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 and examined potential relationships with diet quality, eating behaviours and health-related quality of life (HR-QoL). A total of 1627 adolescents (52% male, median age 16 years) completed a survey including 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. Only 16.5% reported low stress levels, while 21.8% exhibited high perceived stress. Perceived stress was inversely 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 for strategies aimed at reducing stress and promoting balanced dietary patterns as MD.