The impact of perceived stress on adherence to the Mediterranean diet, eating behaviour and quality of life in a group of Italian adolescents

This cross-sectional study assessed perceived stress levels in a group of Italian adolescents andexamined potential relationships with diet quality, eating behaviours and health-related quality oflife (HR-QoL). A total of 1627 adolescents (52% male, median age 16 years) completed a surveyincluding the Perceived Stress Scale (PSS-10), the KIDMED for Mediterranean diet (MD) adherence,the KIDSCREEN-10 for HR-QoL, and the Dutch Eating Behaviour Questionnaire for Children. Only16.5% reported low stress levels, while 21.8% exhibited high perceived stress. Perceived stress wasinversely associated with MD adherence (β = −0.06; p < 0.0001) and HR-QoL (β = −0.45; p < 0.0001),and positively associated with dysregulated eating behaviours, including emotional eating(β = 0.02; p value < 0.0001), external eating (β = 0.01; p < 0.0001) and restrained eating (β = 0.01;p < 0.0001). These results reinforce the importance of adolescent mental health and the need forstrategies aimed at reducing stress and promoting balanced dietary patterns as MD.