Impact of COVID-19 confinement on eating behaviours across 16 European countries: The COVIDiet cross-national study.

We aimed to evaluate the changes in eating behaviours of the adult population across 16 European countries due to the COVID-19 confinement and to evaluate whether these changes were somehow related to the severity of the containment measures applied in each country. An anonymous online self-reported questionnaire on socio-demographic characteristics, validated 14-items Mediterranean diet (MedDiet) Adherence Screener (MEDAS) as a reference of a healthy diet, eating and lifestyle behaviours prior to and during the COVID-19 confinement was used to collect data. The study included an adult population residing in 16 European countries at the time of the survey. Aggregated Stringency Index (SI) score, based on data from the Oxford COVID-19 Government Response Tracker, was calculated for each country at the time the questionnaire was distributed (range: 0-100). A total of 36,185 participants completed the questionnaire (77.6% female, 75.2% with high educational level and 42.7% aged between 21 and 35 years). In comparison to pre-confinement, a significantly higher adherence to the MedDiet during the confinement was observed across all countries (overall MEDAS score prior to- and during confinement: 5.23 ± 2.06 vs. 6.15 ± 2.06; p < 0.001), with the largest increase seen in Greece and North Macedonia. The highest adherence to MedDiet during confinement was found in Spain and Portugal (7.18 ± 1.84 and 7.34 ± 1.95, respectively). Stricter contingency restrictions seemed to lead to a significantly higher increase in the adherence to the MedDiet. The findings from this cross-sectional study could be used to inform current diet-related public health guidelines to ensure optimal nutrition is followed among the population, which in turn would help to alleviate the current public health crisis.

A Novel Urinary Biomarker Approach Reveals Widespread Exposure to Multiple Low-Calorie Sweeteners in Adults.

BACKGROUND: Observational investigations into the health impacts of low-calorie sweeteners (LCSs) in humans fail to adequately identify or fully characterize LCS consumption. OBJECTIVES: We aimed to utilize a novel biomarker approach to investigate exposure to 5 LCSs and to test whether reported low-calorie sweetened beverage (LCSB) consumption effectively identifies exposure to LCSs in adults. METHODS: In this cross-sectional analysis, 2 population studies were conducted in adults. Urinary excretions of 5 LCSs, namely acesulfame-K, saccharin, cyclamate, sucralose, and steviol glycosides, were simultaneously determined using LC tandem-MS. In Study 1, previously collected 24-h urine samples (n = 357) were analyzed. In Study 2, previously collected 24-h urine samples (n = 79) were analyzed to compare urinary excretions of LCSs with self-reported LCSB consumption for identifying LCS exposure. Exposure to LCSs was characterized using descriptive statistics and chi-square tests were performed to assess associations between age-groups and LCS excretion, and to assess the proportion of individuals identified as LCS consumers using biomarker data or reported LCSB consumption. RESULTS: A total of 341 adults (45% men) and 79 adults (39% men) were included in the final analysis of Studies 1 and 2, respectively. In Study 1, >96% of samples contained ≥1 LCS and almost 60% contained ≥3 LCSs. A greater proportion of younger adults (<40 y old) excreted ≥3 LCSs than older adults (>40 y old) (P < 0.001). In Study 2, a much higher prevalence of LCS consumption was observed using biomarker data (92%) than reported LCSB consumption (6%) (P < 0.001). CONCLUSIONS: This work indicates widespread exposure to LCSs, suggesting that population-based research to date into LCS exposure and health may be flawed. Therefore, a urinary biomarker approach offers considerable potential for more robust investigations in this area.

Varietal and Geographical Discrimination of Greek Monovarietal Extra Virgin Olive Oils Based on Squalene, Tocopherol, and Fatty Acid Composition.

Extra virgin olive oil (EVOO) is an important component of the Mediterranean diet and a highly priced product. Despite the strict legislation to protect it from fraudulent practices, there is an increasing demand to characterize EVOOs and evaluate their authenticity. For this purpose, 68 monovarietal EVOOs, originating from three regions of Greece (Peloponnese, Crete, and Lesvos) and two local cultivars (Koroneiki and Kolovi), were obtained during the harvesting period of 2018-2019. Fatty acids, squalene, and tocopherols were determined chromatographically according to official methods in order to study the effect of cultivar and geographical origin. Squalene and γ-tocopherol differed significantly amongst the cultivars tested. Koroneiki samples exhibited higher squalene content than Kolovi samples, whereas the opposite was observed for γ-tocopherol. The tocopherol level was highly geographical dependent, with EVOOs from Peloponnese displaying the highest concentration of α-tocopherol, whereas the content of γ-tocopherol was significantly higher in samples from Lesvos. Unsupervised and supervised multivariate analysis resulted in a satisfactory grouping of EVOOs according to cultivar. γ-Tocopherol, squalene, and the majority of fatty acids were the most discriminant variables, with γ-tocopherol, linoleic, linolenic, and gadoleic acid being present at higher levels in samples from the Kolovi cultivar. Koroneiki samples were characterized with higher levels of squalene, palmitic, palmitoleic, and arachidic acid.

Total antioxidant capacity, total phenolic content and iron and zinc dialyzability in selected Greek varieties of table olives, tomatoes and legumes from conventional and organic farming.

The objective was to compare 10 types of table olives, 11 types of tomatoes and tomato products and 18 types of legumes from conventional or organic farming for selected nutritional properties. All products were tested for their total antioxidant capacity (TAC) (Ferric Reducing Antioxidant Power (FRAP) assay) and total phenolic content (Folin-Ciocalteau method). Tomatoes and legumes were further tested for iron and zinc dialyzability after in vitro digestion. Ascorbic acid content of tomatoes was also measured. The study resulted that the nutritional properties of olives, tomatoes and legumes tested were different among the various cultivars but, in most cases, not between products from organic or conventional farming. Natural black olives, cherry and santorini tomatoes and lentils exhibited superior nutritional properties.

Effect of green tea on postprandial antioxidant capacity, serum lipids, C-reactive protein and glucose levels in patients with coronary artery disease.

PURPOSE: Cardiovascular risk factors have been identified in the postprandial state, particularly in patients with coronary artery disease (CAD). Tea consumption has been linked to cardiovascular risk reduction, but the beneficial effect of tea has not been investigated under postprandial conditions. The objective was to examine the effect of green tea on postprandial levels of plasma total antioxidant capacity (TAC), serum lipids, C-reactive protein (CRP) and glucose in patients with CAD. METHODS: In a randomized controlled, parallel design with 2 arms, 43 patients with CAD were assigned to consume breakfast consisting of bread, butter and 330 ml water or tea (4.5 g green tea/330 ml, providing approximately 400 mg catechins). Blood samples were drawn immediately before and 1.5, 3 and 5 h after breakfast. TAC was measured in plasma with the ferric reducing antioxidant power of plasma and oxygen radical absorbance capacity assays. Total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides, glucose, CRP, uric acid and pancreatic lipase levels were measured in serum. RESULTS: Tested biomarkers did not differ between tea and water group at baseline, 1.5, 3 and 5 h (P > 0.05) postprandially. However, TAC increased 1.5 and 3 h after consumption of breakfast with tea (P < 0.005), but no change was observed after consumption of breakfast with water. Serum triglycerides levels significantly increased 3 h after breakfast with water (P = 0.031), but not after breakfast with tea. Serum uric acid decreased 1.5 h after breakfast with tea (P = 0.038). Pancreatic lipase, CRP, total cholesterol, HDL-C, LDL-C and glucose levels remained unchanged after breakfast with tea at any time point (P > 0.05). CONCLUSIONS: Tea consumption did not affect selected biomarkers at any postprandial time point in patients with CAD.

Estimations of water balance after validating and administering the water balance questionnaire in pregnant women.

Dehydration during pregnancy may be harmful for the mother and fetus; thus our objective was to understand whether pregnant women balance water intake and loss. The Water Balance Questionnaire (WBQ) was modified to reflect pregnancy (WBQ-P). Validation was performed using 3-day diaries (n = 60) and hydration indices in urine (osmolality, specific gravity, pH and color, n = 40). The WBQ-P was found valid according to Kedhal τ-b coefficient agreement. The WBQ-P was administered to 95, 100 and 97 women per trimester, in Greece. Median (IQR) water balance, intake and loss were, respectively, 203 (-577, 971), 2917 (2187, 3544) and 2658 (2078, 3391) ml/day; these did not differ among the trimesters or between pregnant and non-pregnant women. However, more pregnant women were falling in the higher quartiles of water balance distribution. No differences in sources of water intake were identified except that women in the third trimester had lower water intake from beverages.

Precision Food Composition Data as a Tool to Decipher the Riddle of Ultra-Processed Foods and Nutritional Quality.

BACKGROUND: Epidemiology supports a link between ultra-processed foods (UPFs) and health, mediated mainly through the clustering of foods with suboptimal nutrient profiles within UPFs. However, successful NOVA categorization requires access to a food's ingredient list, which we hypothesized can impact both UPF identification and the link between processing and composition. METHODS: Foods (n = 4851) in the HelTH branded food composition database were classified as NOVA1-4, with or without using the ingredient lists (generic and branded approach, respectively), to identify differences in NOVA classification (chi-square test) and the estimated average nutritional composition of each NOVA group (Kruskal-Willis U test). RESULTS: Using the ingredients list increased UPF identification by 30%. More than 30% of foods commonly assumed to be minimally processed (NOVA1-plain dairy, frozen vegetables, etc.) were reclassified as UPFs when using ingredient lists. These reclassified foods, however, had nutritional compositions comparable to NOVA1 foods and better than UPFs for energy, fat, sugars, and sodium (p < 0.001). In fact, UPFs did not show a uniform nutritional composition covering foods from Nutri-Score A (~10%) to Nutri-Score E (~20%). CONCLUSIONS: The assumption that all UPFs have the same unfavorable nutritional composition is challenged when NOVA is applied using the appropriate branded food composition database.

Phytosterol supplementation does not affect plasma antioxidant capacity in patients with metabolic syndrome.

Several studies have observed decreased levels of lipophilic antioxidants after supplementation with phytosterols and stanols. The aim of this study was to examine the effect of phytosterol supplementation on plasma total antioxidant capacity in patients with metabolic syndrome. In a parallel arm, randomized placebo-controlled design, 108 patients with metabolic syndrome were assigned to consume yogurt beverage which provided 4 g of phytosterols per day or yogurt beverage without phytosterols. The duration of the study was 2 months and the patients in both groups followed their habitual westernized type diet. Blood samples were drawn at baseline and after 2 months, and the total antioxidant capacity of plasma was measured using the ferric reducing antioxidant power of plasma and oxygen radical absorbance capacity assays. After 2 months of intervention, plasma total antioxidant capacity did not differ between and within the intervention and the control groups. Phytosterol supplementation does not affect plasma antioxidant status.

Nutritional Quality of Plant-Based Meat and Dairy Imitation Products and Comparison with Animal-Based Counterparts.

While consumers are increasingly adopting plant-based meat and dairy imitation products, the nutritional quality and adequacy of those foods to act as a substitute is still under discussion. The Greek Branded Food Composition Database (HelTH) was expanded to map currently available meat and dairy imitations in Greece. Their main ingredient used, nutritional composition, and promotion as a healthy, nutritious food were described, and their overall nutritional quality using the Nutri-Score algorithm was evaluated. A total of n = 421 plant-based imitations were analyzed, made primarily of wheat or wheat mixes (83.5%) for meat imitations and grain (19.8%) or vegetable oil (17.1%) for dairy imitations. All meat imitations were high in protein and fiber, while, for dairy, only yogurts carried a protein content claim (80.9%). Imitation sausages, milk, and yogurt products had lower total fat and saturated fat content compared to their animal-based counterparts. All dairy imitations had lower protein content than animal-based dairy. The nutritional quality of imitation cheeses was graded as D-E, under the Nutri-Score system, compared to A-C for the animal-based cheese. Plant-based imitations have variable composition based on their main ingredient, and the substitution of specific food groups with plant-based alternatives may not support an equivalent or improved diet.

Ultra-Processed Foods in the Mediterranean Diet according to the NOVA Classification System; A Food Level Analysis of Branded Foods in Greece.

While the Mediterranean diet (MD) is championed as a healthy and sustainable dietary pattern, the NOVA classification is discussed as a tool to identify ultra-processed foods and further specify healthy food choices. We tested whether the NOVA System aligns with the MD recommendations as presented in the MD pyramids. Foods from the Greek branded food composition database, HelTH, (n = 4581) were scored according to NOVA and assigned to the tiers of the traditional and/or sustainable MD pyramids. Nutritional quality was measured as nutrient content and Nutri-Score grades. NOVA identified 70.2% of all foods as UPFs, and 58.7% or 41.0% of foods included in the sustainable and the traditional MD, respectively. Although foods at the top of the pyramids were mostly (>80%) UPFs, NOVA identified > 50% of foods in the MD base as UPFs. Only 22-39% of foods in the MD base were not UPFs and of high nutritional quality (Nutri-Score A-B). NOVA has low discriminatory capacity across the MD tiers, and it restricts food choices to <30% of foods currently available in supermarkets and <60% within the recommended MD tiers. Therefore, the NOVA classification cannot always identify suitable food choices under the MD pyramid in the modern packaged food environment.

Food Allergens in Ultra-Processed Foods According to the NOVA Classification System: A Greek Branded Food Level Analysis.

Ultra-processed foods' (UPFs') consumption has been positively linked to the presence of allergic symptoms, but it is yet unknown whether this is linked to their nutritional composition or allergen load. This study used the ingredient lists available in the Greek Branded Food Composition Database, HelTH, to classify foods (n = 4587) into four grades of food processing (NOVA1-4) according to the NOVA System. Associations between NOVA grades and the presence of allergens (as an ingredient or trace) were studied. Overall, UPFs (NOVA4) were more likely to contain allergens than unprocessed foods, NOVA1 (76.1% vs. 58.0%). However, nested analyses among similar foods showed that in >90% of cases, processing degree was not linked to allergens' presence. Recipe/matrix complexity was more strongly linked to allergens' presence with NOVA4 foods declaring 1.3 allergenic ingredients vs. 0.4 allergenic ingredients in NOVA1 foods (p < 0.01). Exposure to trace allergens was more common for NOVA4 than NOVA1 foods (45.4% vs. 28.7%), but the extent of contamination was similar (2.3 vs. 2.8 trace allergens). Overall, UPFs are more complex mixtures with higher numbers of allergens per food and are more prone to cross-contamination. However, indicating a food's degree of processing is not sufficient to help identify allergen-free choices within the same subcategory.

The water balance questionnaire: design, reliability and validity of a questionnaire to evaluate water balance in the general population.

There is a need to develop a questionnaire as a research tool for the evaluation of water balance in the general population. The water balance questionnaire (WBQ) was designed to evaluate water intake from fluid and solid foods and drinking water, and water loss from urine, faeces and sweat at sedentary conditions and physical activity. For validation purposes, the WBQ was administrated in 40 apparently healthy participants aged 22-57 years (37.5% males). Hydration indices in urine (24 h volume, osmolality, specific gravity, pH, colour) were measured through established procedures. Furthermore, the questionnaire was administered twice to 175 subjects to evaluate its reliability. Kendall's τ-b and the Bland and Altman method were used to assess the questionnaire's validity and reliability. The proposed WBQ to assess water balance in healthy individuals was found to be valid and reliable, and it could thus be a useful tool in future projects that aim to evaluate water balance.

The Nutritional Composition of Natural and Organic Branded Food Products: A Cross-Sectional Analysis of the Greek Foodscape.

Modern consumers turn to foods marketed as 'natural/organic' in their pursuit of healthier options. However, research that links such claims made on pack with improved nutritional composition is limited. The current analysis used data from all packaged foods available in the Hellenic Food Thesaurus (n = 4002), sold in Greece from 09/2020 to 01/2021, to map the prevalence of packaged foods sold under a 'natural/organic' claim and to compare their nutritional composition against food group matched conventional counterparts. Statistical analysis was carried out using IBM SPSS Statistics®. Overall, 'free from' was the most commonly used claim (12.3%), followed by 'natural/pure' (9.1%), 'fresh' (4.6%), and 'bio/organic' (3.3%). Statistically significant differences between the nutritional composition of natural/organic and conventional foods were only found in 5 out of the 13 food categories and in 9 out of 39 subcategories. Being labelled as natural/organic was linked to improved nutritional composition for prepared foods and yogurts, while for breakfast cereal, there was a mixed effect with lower carbohydrate content but higher energy and fat content. Jams labelled as natural/organic had higher energy and total sugar content. Overall, evidence of an association between being labelled as natural/organic and having an improved nutritional composition was extremely rare.

Performance and discriminatory capacity of Nutri-Score in branded foods in Greece.

Background: The harmonization of front-of-pack nutritional declaration is in the heart of food and nutrition policy discussions in Europe. The Nutri-Score system has been proposed by many countries as a potential candidate but its suitability for use across Europe is still under consideration. The current study aimed to evaluate the performance and discriminatory capacity of Nutri-Score in Greece and to test its alignment with the national food-based dietary guidelines. Materials and methods: Data on the energy, saturated fat, total sugars, sodium, protein, and fiber content per 100°g or ml were extracted for all foods available (n = 4,002) in the Greek branded food composition database HelTH. Each food content in fruits, vegetables, pulses, nuts and oils was manually estimated from the ingredients list. The Nutri-Score algorithm was used both as a continuous (FSAm-NPS Score) and a categorical variable [Grades (A)-(E)]. Results: The average FSAm-NPS Score in Greece was 8.52 ± 9.4. More than half of the solid foods (53.8%) were graded from (A) to (C), while most beverages (59.2%) were graded (E). More than 50% of food categories were populated with foods in all Nutri-Score grades, indicative of a good discriminatory capacity. The system scores favorably vegetables, pulses, and low-fat dairy products and unfavourablly sweets and processed meats showing in this way good alignment with the national guidelines. Eggs and seafood scored preferably compared to meat products. Animal fats received less favorable scores and so did cereal products that were highly processed. Discussion: Nutri-Score showed good capacity to inform consumers toward better food choices in line with the national guidelines. It showed a potential to guide consumers and manufacturers toward less energy dense and more nutrient dense options and highlighted areas of improvement in the food supply.

Alignment of Nutri-Score with Mediterranean Diet Pyramid: A Food Level Analysis.

The Mediterranean diet (MD) has been incorporated as a healthy diet pattern in food-based dietary guidelines of countries all over Europe and the world. Testing the alignment of Nutri-Score with the MD Pyramid is a key step in ensuring that future food-level policies will not be conflicting with existing dietary guidelines. All foods available (n = 4002) in the HelTH database, were classified as eligible or not for inclusion in the MD and they were ranked in their respective tier in the food pyramid following two pyramid schemes, the 1995 traditional and 2020 sustainable MD pyramids. For all foods, Nutri-Score was calculated both as the continuous FSAm-NPS score and its categorical outcome-Nutri-Score grades-and their distribution across the MD pyramid tiers was used as a measure of alignment between the MD and the Nutri-Score algorithm. Only 25% of all foods were eligible under the traditional MD, while the sustainable MD covered ~58% of all foods. For both pyramids, Nutri-Score was successful in clearly separating the foods at the top and the bottom of the pyramids (Nutri-Score Mode "D" or "E" for the top tiers and "A" for the bottom tiers), thus suggesting a good alignment between the two. Good discriminatory capacity was also seen within each tier.

Food Composition Data and Tools Online and Their Use in Research and Policy: EuroFIR AISBL Contribution in 2022.

Food, nutrition, and health are linked, and detailed knowledge of nutrient compositions and bioactive characteristics is needed to understand these relationships. Additionally, increasingly these data are required by database systems and applications. This communication aims to describe the contribution to databases and nutrition fields as well as the activities of EuroFIR AISBL; this member-based, non-profit association was founded to ensure sustained advocacy for food information in Europe and facilitate improved data quality, storage, and access as well as encouraging wider exploitation of food composition data for both research and commercial purposes. In addition to the description of its role and main objectives, a snapshot of EuroFIR AISBL's activities over the years is also given using a quantitative research literature analysis approach. The focus of this communication is to provide descriptions and updates of EuroFIR's online tools, i.e., FoodEXplorer, eBASIS, and PlantLIBRA, by highlighting the main uses and applications. Integrating food-related infrastructures and databases, following standardized and harmonized approaches, and considering interoperability and metrological principles are significant challenges. Ongoing activities and future plans of EuroFIR AISBL are highlighted, including, for instance, work within the Food Nutrition Security Cloud (FNS-Cloud) to make food, nutrition, and (food) security data more findable, accessible, interoperable, and ultimately reusable.

The Expansion of the Hellenic Food Thesaurus; Allergens Labelling and Allergens-Free Claims on Greek Branded Food Products.

Branded food composition databases (BFCDs) are valuable information tools that meet multiple user needs. Recently, recognising allergies and intolerances as an emerging concern for various stakeholders, BFCDs evolve to embed information on allergens. This study aims to expand the Greek BFCD, HelTH, to include allergen information for its 4002 products. A new file was added to the structure of HelTH, and data were curated to record label information. In 68.4% of products, at least one allergen was present in the ingredient list and in 38.9% at least one allergen in a precautionary statement. Milk (38.8%), gluten (32.7%), and soybeans (17.4%) were most commonly declared in the ingredient list; nuts (18.3%), eggs (13.1%), and milk (12.2%) were most commonly declared in precautionary statements. Allergen-free claims were present in 5.3% of the products and referred mostly on gluten and milk. In general, no statistically significant differences were identified between the nutritional composition of allergen-free claimed products and their equivalents. This study delivers an expanded BFCD that provides organised and detailed allergen information; new insights on the presence of food allergens in branded foods and issues of concern regarding allergen declaration that need to be addressed in order to improve label information.

Adherence to the Mediterranean type of diet is associated with lower prevalence of asthma symptoms, among 10-12 years old children: the PANACEA study.

Epidemiological studies have shown several associations between asthma symptoms and dietary factors. The aim of this work was to evaluate the relationship between adherence to the Mediterranean diet and childhood asthma. A cross-sectional analysis was performed on 700 children (323 boys), 10-12 yr old, selected from 18 schools located in Athens greater area. Children and their parents completed questionnaires, which evaluated, among others, dietary habits. Asthma was defined according to ISAAC II criteria. Adherence to the Mediterranean diet was evaluated using the KIDMED score (theoretical range 0-12). Higher KIDMED score corresponds to greater adherence to the Mediterranean diet. Greater adherence to the Mediterranean diet was inversely associated with ever had wheeze (p = 0.001), exercise wheeze (p = 0.004), ever had diagnosed asthma (p = 0.002) and with any asthma symptoms (p < 0.001). One-unit increase in the KIDMED score was associated with 14% lower likelihood of having asthma symptoms (odds ratio = 0.86, 95% confidence interval 0.75-0.98), after adjusting for various confounders. No significant associations were found between asthma symptoms and consumption of fruits (p = 0.25), vegetables (p = 0.97), legumes (p = 0.76), cereals (p = 0.71), dairy (p = 0.61), salty snacks (p = 0.53), or margarine/butter (p = 0.42) consumption, while increased fish and meat intake was associated with less asthma symptoms (p = 0.04 and p = 0.01, respectively). Our findings suggest an inverse relationship between level of adherence to the Mediterranean diet and prevalence of asthma in school-aged children.

Development of the Hellenic Food Thesaurus (HelTH), a branded food composition database: Aims, design and preliminary findings.

The Hellenic Food Thesaurus (HelTH) is the first systematic attempt to create a Greek Branded Food Composition Database. Data on the nutritional composition of foods for up to 45 nutrients, on-pack claims (health, nutrition, social, environmental), quality indicators, and prices were recorded for more than 4,000 foods as they appear on the photographs of their packages available on retailers' websites. A group of trained researchers carried out data collection and classification using LanguaL. HelTH highlights the variability in nutritional compositions of packaged foods in Greece and the need for better labelling of key nutrients such as trans fatty acids. According to a preliminary analysis of on-pack communications (n = 2008 products), health claims are used rarely (4.1% of products analyzed) with greater prevalence of nutrition (~32%) and natural claims (~24%). HelTH is a key infrastructure for the implementation of food and nutrition policies, new product development, and nutrition and consumer research.

Social Capital and Self-Perceived Quality of Life-Interrelated Predictors of Mediterranean Diet Adherence in Older Adults.

Living a healthy life in a supporting environment are key elements towards higher diet quality in older age. The Mediterranean Diet in Older Adults (MINOA) study collected cross-sectional data from adults ≥65 years old (n = 436) from April 2014 to November 2015 in rural Crete, aiming to understand the interrelations between Mediterranean Diet adherence, Social Capital and Health-Related Quality of Life (HRQL). Multivariate linear regression, carried out using SPSS 20.0, revealed that both Social Capital and HRQL has a positive impact on Mediterranean Diet adherence after adjustment for confounders and independently of each other. Total Social Capital as well as its Value of Life/Social Agency component (ß = 0.04 and ß = 0.1, p < 0.05, respectively) had a positive relationship with Mediterranean Diet adherence. As far as HRQL is concerned, only the Physical Health components were found to have a positive association with Mediterranean Diet adherence (ß = 0.09, p < 0.001). At the same time Total Social Capital was also seen to have a positive relationship with perceived Physical and Mental Health (ß = 0.21 and ß = 0.28, p < 0.001, respectively). In a population of older adults Social Capital, HRQL and Mediterranean Diet adherence seem to share intricate interrelations that impact both diet quality and quality of life overall.