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May 14, 2026Dietetics0 citationsOpen Access

Exploring the Relationship Between Nutrition Literacy and Mediterranean Diet Adherence in Type 2 Diabetes: A Cross-Sectional Study

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GTGeorgia TsakalouKGKalliopi Georgakouli

Key Points

  • This study investigates the relationship between nutrition literacy and adherence to the Mediterranean Diet in patients with Type 2 Diabetes Mellitus.
  • Cross-sectional design involving 81 patients from two Greek hospitals.
  • Participants completed NLS-GR and 14-MEDAS questionnaires to assess nutrition literacy and Mediterranean diet adherence, respectively.
  • Socio-demographic and clinical data were collected through interviews and medical records.
  • 71.6% of participants had moderate adherence to the Mediterranean Diet with a median 14-MEDAS score of 7.
  • 96.3% exhibited adequate nutrition literacy with a median NLS-GR score of 23.
  • Weak negative correlation found between HbA1c and Mediterranean Diet adherence (r = -0.238, p = 0.033).

Abstract

Adherence to the Mediterranean Diet (MD) is a cornerstone in managing Type 2 Diabetes Mellitus (T2DM), with patients’ Nutrition Literacy (NL) playing a potential role in their dietary choices. This cross-sectional study investigated the association between NL and MD adherence in 81 patients with T2DM from two Greek hospitals. Participants completed the NLS-GR questionnaire to assess NL and the 14-MEDAS for MD adherence, while socio-demographic and clinical data, including glycated haemoglobin (HbA1c), BMI, and disease duration, were obtained through researcher-conducted interviews and medical records. Median HbA1c was 6.9%, duration of T2DM was 13 years, and BMI 26.9 kg/m2. A total of 71.6% had moderate MD adherence (median 14-MEDAS: 7), and 96.3% had adequate NL (median NLS-GR: 23). HbA1c showed a weak negative correlation (r = −0.238, p = 0.033) with the 14-MEDAS. Median duration of DM showed a low negative correlation with NL (NLS-GR: r = −0.323, p = 0.003). No statistically significant correlation was found between 14-MEDAS and NLS-GR (r = 0.032, p = 0.775). Although MD adherence was correlated with HbA1c, neither MD adherence nor nutrition literacy were independent predictors after adjustment for confounding factors. Further studies are needed to demonstrate the extent to which NL can influence adherence to a specific dietary pattern.

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Cite This Study

Tsakalou et al. (2026) studied this question.

synapsesocial.com/papers/6a0567bca550a87e60a1feb9https://doi.org/10.3390/dietetics5020030
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