Arslan, NurgülÇifçi, SemaAlataş, Hacer2026-05-152026-05-1520263005-0774https://hdl.handle.net/20.500.12514/10912https://doi.org/10.1186/s12982-026-01948-5Background Türkiye hosts over 3.5 million Syrian refugees, with women facing heightened socioeconomic and health-related vulnerabilities. Structural constraints, including food insecurity, may influence dietary behaviors and overall well-being. Objective This study aimed to assess quality of life (QoL), Mediterranean diet adherence, and food security levels among Syrian refugee women living in Mardin, Türkiye; to examine the association between Mediterranean Diet Score (MDS) and QoL domains; to identify independent predictors of total QoL; and to explore the mediating role of food insecurity in this relationship. Methods A cross-sectional study was conducted with 310 Syrian refugee women aged 18-49 years. Data were collected using structured questionnaires, including the 14-item Mediterranean Diet Adherence Screener and the WHOQOL-BREF instrument. Descriptive statistics, ANOVA, Pearson correlation analysis (continuous variables only), multiple linear regression, and exploratory mediation analysis were performed. Results The mean total QoL score was 59.3 (SD = 14.5). The mean Mediterranean Diet Score (MDS) was 7.1 (SD = 2.6), with 22.6% of participants demonstrating high adherence. Food insecurity was prevalent, affecting 79.4% of households. Higher MDS was positively associated with all QoL domains (physical: r = 0.28, p < 0.001; psychological: r = 0.24, p = 0.002; social: r = 0.21, p = 0.004; environmental: r = 0.19, p = 0.007). Although statistically significant, these correlations were weak in magnitude (r < 0.30). In multiple regression analysis, MDS, education, and income were positive predictors of QoL, whereas food insecurity and larger household size were negatively associated. Exploratory mediation analysis identified a statistically significant indirect effect consistent with a potential partial mediation pattern; however, given the cross-sectional design, these findings should not be interpreted as evidence of a causal pathway. Conclusion Mediterranean diet adherence was positively associated with quality of life among Syrian refugee women. Socioeconomic disadvantage and food insecurity were linked to lower well-being. Given the cross-sectional design, causal inferences cannot be made, and longitudinal studies are needed to clarify these relationships.en10.1186/s12982-026-01948-5info:eu-repo/semantics/openAccessMediterranean DietFood InsecurityQuality of LifeNutritional HealthSyrian RefugeesMardinArticle2-s2.0-105036871496