Background/Objectives: Despite growing recognition of sex as a biological variable that may influence responses to dietary interventions, many studies still pool data from women and men. Moreover, sex-stratified changes in eating behaviors and mental health following dietary interventions remain underexplored. This study aimed to describe sex-stratified changes in adiposity, eating behaviors, and mental health outcomes in men and women following a hypocaloric Mediterranean-style diet. Methods: A 12-week exploratory prospective longitudinal study was conducted in nineteen women and nine men with overweight or obesity. Participants attended two clinical visits (baseline and week 12), where adiposity parameters (body mass index BMI, body fat, waist and hip circumference), diet quality, eating behaviors, mental health parameters (well-being, perceived stress, flourishing, anxiety and depression) and biochemical parameters were assessed. Analyses were stratified by sex to evaluate changes from baseline to week 12, and repeated-measures correlations were used to explore within-individual associations between concurrent changes in outcomes. Results: Women and men improved significantly in adiposity and diet quality. Uncontrolled eating decreased and cognitive restraint increased in both sexes (p < 0.05). In men, emotional eating decreased (p = 0.011), and mental health improved, with higher well-being (p = 0.043) and flourishing (p = 0.027), and lower stress (p = 0.021), anxiety (p = 0.017), and depression (p = 0.027). Also, in men, anxiety was positively correlated with body fat percentage (p = 0.012) and BMI (p = 0.002) and inversely correlated with diet quality (p = 0.013). Uncontrolled eating was positively associated with BMI in men (p = 0.022) and women (p = 0.006), and cognitive restraint was positively associated with diet quality (both p = 0.003). Conclusions: Women and men achieved similar improvements in adiposity, whereas improvements in mental health variables and emotional eating were observed only in men. These preliminary findings suggest that dietary interventions may benefit from considering sex-sensitive and multidisciplinary approaches, especially psychological support and stress-management components, may be required for women. However, these observations should be confirmed in adequately powered studies.
Diez-Hernández et al. (Thu,) studied this question.
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