Abstract P200: Mediterranean Diet and Metabolic Syndrome in Adolescents: An Analysis From the National Health and Nutrition Examination Survey 2015-2020

Abstract

Background: The Mediterranean Diet (MD) is an evidence-based dietary approach emphasizing fruits, vegetables, whole grains, seafood, and olive oil. While it’s demonstrated efficacy in enhancing cardiometabolic health in adults, it’s received minimal evaluation in adolescents with metabolic syndrome (MetS). Hypothesis: We hypothesized that higher consumption of MD foods was associated with better metabolic health in a nationally representative sample of U.S. adolescents. Methods: A secondary analysis was conducted using data from the National Health and Nutrition Examination Surveys 2015-2020 (pre-COVID) in adolescents (12-19 years) with ≥ 2 valid 24-hour dietary recalls, complete fasting data for all components of the International Diabetes Foundations definition of MetS risk factors, and no known diabetes. Consumption of MD foods was evaluated using the validated, literature-based MD intake score (Medi-Lite, 0-16 score, excluding alcohol). MetS was evaluated using a continuous MetS score (cMetS) and separated into quartiles [Q1, metabolically unhealthy (cMetS score 1.83 ± 1.64) vs. Q4, metabolically healthy (cMetS score -4.16 ± 0.89)]. Correlation of Medi-Lite scores with cMetS scores and quartile groups controlled for energy intake, age, sex, and BMI were assessed via Pearson correlation and odds ratios, respectively. Results: The primary analyses included 886 adolescents (~15 years, 49% female, 70% non-Hispanic, body mass index ~25 kg/m 2 ) with a mean cMetS score of -1.40 ± 2.39. In the total sample, overall consumption of the MD was low (mean score 6.95 ± 1.83) and cMetS scores were not associated with Medi-Lite scores (r = -0.05, p = 0.21). There was a significant between-group difference for Medi-Lite scores between quartiles (F = 1.69, p = 0.05). In the metabolically healthy group, there was a positive trend towards between cMetS score and Medi-Lite score (r = 0.15, p = 0.06). No correlation was found between cMetS and Medi-Lite scores in the metabolically unhealthy group (r = -0.04, p = 0.59). Metabolically healthy adolescents had higher odds of consuming the MD compared to metabolically unhealthy adolescents (OR 2.012, 95% CI 1.44 to 2.81, p < 0.001). Conclusion: In conclusion, U.S. adolescents had an overall low consumption of MD foods. Metabolically healthy adolescents consumed more MD foods compared to metabolically unhealthy adolescents. Future research should evaluate a MD lifestyle intervention as a treatment option for adolescents with MetS.