Limitations and strengths
Some limitations need to be highlighted. First, the observational design does not allow a clear cause–effect identification. Second, the results should be interpreted cautiously, as we could be limited to detect small association sizes. Larger studies should further explore these associations to corroborate our results. Third, the participants were enroled in an exercise intervention that might affect our findings. However, we included the group allocation as a confounder in our longitudinal analyses. Furthermore, we observed that the GESTAFIT exercise intervention did not have any effect on the MD adherence, nor on any of its components (except for legumes). Thus, the primary exposure (i.e., exercise) is not likely to have affected our findings. Fourth, the limited data (