Mediterranean Diet Adherence, Physical Activity, and Motivation Toward Physical Education in Adolescent Girls: A Cross-Sectional Study

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Abstract
Background: Healthy lifestyle habits, such as adherence to the Mediterranean diet (MD) and regular engagement in physical activity (PA), have been associated with physical and psychological well-being during adolescence. However, there is limited evidence regarding their combined association with motivation towards physical education (PE), particularly among adolescent girls from different residential environments. Objective: The objective of this study was to analyse the association between adherence to the MD, levels of PA, and motivation towards PE in adolescents from urban and rural environ-ments. Methods: A cross-sectional study was conducted with adolescents aged 12 to 14 years. Adherence to the MD, PA levels, and motivational dimensions towards PE were assessed using validated questionnaires. Differences between groups were analysed using analysis of variance (ANOVA), and an analysis of covariance (ANCOVA) was performed controlling for PA levels. Effect sizes were calculated using partial eta squared (η²p). Results: Significant differences were observed in intrinsic motivation, identified regulation, introjected regulation, and motivation according to adherence to the Mediterranean diet (MD) (p < 0.05), with small to moderate effect sizes. Post hoc analyses showed that girls with optimal adherence to the MD exhibited higher intrinsic motivation towards PE compared with those with low adherence. The ANCOVA re-vealed that higher levels of PA were significantly associated with greater intrinsic mo-tivation, particularly among girls from urban environments. No significant differences were found between urban and rural environments in overall PA levels or dietary ad-herence. Conclusions: Greater adherence to the MD and higher levels of PA are associ-ated with more self-determined motivational profiles towards PE in adolescent girls. These findings highlight the importance of integrated school-based interventions that promote healthy eating and active lifestyles to enhance motivation and engagement in PE, particularly among adolescent girls.
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