Younger age, higher father education level, and healthy lifestyle behaviors are associated with higher adherence to the Mediterranean diet in school-aged children

Abstract

ObjectivesThis study aimed to assess adherence to the Mediterranean Diet (MDiet) in school-aged children in Turkey and explore the associated factors with high adherence to the MDiet. MethodThis cross-sectional was conducted with 2693 school-aged children. Sociodemographic, dietary, and lifestyle data were collected using a questionnaire. Mediterranean Diet Quality Index (KIDMED) was used to evaluate adherence to the MDiet. Body weight, height, neck, waist, and hip circumference were measured. Dietary intake was assessed with a 24-h food consumption record. ResultsOf the 2693 children, 29.5% had high, 53.9% had moderate, and 16.6% had low adherence to the MDiet. Primary school children had significantly higher adherence to the diet than secondary school children. Adherence to the MDiet was higher in children whose fathers were university graduates. There were no significant differences in sex, body mass index (BMI), or anthropometric measurements according to MDiet adherence. The high adherence group had a significantly higher intake of protein, fiber, vitamins C, B1, B6, B2, folate, polyunsaturated fatty acids, zinc, potassium, and calcium, but lower carbohydrate intake compared with the low/moderate adherence group. Higher adherence to the MDiet was associated with adequate sleep duration (≥9 to <12 h) (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.24–2.78), whereas poor/moderate adherence was associated with age (OR, 0.80; 95% CI, 0.73–0.87) and screen time (OR, 0.50; 95% CI, 0.40–0.63). Children who reported engaging in regular physical activity were more likely to have higher MDiet adherence (OR, 1.46; 95% CI, 1.16–1.85). ConclusionThe results of this study showed that >50% of the children presented moderate MDiet adherence. Younger age, adequate sleep duration, engaging in regular physical activity, less screen time, and higher education level of fathers were associated with higher adherence to the diet.