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Mediterranean Diet Adherence in Cardiac Patients: A Cross-sectional Study

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We analyzed the constructs of social cognitive theory that explain adherence to the Mediterranean diet in patients diagnosed with cardiovascular disease.


A cross-sectional study of 337 cardiac patients using a validated questionnaire was conducted and analyzed at an outpatient cardiology clinic, employing social cognitive theory (SCT) as the theoretical framework.


Dietary adherence was associated with statistically significant improvements in the SCT constructs. Self-regulation to consume healthy diet groups, negative perceived outcomes, and self-efficacy had the most influence on patient ability to maintain the Mediterranean diet. Self-regulation to avoid unhealthy food options like processed, sugary foods and positive perceived outcomes had smaller associations with patient ability to maintain the Mediterranean diet.


SCT constructs should be utilized by physicians when educating patients on heart healthy dieting as they are highly associated with improved dietary behaviors. Self-efficacy, self-regulation in choosing healthy diet options, and negatively perceived expected outcomes predicted diet quality in cardiac patients. Improvements in these constructs might yield positive results in cardiac patients attempting diet modifications.
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Keywords: Mediterranean diet; diet adherence; health promotion; social cognitive theory

Document Type: Research Article

Publication date: November 1, 2018

More about this publication?
  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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