Perceived barriers to healthy eating and Mediterranean diet adherence among medical and health professions students: Two cross-sectional surveys at the University of Bologna

Abstract

To describe meal-preparation practices, perceived barriers to healthy eating, and Mediterranean-oriented dietary adherence among medical and health professions students at the University of Bologna. Two anonymous online cross-sectional surveys were conducted within a University Third Mission public-engagement initiative. Survey 1 included 343 complete submissions to an author-developed 19-item questionnaire. Survey 2 included 59 complete responses to an author-adapted 16-item screener based on the Mediterranean Diet Adherence Screener. In Survey 1, most respondents prepared their own meals (88.0%) and enjoyed cooking (71.7%), but 75.8% spent <30 min preparing meals and 81.9% reported that budget influenced healthy food purchasing; 45.8% had a weekly food budget of EUR 31-50. Frequent purchasing of highly-processed foods was reported by 42.6%. Although 94.5% considered healthy food choices important, only 17.8% perceived their meals as consistently healthy; 93.9% wished to improve healthy meal-preparation skills. Healthy-food selection self-efficacy was correlated with perceived meal healthiness (rho = 0.441, p < 0.001). In Survey 2, the mean 16-item score was 10.85 ± 2.52. Adherence was highest for extra-virgin olive oil use (96.6%) and lowest for fish (37.3%), nuts (45.8%), and whole grains (49.2%). These two independent surveys identified high interest in healthy eating and meal preparation, together with perceived time and budget constraints and heterogeneous adherence to selected Mediterranean-oriented behaviors. Given the convenience sampling and non-linkable design, these findings describe two separate samples rather than a direct association between barriers and adherence. Nevertheless, the results may inform initiatives that promote affordable healthy choices and meal-preparation skills among future healthcare professionals.