ADHERENCE TO THE MEDITERRANEAN DIET IN ELEMENTARY SCHOOL CHILDREN (1ST CYCLE)

Sara Maria Oliveira Pinto,Goreti Filipa Santos Marques,Ana Catarina Rodrigues Da Silva Reis,Tânia Daniela Barbosa Martins,Ana Rita Vieira Pinheiro,Ana Paula Da Conceição

doi:10.1590/1984-0462/2021/39/2019259

Sara Maria Oliveira Pinto, Goreti Filipa Santos Marques + Show 4 more

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https://doi.org/10.1590/1984-0462/2021/39/2019259

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Abstract

ABSTRACTObjective: To characterize the adherence to the Mediterranean diet (MD) in students from elementary schools in Porto and Maia and analyze its association with sleep hygiene, physical activity, cardiometabolic risk, and school performance.Methods: This is a cross-sectional study with 891 Portuguese students: 455 boys (51%) and 436 girls (49%), aged between 9 and 11 years old (mean [M]=9.2, standard deviation [SD]=0.4), with an average weight of 35.9 kg (SD=8.1), average height of 1.4 m (SD=0.1), average body mass index (standardized BMI Z score for the pediatric age group) of 0.76 (SD=1.21); 59.5% of them had normal weight and 15.9% were obese. The students filled a questionnaire on the adherence to the Mediterranean Diet (Mediterranean Diet Quality Index in Children and Adolescents [KIDMED]), participated in a socio-demographic interview, and had their anthropometric data collected after their parents signed the informed consent form.Results: The results suggest high levels of adherence to the MD (77.6%) both in males and females. Using Pearson’s correlation coefficient, we found that the Z score was positively associated to cardiometabolic risk and the starting age of an extracurricular physical activity, and negatively associated to the average hours of sleep on a typical day both in males and females. We also identified a negative relation between KIDMED and the starting age of physical activity.Conclusions: This study has contributed to the knowledge of adherence to the MD among Portuguese elementary students and correlations with variables associated to a healthier lifestyle (MD, hours of sleep, and physical activity). Future studies should focus their attention on other countries and more heterogeneous samples.

Highlights

The Mediterranean diet (MD) is considered one of the healthiest dietary patterns in the world, characterized by a nutritional regime consisting of abundant pieces of food of vegetable origin such as bread, pasta, vegetables, fresh fruit, and oilseeds; the use of olive oil as the main source of fat; the moderate consumption of fish, poultry, dairy products, and eggs; the intake of small amounts of red meat; and moderate ingestion of wine, usually during main meals
Regarding the hours devoted to physical activity, we identified that this variable is positively associated with the KIDMED total score and negatively with sedentary hours, that is, children who spend more time in sedentary activities have lower adherence to MD
We identified that the starting age of an extracurricular physical activity had a positive and significant association with the Z score and cardiometabolic risk; these findings suggest that children with higher Z score and cardiometabolic risk started practicing physical activity later

Summary

Introduction

The Mediterranean diet (MD) is considered one of the healthiest dietary patterns in the world, characterized by a nutritional regime consisting of abundant pieces of food of vegetable origin such as bread, pasta, vegetables, fresh fruit, and oilseeds; the use of olive oil as the main source of fat; the moderate consumption of fish, poultry, dairy products, and eggs; the intake of small amounts of red meat; and moderate ingestion of wine, usually during main meals. Adherence to the MD in children and adolescents still lacks investigation, but some studies suggest that this dietary pattern is a protective factor for overweight and obesity, contributing to reduce the risks of disease and morbidity associated with a poor[3] diet, and preventing the onset of respiratory diseases such as asthma and allergies.[4] In this sense, it is important to alert to current problems related to childhood obesity, which is a major public health issue.[5] Estimates indicate that 200 million children are overweight, and 40 to 50 million are obese worldwide. In Portugal, this problem affects all age groups and reaches alarming numbers.[6]

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