Observational studyBMJ open2026
Adherence to the Mediterranean diet and psychological wellbeing before and during the COVID-19 pandemic: a prospective analysis of the English Longitudinal Study of Ageing.
Observational study in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
objectivesFollowing a Mediterranean-like diet has been associated with lower depression levels but there has been limited study of links with positive states of psychological well-being. We tested whether adherence to a Mediterranean diet was cross-sectionally associated with positive well-being among older adults in England in 2018/2019 and prospectively through the COVID-19 pandemic.
designProspective observational cohort analysis.
settingPopulation study of older people ≥50 years in England.
participants3296 participants (46% men) in the English Longitudinal Study of Ageing (ELSA) aged 68.18±7.43 years, who completed a dietary module in 2018/2019 for the assessment of the Mediterranean diet (relative Mediterranean Diet Index (rMED)). PRIMARY AND SECONDARY OUTCOME MEASURES: Psychological well-being measured using the CASP12 at baseline (2018/2019) and again in the early months of the COVID-19 pandemic (2020).
resultsCross-sectionally, higher rMED scores were associated with greater psychological well-being (β=0.054, p<0.001), independent of depressive symptoms, income, education, physical activity, smoking, self-rated health and limiting long-standing illness. Longitudinal analyses revealed that higher adherence to the Mediterranean diet predicted smaller declines in well-being during the early months of the COVID-19 pandemic (β=0.026, p=0.042), even after accounting for baseline well-being and COVID-19 infection experience.
conclusionsGreater adherence to a Mediterranean diet was positively associated with psychological well-being among older adults in England. This relationship persisted even during a period of widespread societal stress. Promoting Mediterranean-style dietary patterns may support not only physical but also mental well-being in later life, underscoring the importance of nutritional public health strategies for mental health resilience in ageing populations.
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