Smartphone and Internet Addictive Behaviors Are Differentially Associated with Mediterranean Diet Adherence in Young Adults: The EVA-Adic Study

Background/Objectives: The Mediterranean diet (MedDiet) is a protective nutritional model against cardiometabolic risk, but current sociodemographic changes have favoured the abandonment of this pattern in favour of sedentary behaviours and increasing digitalisation. Screen-related behavioral addictions represent an emerging challenge for public health and nutritional psychiatry. However, scientific evidence on how different digital dependence profiles influence young adults’ diets remains scarce. The aim of this study was to evaluate the relationship between adherence to the Mediterranean diet and various dimensions of problematic screen use (smartphone dependence, compulsive internet use, and problematic experiences with video games) in a sample of young adults. Methods: Observational, descriptive and cross-sectional study conducted in 496 young adults between 18 and 34 years of age enrolled in the EVA-Adic study. Adherence to the MedDiet was assessed using the 14-item MEDAS questionnaire. Digital addictions were determined using three continuously validated psychometric instruments: the EDAS-18 scale (smartphone), the CIUS questionnaire (internet) and the CERV questionnaire (video games), also generating a Global Digital Addiction index. Hierarchical multivariate linear regression models (adjusted for sociodemographic, anthropometric and lifestyle factors) and binary logistic regression models were performed to analyze each component of the MEDAS individually. Results: The mean age of the 496 subjects analyzed was 26.60 ± 4.41 years. 339 subjects had low-moderate adherence (< 9) and 157 high adherence (≥ 9). The mean values of the psychometric scales of digital addiction were: smartphone dependence: 40.87 ± 12.24 points, for compulsive use of the internet: 13.83 ± 9.89 points, for video game dependence: 3.54 ± 5.22 points, and the global digital addiction index: 58.25 ± 21.76 points. In the multivariate linear regression analysis in the total fit model, smartphone dependence (EDAS-18) was inversely associated with the MEDAS score (β = -0.021 {95% CI} [-0.041 -0.003]). Problematic internet use (CIUS) showed a positive association with dietary adherence (β = 0.025 {95% CI} [0.002, 0.049]). Problematic experiences with video games (CERV) and the global digital addiction index did not demonstrate an association. In the logistic regression analysis of each of the components of the MEDAS: each one-point increase on the EDAS-18 scale reduced the probability of meeting the fruit consumption criterion ≥3 pieces/day (OR = 0.980); the criterion of low consumption of sugary beverages or less than one per day (OR = 0.956) and was linked to a higher probability of meeting the criterion of using olive oil as the main cooking fat (OR = 1.026). Compulsive use of the Internet (CIUS): A higher score on the CIUS scale decreased the probability of registering a low consumption of sugary drinks (OR = 0.955); positive association with compliance with olive oil consumption ≥ 4 tablespoons/day (OR = 1.035) and with the consumption of sofrito ≥ 2 times/week (OR = 1.026). Conclusions: The results of this study suggest that digital addictive behaviors are differentially associated with the quality of the Mediterranean diet. Higher smartphone addiction risk was associated with lower adherence to the Mediterranean diet, which may reflect a less healthy behavioral pattern linked to problematic mobile phone use. In contrast, problematic internet use may represent a different profile in relation to dietary habits, possibly influenced by the type of digital use, the context of exposure, or the characteristics of the participants evaluated. These findings reinforce the need to analyze different forms of digital addiction separately, rather than treating them as a homogeneous phenomenon, and suggest that interventions aimed at improving adherence to healthy dietary patterns should include the assessment of digital behavior.