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SYSTEMATIC REVIEW article

Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1501646
This article is part of the Research Topic Multidimensional Benefits of the Mediterranean Diet Across the Lifespan and Cultures View all articles

Gender and Sex Differences in Adherence to a Mediterranean Diet and Associated Factors during the COVID-19 Pandemic: A Systematic Review

Provisionally accepted
Gerrit Brandt Gerrit Brandt 1*Marie Pahlenkemper Marie Pahlenkemper 1Cristina Ballero Reque Cristina Ballero Reque 1Luisa Sabel Luisa Sabel 1Christopher Zaiser Christopher Zaiser 1Nora M. Laskowski Nora M. Laskowski 1Georgios Paslakis Georgios Paslakis 2
  • 1 Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bochum, Ruhr-Universität Bochum, Bochum, Germany
  • 2 University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr University Bochum, Bochum, North Rhine-Westphalia, Germany

The final, formatted version of the article will be published soon.

    The COVID-19 pandemic has led to significant lifestyle changes, including alterations in dietary habits and increases in sedentary behavior. The Mediterranean Diet (MD) has been associated with various health benefits, which are especially important given the health challenges posed by the pandemic. During the pandemic, an overall shift towards consuming more highly processed foods has been observed.This systematic review investigated adherence to MD during the COVID-19 pandemic, focusing on gender differences and factors influencing adherence to MD in the general public. The literature search focused on papers published between January 1, 2019, and July 8, 2024, across various databases such as Web of Science (WOS), Scopus, PubMed MEDLINE, and PsycINFO.Results: Following the PRISMA guidelines, this search identified 14,347 references, of which 5,734 were duplicates. After a thorough multi-level screening process, 29 studies, encompassing 55,242 participants, met the inclusion criteria. While seven studies reported that men adhered to a MD more than women during the COVID-19 pandemic, twelve studies also indicated that women had higher adherence to a MD compared to men. Nine studies, however, found no significant gender differences in MD adherence. Additionally, older age, higher education levels, higher socioeconomic status, and increased physical activity were linked to greater adherence to a MD in the pandemic context.Gender-specific differences in dietary behavior are influenced by factors such as socioeconomic status, gender roles, and pandemic phases as well as biases in sample composition and methodological weaknesses. Significant gaps in the evidence, particularly concerning sexual and gender minorities, are highlighted.

    Keywords: COVID-19, mediterranean diet, gender differences, Sexual and gender minorities, Health care inequities

    Received: 25 Sep 2024; Accepted: 20 Dec 2024.

    Copyright: © 2024 Brandt, Pahlenkemper, Ballero Reque, Sabel, Zaiser, Laskowski and Paslakis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Gerrit Brandt, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bochum, Ruhr-Universität Bochum, Bochum, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.