Differential Associations of Mediterranean Diet Adherence and Physical Activity with Domain-Specific Quality of Life Among Rotating-Shift Nurses: A Pilot Cross-Sectional Study

Rotating shift work has been associated with impaired quality of life and changes in health behaviors among nurses. Although maintaining a healthy diet and engaging in physical activity may be associated with better quality of life, evidence in shift-working nurses remains limited. This pilot cross-sectional study explored associations between adherence to the Mediterranean diet, physical activity, and quality of life among nurses in Northern Greece from October 2025 to February 2026. A total of 100 nurses working rotating shifts participated in the study. Quality of life, adherence to the Mediterranean diet, and physical activity were assessed using the WHOQOL-BREF, MedDietScore, and IPAQ questionnaires, respectively. The mean MedDietScore was 22.56 ± 4.83, and the mean physical activity was 711.16 ± 576.05 MET-min/week. Adherence to the Mediterranean diet was positively associated with the Physical Health, Psychological Health, and Environment domains. In the multivariable model, physical activity remained positively and independently associated with Physical Health (β = 0.31, p = 0.002), whereas both physical activity and adherence to the Mediterranean diet were positively associated with the Environment domain. These findings suggest that lifestyle behaviors are associated with specific dimensions of quality of life among shift-working nurses and emphasize the need for larger studies.