Association between Mediterranean diet adherence and dyspeptic symptoms in older adults: a cross-sectional study in a geriatric outpatient population

Abstract Background Dyspeptic symptoms are common in older adults and may impair nutritional status and quality of life. Dietary patterns are increasingly recognized as modifiable determinants of gastrointestinal symptom burden, yet evidence regarding Mediterranean diet adherence and dyspepsia severity in geriatric populations remains limited. We aimed to examine the association between Mediterranean diet adherence and dyspeptic symptom severity—including pain, non-pain symptoms, and symptom-related satisfaction—among adults aged ≥ 65 years presenting with dyspeptic complaints. Methods This cross-sectional study was conducted between January 2023 and December 2024 in a geriatric outpatient clinic at Gaziantep University Training and Research Hospital. Consecutive adults aged ≥ 65 years with dyspeptic symptoms lasting ≥ 4 weeks and adequate cognitive capacity (clinical judgment and/or MMSE ≥ 24) were enrolled. Mediterranean diet adherence was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS; score 0–14) and categorized as low (≤ 5), moderate (6–9), or high (≥ 10). Dyspeptic symptoms were evaluated using the interviewer-administered Severity of Dyspepsia Assessment (SODA) scale (pain, non-pain symptoms, satisfaction; 7-day recall). Pearson correlations, one-way ANOVA with appropriate post-hoc tests, and multivariable linear regression analyses were performed; models were adjusted for age, sex, and BMI as clinically relevant covariates. Results A total of 165 participants were included (70.9% women; mean age 71.47 ± 6.43 years; mean BMI 28.51 ± 4.99 kg/m 2 ). Most exhibited moderate MEDAS adherence (73.9%), while 18.2% had low and 7.9% high adherence. Higher MEDAS scores were associated with lower SODA pain ( r = − 0.177, p =  0.02) and non-pain symptom scores ( r = − 0.429, p <  0.001), and higher satisfaction scores (indicating better perceived gastrointestinal well-being; r =  0.431, p <  0.001). SODA subscale scores differed significantly across adherence categories (all p <  0.05), whereas BMI did not ( p =  0.521). In adjusted regression models, each one-point increase in MEDAS was associated with lower pain (B = − 1.50, p =  0.001), non-pain symptoms (B = − 1.66, p <  0.001), and higher satisfaction (B = 0.77, p <  0.001). Conclusions Greater Mediterranean diet adherence was independently associated with lower dyspeptic symptom severity and higher symptom-related satisfaction in older adults with dyspepsia. Prospective and interventional studies are warranted to determine whether improving Mediterranean diet adherence can causally reduce dyspeptic symptoms in geriatric care.