Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations.

Background/Objectives: Beetroot juice (BJ), a natural source of dietary nitrate, has gained increasing attention for its potential to improve exercise performance and cardiovascular function. While its benefits are well documented in endurance contexts, less is known about its short-term effects on resistance training performance and recovery. Thus, this study investigated the effects of short-term BJ supplementation on strength performance, cardiovascular responses, muscle oxygenation, and post-exercise recovery in resistance-trained males. Methods: Twelve healthy men (age: 21.3 ± 1.9 years; body mass index: 21.42 ± 2.36 kg/m2) completed two supplementation protocols involving BJ, providing 450 mg of nitrate per day, and a nitrate-free placebo (PLA). Each protocol consisted of two laboratory visits, one to assess the acute ergogenic effects and another to evaluate recovery after 72 h, resulting in a total of four sessions over a two-week period. During the three consecutive days of supplementation, participants ingested a single 900 mL dose (15 g BJ powder/PLA) 2 h before the first session, followed by three daily 300 mL doses (5 g BJ each/PLA) over the next two days, and a final dose (15 g BJ powder/PLA) taken 2 h before the second session (72 h post-first session). Each testing session involved incremental back squat (BS) and bench press (BP) exercises at 60%, 70%, and 80% of the one-repetition maximum (1RM) performed to failure, with three-minute rest intervals between sets. Repetition to failure, movement velocity, peak power, peak heart rate (HR), and muscle oxygenation (SmO2) were recorded during BP and BS exercises. Heart rate variability (HRV) and blood lactate were assessed before and after each training session. Lower-limb strength (CMJ and SJ) and delayed-onset muscle soreness (DOMS) were assessed daily during the 3-day supplementation period. Results: BJ significantly increased repetitions completed at 80% 1RM during BP and BS (p < 0.05) compared to the PLA. Peak movement velocity improved across all intensities using BJ with higher values compared to the PLA at 60–80% 1RM (p < 0.05). SmO2 was higher in BJ at 70–80% 1RM) and further improved after 72 h of BJ supplementation (p < 0.05). Cardiovascular strain was reduced in BJ, evidenced by lower peak HRs and smaller post-exercise declines in HRV indices (p < 0.05). Post-exercise recovery favored BJ, with faster recovery in jump performance at 24 h and reduced upper-limb DOMS at 24–48 h (p < 0.05). Conclusions: Short-term BJ supplementation enhances high-intensity resistance performance, improves muscle oxygenation, attenuates cardiovascular strain, and accelerates neuromuscular recovery. These benefits highlight its potential as a practical strategy for athletes seeking to optimize training performance and recovery during periods of intense resistance training.

Background and Aims: Ramadan intermittent fasting (RIF), a form of time‐restricted feeding, influences various physiological and psychological functions. However, its effects on older adults remain insufficiently understood. This study examined the impact of RIF on physical and mental health parameters, comparing active and sedentary older individuals. Specifically, we assessed handgrip strength (HGS), vigilance performance, anxiety, and depression levels to determine whether regular physical activity mitigates potential adverse effects of RIF.Methods: Fifty‐eight older adults (mean age 62.93 ± 3.99 years; 50% female) participated in this study. They were classified into an active group (n = 26) and sedentary group (n = 32) based on self‐reported physical activity levels. Assessments were conducted before and during RIF and included HGS measurement using a handheld dynamometer, a digital psychomotor vigilance test, and validated questionnaires (General Anxiety Disorder‐7, Geriatric Depression Scale, and Physical Activity Scale for the Elderly).Results: During RIF, both groups showed significant improvements in vigilance, anxiety, and depression scores, with more pronounced benefits in the active group. However, sedentary participants experienced a decline in HGS, whereas active individuals maintained stable muscle strength.Conclusion: Regular physical activity during RIF appears to enhance vigilance and mental health while preventing muscle strength decline in older adults. These findings highlight the importance of maintaining an active lifestyle during RIF to support both physical and mental health in aging populations.

Background/Objectives: Physical activity and sedentary behaviour represent related yet distinct movement behaviours with potentially different behavioural, psychosocial, and lifestyle correlates. However, multinational evidence examining these behaviours within the Mediterranean lifestyle framework remains limited. This study investigated correlates of physical activity and sedentary behaviour among adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Methods: Data were collected from 4010 adults (37.2 ± 15.4 years; 59.5% female) across 10 Mediterranean and neighbouring countries using a standardized multilingual e-survey. Physical activity was assessed using the short International Physical Activity Questionnaire (IPAQ-SF; MET-min/week), and sedentary behaviour was assessed by daily sitting time. Hierarchical multiple linear regression analyses were conducted separately for physical activity and sedentary behaviour. Exploratory bootstrapped mediation analyses examined whether life satisfaction (SLSQ) or social participation (SSPQ) mediated associations between MEDLIFE dietary dimensions and sitting time. Results: Higher physical activity was associated with more rural living environments, lower body mass index, more favourable smoking status, higher alcohol consumption, stronger adherence to Mediterranean dietary habits, longer sleep latency, higher stress, and greater social participation (β ≈ 0.05–0.11), whereas female sex, longer sleep duration, and higher anxiety were associated with lower physical activity (β = −0.04 to −0.23); the positive association with alcohol consumption should be interpreted cautiously in light of potential residual confounding. By contrast, sedentary behaviour was positively associated with higher education, higher body mass index, and more favourable smoking-status (β ≈ 0.04–0.09) and inversely associated with better self-reported health status, Mediterranean dietary consumption patterns, life satisfaction, and social participation (β = −0.04 to −0.07). Mediation analyses showed significant but small-magnitude indirect effects for the pathways linking MEDLIFE dietary consumption patterns and MEDLIFE dietary habits with sitting time through social participation (indirect β = −0.0032 and −0.0045, respectively), which should be interpreted with caution, whereas no significant indirect effects were observed through life satisfaction. Conclusions: Physical activity and sedentary behaviour are associated with different, though partially overlapping, lifestyle and psychosocial correlates within the MEDIET4ALL framework. Social participation may represent a modest behavioural pathway linking Mediterranean dietary dimensions with lower sitting time. Given the cross-sectional design, these findings should be interpreted as associative rather than causal, but they nonetheless reinforce the importance of integrated and context-sensitive lifestyle promotion strategies.