environ. Res., 2014, 133, 141-148

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