Abstract

Obesity is a rapidly growing problem in European countries, Croatia being among them. According to the latest CroCOSI data, every third child in Croatia aged 8.0–8.9 years is overweight or obese. The Mediterranean diet (MeDi) and its impact on nutritional status and health has been the focus of recent research. Therefore, the aim of this cross-sectional, observational study was to determine the nutritional status and adherence to the MeDi of preschool children in Split, Croatia. We included 598 preschool children aged 3 to 7 years and, for each child, parents completed a lifestyle questionnaire and the Mediterranean Diet Quality Index (KIDMED) in order to assess adherence to the MeDi. The anthropometric assessment included the measurement of weight, height, mid-upper arm circumference (MUAC), waist circumference (WC) and the z-score was calculated. According to the z-score, 420 (70.2%) children had a healthy body weight with 54 (9%) underweight and 124 (20.8%) overweight or obese children. Almost half (49%) of the study participants had a low KIDMED index score, indicating a low MeDi adherence, 37% had an average score, while only 14% had high MeDi compliance. Statistically significant negative correlations between MUAC and WC and the consumption of a second daily serving of fruit (p = 0.04) as well as a daily serving of vegetables (p = 0.03) were found. In conclusion, low compliance to the MeDi principles in preschool children is concerning. Considering the beneficial effects of the MeDi on overall health, further education, and the adoption of healthy eating habits in preschool children in this Mediterranean region are required.

Highlights

  • For preschool children, a healthy nourishment characterized by an adequate and balanced nutritional intake alone can ensure proper physical growth as well as cognitive and emotional development, a feeling of satiety and sufficient physical ability [1]

  • Almost half of the preschool children included in this study presented a lowoverweight adherence to

  • The results of this study conducted with preschool children showed low adherence to the principles of the Mediterranean diet, which is characterized by a high presence of plant-based food as well as fish and dairy products

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Summary

Introduction

A healthy nourishment characterized by an adequate and balanced nutritional intake alone can ensure proper physical growth as well as cognitive and emotional development, a feeling of satiety and sufficient physical ability [1]. In this preschool period, children shape their dietary patterns by developing independent feeding skills and forming their own food preferences [2]. As the growth and nutritional assessment by health professionals become less frequent after the first year of a child’s life, dietary habits are most often guided by parents, caregivers, or kindergarten professionals. The main aim of this study was to determine nutritional status and adherence to the MeDi in preschool children from

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