Physical Activity, Body Mass, and Adherence to the Mediterranean Diet in Preschool Children: A Cross-Sectional Analysis in the Split-Dalmatia County (Croatia).

Lejla Obradovic Salcin,Marko Ostojic,Maja Lang-Morovic,Damir Sekulic,Josko Markic,Andrea Vrdoljak,Dorica Sajber,Zeljka Karin,Vesna Miljanovic Damjanovic,Barbara Gilic

doi:10.3390/ijerph16183237

Abstract

Physical activity, body mass, and dietary habits are known to be important determinants of overall health status, but there is an evident lack of studies that examine these issues specifically in preschool children. The aim of this study was to identify associations that may exist between adhering to the Mediterranean diet (MD), levels of physical activity (PA), and body composition indices in apparently healthy preschool children from southern Croatia. Participants were 5- to 6-year-old preschoolers from the Mediterranean part of the country (the Split-Dalmatia County; n = 260, 126 females). Adherence to the MD was observed by the Mediterranean Diet Quality Index (KIDMED), PA level was evaluated by the Preschool-age Children’s Physical Activity Questionnaire (Pre-PAQ), and responses were collected from the parents. The participants’ waist circumferences (in cm), waist-to-hip ratios, and body mass index (in kg/m2, and in a z-score calculated relative to the normative value for age and sex) were used as indicators of body composition. All children were of the same age and tested over a one-month period of the same year as a part of the regular examination undertaken before attending elementary school. With only 6% of the children having a low KIDMED score, adherence to the MD was high. MD adherence was higher in girls (Chi-square = 15.31, p < 0.01) and children who live on the coast of the Adriatic Sea (Chi-square = 18.51, p < 0.01). A mixed effects logistic regression (with kindergarten as random factor) identified sedentary activity to be negatively associated with MD adherence (OR per point: 0.65, 95% CI: 0.44–0.91). High adherence to the MD in the studied sample may be attributed to regulated feeding in kindergarten. Considering that most Croatian elementary schools do not provide food to their students, MD adherence should be investigated later in life and also in other parts of the country where the MD is culturally less prevalent.

Highlights

The human body is designed such that most of its systems cannot develop and function optimally if they are not stimulated by regular physical activity [1]
24%had had average adherence, and almost of the children were classified as having high average Mediterranean diet (MD) adherence, and almost 70% of the children were classified as having high MD adherence
0.01).children who live in coastal municipalities had higher adherence to the than their children who live in coastal municipalities had higher adherence to the MD than theirpeers peerswho whowere were residentially located inland (Chi square: 18.51, p residentially located inland (Chi square: 18.51, p < 0.01) (Figure 1)

Summary

Introduction

The human body is designed such that most of its systems (cardiovascular, metabolic, skeletal, muscle, etc.) cannot develop and function optimally if they are not stimulated by regular physical activity [1]. It is well established that physical activity (PA) provides numerous health benefits, such as assisting in the prevention of chronic diseases, balancing energy expenditure, and maintaining a healthy body composition [2]. PA increases functional capacities and can reduce cardiovascular risks [3]. Regular and appropriate PA is an important component for normal growth and the development of the aerobic capacity, muscular strength, flexibility, and motor skills of children and adolescents [4,5]. It is evident that children are currently insufficiently active and do not achieve PA recommendations [7]

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Conclusion