Mediterranean diet boosts quality of life—here’s how

By Priyanjana Pramanik, MSc.Reviewed by Susha Cheriyedath, M.Sc.Feb 10 2025

Discover how the Mediterranean diet not only enhances longevity but also strengthens mental resilience, physical health, and social well-being—offering a powerful strategy to improve quality of life at any age!

Mediterranean Diet and Quality of Life in Adults: A Systematic Review. Image Credit: Spalnic / Shutterstock

In a recent systematic review article in the journal Nutrients, researchers investigated how following the Mediterranean diet can influence health-related quality of life (HRQoL) in terms of physical, mental, and social well-being.

Overall, current research indicates that this diet is associated with improved quality of life for aging populations, which has important implications for preventing diseases and managing chronic conditions. However, not all studies found strong effects; some results were more pronounced in older adults or those with chronic conditions.

A holistic indicator of well-being

Health-related quality of life (HRQoL) is a holistic concept that covers social, mental, and physical well-being. It is assessed using validated tools such as SF-36, SF-12, WHO-QoL-BREF, and disease-specific scales like ADDQoL-19 (diabetes), IBDQ (inflammatory bowel disease), and MSQOL-54 (multiple sclerosis). The physical domain of HRQoL includes fatigue, pain, and mobility. The psychological domain includes depression, anxiety, and mental health. The social domain comprises independence, social engagement, and relationships. Since it includes overall life satisfaction and functioning in daily life, it is an important indicator in healthcare policy, clinical research, and public health.

As people age, chronic conditions such as arthritis, diabetes, and heart disease can significantly affect HRQoL, particularly for those with multimorbidities, cognitive impairment, or reduced physical mobility or function. Gender differences have been observed, with some studies showing that men experienced improvements in both mental and physical health while women benefited mainly in physical health. This can be further exacerbated by limited access to healthcare, financial issues, and social isolation.

Known benefits of the Mediterranean diet

Researchers have found that following a Mediterranean diet has many significant health benefits. This diet, which includes moderate amounts of wine and meat and large amounts of fish, olive oil, nuts, legumes, whole grains, vegetables, and fruits, is known to promote immune and gut health while providing essential nutrients. Key compounds such as dietary fiber, polyphenols, omega-3 fatty acids, and antioxidants play a significant role in these benefits.

The Mediterranean diet's properties help improve sensitivity to insulin and regulation of blood sugar among people with type-2 diabetes. It has also been linked to lower risks of cancers such as breast and colorectal cancers, metabolic conditions, and cardiovascular disease.

It may also potentially benefit people with musculoskeletal conditions, mood disorders, and neurodegenerative diseases. For example, people with multiple sclerosis who adhered more closely to the diet showed slower disease progression and improved physical activity levels. With its metabolic, antioxidative, and anti-inflammatory benefits, it could improve HRQoL among aging individuals and populations.

The Mediterranean diet and HRQoL

Early investigations into this relationship included two cross-sectional surveys in Spain, which found a significant positive association between diet adherence and mental and physical health in men; only physical health was positively impacted for women.

Other studies found positive links to emotional well-being, social functioning, sleep quality, vitality, increased physical activity, and lower alcohol consumption. During the pandemic, people who followed the Mediterranean diet more closely were less likely to have depression or anxiety. Outcomes negatively correlated with diet adherence included fat percentage and body mass index (BMI). Some studies noted that the benefits were more pronounced in older adults rather than younger populations.

Notably, one study that included students and professors found that the effects were more pronounced for older individuals. Another study found that higher adherence was linked to improved quality of life for individuals with healthy cardiometabolic profiles.

There was also some evidence that the associations could be driven by the antioxidant and dietary fiber in the diet. Social factors, such as higher social capital and community engagement, were also associated with better adherence to the Mediterranean diet and improved quality of life. Other factors that affected both quality of life and diet adherence included social capital and physical activity levels.

While these were all findings from healthy populations, similar results were seen for investigations where participants had high cardiometabolic risk, diabetes, moderate cardiovascular risk, and coronary artery disease. Following the Mediterranean diet was linked to feeling greater freedom, well-being, and self-confidence, as well as physical functioning and self-care.

Adherence to the Mediterranean diet was also associated with a lower risk of psoriasis, improved quality of life for asthma patients—particularly those with lower BMI—and fewer depressive symptoms in individuals with osteoarthritis. People with inflammatory bowel diseases also reported improved well-being, though benefits were more evident in ulcerative colitis than in Crohn’s disease. Adherence to the diet improved life quality for teens with celiac disease but not adults.

Another set of studies included participants who had or had survived breast cancer. For people with breast cancer, following the diet more closely was linked to less pain and improved physical function. Those who had survived the disease reported better social, cognitive, and emotional functioning.

People with multiple sclerosis who followed the diet were able to increase their physical activity and overall quality of life; they also reported fewer symptoms of depression. Higher adherence was an important predictor of lower disease progression, reinforcing the potential therapeutic role of this diet. While fruit intake was closely linked to mental health, vegetable intake was associated with both mental and physical quality of life.

However, not all studies found significant associations. Some cross-sectional studies did not show strong links between Mediterranean diet adherence and HRQoL, particularly in younger or healthy individuals. Longitudinal studies, which follow participants over time, tended to show stronger effects than cross-sectional studies.

Conclusions

Improving HRQoL is essential to increase the well-being of aging people while reducing their healthcare costs. Aging is associated with changes such as increasing frailty, reduced metabolic efficiency, lower bone density, and muscle mass loss. Thus, older adults who are physically resilient are better equipped to recover from health challenges and manage chronic diseases.

A healthy diet can help aging individuals reduce their disease burden and maintain their independence. The Mediterranean diet has the potential to prevent chronic disease while improving cognitive functions such as decision-making and verbal memory. While traditionally followed in Mediterranean regions, studies indicate that this diet can be successfully adapted for non-Mediterranean populations. When combined with regular physical activity, it offers a powerful strategy for enhancing overall quality of life.