Evaluation of Sustainable Food Choices and Adherence to the Mediterranean Diet in Turkish Adults

Abstract

Aim: The growing global population and unsustainable dietary patterns have intensified environmental degradation and public health challenges. This study aimed to examine the relationship between sustainable food choices and adherence to the Mediterranean Diet (MD) among Turkish adults. Individuals and Methods: A cross-sectional survey was conducted with 320 participants aged 19–64 years using validated tools including the Food Choice Questionnaire (FCQ), Sustainable Food Choice Questionnaire (SUS-FCQ), and the Mediterranean Diet Adherence Screener (MEDAS). Anthropometric data and 24-hour dietary recalls were also collected. Results: Results showed that female participants had significantly higher adherence to the Mediterranean Diet (MEDAS score: 6.26 ± 2.02) than men (5.12 ± 2.12; p

Keywords

• Eating Behaviours

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References

1. 1. The State of Food and Agriculture 2021. FAO; 2021.
2. 2. Willett W, Rockström J, Loken B, Springmann M, Lang T, Vermeulen S, et al. Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems. The Lancet. 2019;393(10170):447–92.
3. 3. Poore J, Nemecek T. Reducing food’s environmental impacts through producers and consumers. Science. 2018;360(6392):987–92.
4. 4. Clark MA, Domingo NGG, Colgan K, Thakrar SK, Tilman D, Lynch J, et al. Global food system emissions could preclude achieving the 1.5° and 2°C climate change targets. Science. 2020;370(6517):705–8.
5. 5. Monteiro CA, Moubarac JC, Levy RB, Canella DS, Da Costa Louzada ML, Cannon G. Household availability of ultra-processed foods and obesity in nineteen European countries. Public Health Nutr. 2018;21(1):18–26.
6. 6. Afshin A, Sur PJ, Fay KA, Cornaby L, Ferrara G, Salama JS, et al. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet.2019;393(10184):1958–72.
7. 7. Tilman D, Clark M. Global diets link environmental sustainability and human health. Nature. 2014;515(7528):518–22.
8. 8. Springmann M, Godfray HCJ, Rayner M, Scarborough P. Analysis and valuation of the health and climate change cobenefits of dietary change. Proc Natl Acad Sci USA. 2016;113(15):4146–51.
9. 9. Garnett T, Appleby MC, Balmford A, Bateman IJ, Benton TG, Bloomer P, et al. What is a sustainable healthy diet? A discussion paper. Food Climate Research Network. 2014.
10. 10. Fischer CGonzalez, Garnett Tara. Plates, pyramids, and planets : developments in national healthy and sustainable dietary guidelines : a state of play assessment. Food and Agriculture Organization of the United Nations; Food Climate Research Network, University of Oxford; 2016. 70 p.
11. 11. Teixeira B, Afonso C, Rodrigues S, Oliveira A. Healthy and Sustainable Dietary Patterns in Children and Adolescents: A Systematic Review. Adv Nutr. 2022;13(4):1144–85.
12. 12. Macdiarmid JI, Kyle J, Horgan GW, Loe J, Fyfe C, Johnstone A, et al. Sustainable diets for the future: can we contribute to reducing greenhouse gas emissions by eating a healthy diet? Am J Clin Nutr. 2012;96(3):632–9.
13. 13. Dernini S, Berry EM. Mediterranean Diet: From a Healthy Diet to a Sustainable Dietary Pattern. Front Nutr. 2015;2:15.
14. 14. Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health status: An updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr. 2013:6;17(12):2769–82.
15. 15. Dinu M, Pagliai G, Casini A, Sofi F. Mediterranean diet and multiple health outcomes: An umbrella review of meta-analyses of observational studies and randomised trials. Eur J Clin Nutr. 2018;72(1):30–43.
16. 16. Lorca-Camara V, Bosque-Prous M, Bes-Rastrollo M, O’Callaghan-Gordo C, Bach-Faig A. Environmental and Health Sustainability of the Mediterranean Diet: A Systematic Review. Adv Nutr. 2024;15(12).
17. 17. Donini LM, Dernini S, Lairon D, Serra-Majem L, Amiot MJ, del Balzo V, et al. A Consensus Proposal for Nutritional Indicators to Assess the Sustainability of a Healthy Diet: The Mediterranean Diet as a Case Study. Front Nutr. 2016;3:37.
18. 18. Harrison MR, Palma G, Buendia T, Bueno-Tarodo M, Quell D, Hachem F. A Scoping Review of Indicators for Sustainable Healthy Diets. Front Sustain Food Syst. 2022;5:822263.
19. 19. Serra-Majem L, Ribas L, Ngo J, Ortega RM, García A, Pérez-Rodrigo C, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. 2021.
20. 20. Association WM. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA. 2013;310(20):2191–4.
21. 21. Steptoe A, Pollard TM, Wardle J. Development of a Measure of the Motives Underlying the Selection of Food: the Food Choice Questionnaire. Appetite. 1995;25(3):267–84.
22. 22. Dikmen D, Inan-Eroğlu E, Göktaş Z, Barut-Uyar B, Karabulut E. Validation of a Turkish version of the food choice questionnaire. Food Qual Prefer. 2016;52:81–6.
23. 23. Verain MCD, Dagevos H, Antonides G. Sustainable food consumption. Product choice or curtailment? Appetite. 2015;91:375–84.
24. 24. Aksoy Canyolu B, Martini D, Şen N. Determining Sustainable Food Choice Motives: Validity and Reliability of the Sustainable Food Choice Questionnaire (SUS-FCQ) in Turkish Adults. Sustainability (Switzerland). 2024;16(9):3519.
25. 25. Fatma E, Pehlivanoğlu Ö, Balcıoğlu H, Ünlüoğlu İ, İl B, Müdürlüğü S, et al. Akdeniz Diyeti Bağlılık Ölçeği’nin Türkçe’ye Uyarlanması Geçerlilik ve Güvenilirliği. OJM. 2020;42(2):160–4.
26. 26. Rakicioglu N, Acar Tek N, Ayaz A, Pekcan G. Yemek ve Besin Fotoğraf Kataloğu Ölçü ve Miktarlar. Vol. 8. Ankara; 2021.
27. 27. Beyhan Y, Bilici S, Kızıl M. Toplu Beslenme Sistemleri (Toplu Tüketin Yerleri) İçin Ulusal Menü Planlama ve Uygulama Rehberi. 1st ed. Vol. 1. 2020.
28. 28. Body mass index (BMI) [Internet]. [cited 2026 Feb 9]. Available from: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index
29. 29. WHO. Waist Circumference and Waist–Hip Ratio. WHO Expert. 2011;64(1):2–5.
30. 30. Álvarez-Álvarez L, Rubín-García M, Vitelli-Storelli F, García S, Bouzas C, Martínez-González MÁ, et al. Effect of a nutritional intervention based on an energy-reduced Mediterranean diet on environmental impact. Sci. Total Environ. 2024;928.
31. 31. Irgat Sİ, Bakırhan H, Bakırhan YE, Sonkaya Zİ. Determining food choice motivations in Turkish adults: sustainable and healthy eating behavior, ecological footprint awareness, and food insecurity perspective. BMC Public Health. 2024;24(1):1–11.
32. 32. Şahin Bayram S, Kızıltan G. The Correlation between Knowledge of Food Sustainability, Sustainable Eating Attitudes, and Adherence to the Mediterranean Diet among Blue- and White-Collar Employees. Sustainability. 2024;16(19):8644.
33. 33. Dernini S, Berry EM, Serra-Majem L, La Vecchia C, Capone R, Medina FX, et al. Med Diet 4.0: The Mediterranean diet with four sustainable benefits. Public Health Nutr. 2017;20(7):1322–30.
34. 34. Vargas AM, de Moura AP, Deliza R, Cunha LM. The role of local seasonal foods in enhancing sustainable food consumption: A systematic literature review. Foods. 2021;10(9).
35. 35. Bai Y, Martinez EM, Yamanaka M, Rissanen M, Herforth A, Masters WA. Climate impacts and monetary costs of healthy diets worldwide. 2025.
36. 36. Lombardo M. Assessing Gender and Age Differences in the Adoption of Sustainable Diets: Insights from an Intervention of the Mediterranean Diet. Sustainability. 2025;17(5):1962.

Cite this publication

@article{ozkaya2025evaluation,
  author = {Ozkaya, Buse and Fisuno{\u{g}}lu, Mehmet},
  title = {{Evaluation of Sustainable Food Choices and Adherence to the Mediterranean Diet in Turkish Adults}},
  journal = {Current Research in Nutritional Sciences and Dietetics Journal},
  volume = {1},
  number = {1},
  pages = {31--43},
  publisher = {Hacettepe {\"U}niversitesi},
  year = {2025},
  month = {10},
  url = {https://hacettepe.hbtech.com.tr/en/publication/evaluation-of-sustainable-food-choices-and-adherence-to-the-mediterranean-diet-in-turkish-adults},
  language = {en},
  keywords = {Eating Behaviours},
  abstract = {Aim: The growing global population and unsustainable dietary patterns have intensified environmental degradation and public health challenges. This study aimed to examine the relationship between sustainable food choices and adherence to the Mediterranean Diet (MD) among Turkish adults. Individuals and Methods: A cross-sectional survey was conducted with 320 participants aged 19--64 years using validated tools including the Food Choice Questionnaire (FCQ), Sustainable Food Choice Questionnaire (SUS-FCQ), and the Mediterranean Diet Adherence Screener (MEDAS). Anthropometric data and 24-hour dietary recalls were also collected. Results: Results showed that female participants had significantly higher adherence to the Mediterranean Diet (MEDAS score: 6.26 ± 2.02) than men (5.12 ± 2.12; p},
  affiliation = {HACETTEPE UNIVERSITY and HACETTEPE UNIVERSITY}
}

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T2  - Current Research in Nutritional Sciences and Dietetics Journal
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PY  - 2025
DA  - 2025/10/01/
SP  - 31
EP  - 43
PB  - Hacettepe Üniversitesi
UR  - https://hacettepe.hbtech.com.tr/en/publication/evaluation-of-sustainable-food-choices-and-adherence-to-the-mediterranean-diet-in-turkish-adults
AB  - Aim: The growing global population and unsustainable dietary patterns have intensified environmental degradation and public health challenges. This study aimed to examine the relationship between sustainable food choices and adherence to the Mediterranean Diet (MD) among Turkish adults. Individuals and Methods: A cross-sectional survey was conducted with 320 participants aged 19–64 years using validated tools including the Food Choice Questionnaire (FCQ), Sustainable Food Choice Questionnaire (SUS-FCQ), and the Mediterranean Diet Adherence Screener (MEDAS). Anthropometric data and 24-hour dietary recalls were also collected. Results: Results showed that female participants had significantly higher adherence to the Mediterranean Diet (MEDAS score: 6.26 ± 2.02) than men (5.12 ± 2.12; p
KW  - Eating Behaviours
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AD  - HACETTEPE UNIVERSITY
AD  - HACETTEPE UNIVERSITY
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