Summary
This cross-sectional study aimed to assess perceptions of healthy food and motivation for health behaviour (MHB) in different Mediterranean countries. Multiple linear regression was used to identify the association between perception of healthy food and MHB in different countries. The highest MHB was observed in Portugal (median 38.0 ; IQR 7.0) and the lowest in Greece (median 34.0 ; IQR 8.0). Compared to Portuguese respondents, respondents from Croatia (ß=0.35 ; p<0.001), Egypt (ß=0.24 ; p<0.001), and Greece (ß=0.10 ; p<0.001) had a higher probability of a better perception of healthy food. Slovenia respondents had reduced perception of healthy food (ß=-0.10 ; p<0.001) and MHB (ß=-0.22 ; p<0.001), despite higher adherence to a healthy diet (ß=0.22 ; p<0.001). Lifestyle habits, such as physical exercise, showed a weak association with MHB (ß=0.14 ; p<0.001) and adherence to healthy food (ß=0.18 ; p<0.001). The presence of most chronic diseases was negatively associated with MHB. The association between the perception of healthy food, MHB, and adherence to a balanced and healthy diet across different countries could be useful for implementing strategies to promote healthy eating and prevent chronic diseases.

Relevance
This cross-sectional study sought to evaluate attitudes about nutritious food and motivation for healthy behavior in various Mediterranean nations. Exercise and other lifestyle behaviors revealed a correlation with motivation for healthy behavior and adherence to a healthy diet. The majority of chronic illnesses were inversely correlated with motivation for healthy behavior. This indicates the importance of consuming a healthy diet in the prevention of many diseases, such as chronic pulmonary diseases, which may be related to unhealthy food consumption. Implementation of initiatives to promote healthy eating and avoid chronic diseases, increasing physical activity, and the links between the perception of healthy food, motivation for good behavior, and adherence to a balanced and healthy diet may be relevant in the prevention of all pulmonary disorders, and especially chronic pulmonary diseases.