Chilean Schoolchildren Research Articles

The Mediating Role of Cardiorespiratory Fitness in the Association between a Negative Lifestyle and Poor Mental Health in Chilean Schoolchildren.

A negative lifestyle has a reported relationship with psychological problems and deteriorated well-being. However, there is little information regarding the mediating role of cardiorespiratory fitness (CRF) in this relationship. The objectives of the present study are twofold: first, to investigate the association between negative lifestyle, physical self-concept (PSC), and depression, and second, to assess the potential mediating role of CRF in this complex relationship. This cross-sectional study included 612 schoolchildren aged between 9 and 14 years from the Araucanía region (southern Chile). CRF was measured using the Leger test, and lifestyle, depression, and PSC were measured using validated questionnaires. A negative lifestyle reported an inverse association with PSC (p < 0.001) and a positive association with depression levels (p < 0.001). The mediation analysis showed that CRF was positively related to PSC (p < 0.001) and inversely related to depression (p = 0.001); besides, the indirect effect CRF acted as a partial mediator in the association between a negative lifestyle and PSC (indirect effect = -1.15; SE = 0.01; 95% CI, -1.87, -0.55) and depression levels (indirect effect = 0.22; SE = 0.08; 95% CI, 0.08, 0.38). In conclusion, CRF in schoolchildren played a potential mediating role in the association between a negative lifestyle and depression and PSC.

Conceptual subordination in the oral retelling of Spanish-speaking children

Although retelling as a technique to assess narration has been widely used, the input modality seems to impact in different ways on the elicited text, generating a debate about the biases that may appear. To contribute to this discussion, the objective of this study is to describe the development of conceptual subordination and its forms of coding in the oral stories of Spanish-speaking children as well as its relationship with the source text. The stories of 28 five-year-old Chilean school children collected through a retelling task were studied. The analysis consisted of firstly assessing the production of conceptual subordination through the identification of asymmetric links between states of affairs. Then, the encoding forms that instantiated these links were classified. Finally, indices were constructed and applied to compare the children’s texts with the source text. During the comparative analysis with the input, three qualitative categories emerged: similar production, reformulation and new link. The results showed that the participants’ stories present significantly less production of conceptual subordination link than the source text. However, the children were able to create new links that were not presented in the story and reformulated others, as evidence of an interpretive process that goes beyond the mere reproduction of the input in these types of tasks. Regarding the encoding forms, the results were very similar between the source text and the children’s text without significant differences. Both in source texts and children’s texts, the prototypical forms of Spanish dominated, allowing us to conclude a possible input bias.

Motor competence and compliance with physical activity recommendations in Chilean schoolchildren.

The development of motor competence is thought to be a crucial precursor to raising the trajectory of PA throughout a person's life. The objectives of this study are to determine motor competence and the daily time of moderate and vigorous physical activity of students in 5th and 6th grade elementary in Chile, and to establish whether there are differences in motor competence according to sex and compliance with physical activity recommendations. 368 schoolchildren (M = 11.10 years; 54.3% girls) participated. To assess motor competence, the MOBAK 5-6 test was used. Physical activity was measured using ActiGraph wGT3X-BT® accelerometers. Boys (M = 3.65, SD = 2.14) showed better performance than girls (M = 2.39, SD = 1.80) in Object Control (p ≤ 0.001, PS = 0.67). For Self-Movement, the girls (M = 2.72, SD = 2.14) performed better than the boys (M = 2.40, SD = 1.86); however, there were no significant differences between the two sexes (p = 0.257). Boys (M = 48.4, SD = 22.8) presented more daily minutes of moderate and vigorous physical activity than girls (M = 35.9, SD = 16.9), with statistically significant differences (p ≤ 0.001, PS = 0.67). About MC according to compliance with the physical activity recommendations, only in Object Control there is a statistically significant difference (p ≤ 0.001; PS = 0.29) between the students who comply with the recommendations (M = 4.28, SD = 2.12) and those who do not achieve the recommended minutes (M = 2.67, SD = 1.29). By contrast, an analysis of Self-Movement found no significant difference (complies: M = 2.73, SD = 1.97; does not comply: M = 2.54, SD = 2.04; p = 0.408) between the two groups. It is necessary to generate instances that develop motor competence in all its dimensions to promote higher levels of moderate to vigorous physical activity.

Exploring perceptions of extreme environments and extremophiles in Chilean schoolchildren: an ethnographic study.

Chile is unique because of its diverse extreme environment, ranging from arid climates in the north to polar climates in Patagonia. Microorganisms that live in these environments are called extremophiles, and these habitats experience intense ecosystem changes owing to climate warming. Most studies of extremophiles have focused on their biotechnological potential; however, no study has examined how students describe extremophiles. Therefore, we were interested in answering the following question: How do schoolchildren living in extreme environments describe their environments and extremophiles? We performed an ethnographic study and analyzed the results of 347 representative drawings of participants aged 12-16 years from three schools located in the extreme environments of Chile San Pedro de Atacama (hyper-arid, 2,400 m), Lonquimay (forest, 925 m), and Punta Arenas (sub-Antarctic, 34 m). The social representation approach was used to collect data, and systemic networks were used to organize and systematize the drawings. The study found that, despite differences between extreme environments, certain natural elements, such as trees and the sun, are consistently represented by schoolchildren. The analysis revealed that the urban and rural categories were the two main categories identified. The main systemic networks were rural-sun (21,1%) for hyper-arid areas, urban-tree (14,1%) for forest areas, and urban-furniture (23,4%) for sub-Antarctic areas. When the results were analyzed by sex, we found a statistically significant difference for the rural category in the 7th grade, where girls mentioned being more rural than boys. Students living in hyper-arid areas represented higher extremophile drawings, with 57 extremophiles versus 20 and 39 for students living in sub-Antarctic and forest areas, respectively. Bacteria were extremophiles that were more represented. The results provide evidence that natural variables and semantic features that allow an environment to be categorized as extreme are not represented by children when they are focused on and inspired by the environment in which they live, suggesting that school literacy processes impact representations of their environment because they replicate school textbooks and not necessarily their environment.

Mental Health, Subjective Well-Being, and Academic Performance in Chilean Schoolchildren Who Are Part and Are Not Part of the School Inclusion Program

Inclusive education acknowledges and values the capabilities and needs of every student. Exploring their perceptions of psychosocial variables and academic performance can significantly enhance inclusive practices and improve overall school performance, particularly for students with special educational needs (SEN). This study aimed to assess mental health, subjective well-being, and academic performance among students in the school inclusion program (SIP) and those not in the program. Conducted as an analytical cross-sectional study, this research endeavor entailed the utilization of a probabilistic, stratified sampling approach designed to ensure community representativeness. The study sample encompassed a cohort of 730 school students aged between 10 and 15 years (M = 12; SD = 1.3 years) representing five different public schools in the Biobío region, all integrating SIPs into their educational structure. Student assessments involved the Rosenberg Self-Esteem Scale, Beck Anxiety Inventory, and Subjective Happiness Scale. Additionally, their academic performance was measured based on grade point averages (GPAs) and final accumulated grades in language and literature as well as mathematics. Students enrolled in the SIP obtained lower scores in the self-esteem, anxiety, and happiness assessments along with poorer academic performance compared to their non-SIP counterparts. Consequently, students participating in the SIP displayed lower levels of mental health and subjective well-being along with inferior academic performance in contrast to their non-participating counterparts. These findings are alarming, as SIP implementation is a key strategy for promoting inclusive education in Chile and enhancing the learning of all students, especially those with SEN.

Low Sleep Hygiene Is Associated with Less Adherence to the Mediterranean Diet in Chilean Schoolchildren from Rural Public Schools-A Cross-Sectional Study.

The Mediterranean diet stands as a widely acknowledged and health-promoting dietary pattern, renowned for its notable linkage to the mitigation of noncommunicable chronic maladies. Nonetheless, the existing body of evidence concerning the potential interrelation between sleep hygiene and this dietary regimen remains circumscribed. The main objective was to determine the association between sleep hygiene and adherence to the Mediterranean diet in Chilean schoolchildren from rural public schools in southern Chile. A non-experimental study was carried out, with an analytical, cross-sectional design. A total of 265 students (56.6% women, mean age 13.5 ± 1.8) from a rural community in southern Chile were recruited. Sleep habits were evaluated using Section 6 of the Life Habits and Adolescence Questionnaire, Sleep and Rest, and adherence to the Mediterranean diet was assessed with the KIDMED Mediterranean Diet Adherence Questionnaire. The main results indicated that 52.8% of schoolchildren need to improve adherence to the Mediterranean diet and 16.6% have a low-quality Mediterranean diet. A high percentage of schoolchildren have behaviors related to poor sleep hygiene (going to bed late (46%), waking up tired and wanting to continue sleeping (63.8%), and having problems falling asleep (42.6%)). Schoolchildren who got up after 8:30 a.m., those who fell asleep after midnight, upon conducting a comparative analysis of the students based on their sleep patterns, those who woke up tired and those who had trouble falling asleep had a lower level of adherence to the Mediterranean diet compared to schoolchildren who got up earlier than 8:30 a.m., fell asleep before midnight, did not wake up tired, and those who did not find it difficult to fall asleep, respectively. In conclusion, having poor sleep patterns including difficulties in both awakening and falling asleep are associated with less adherence to the Mediterranean diet in schoolchildren from rural public schools in southern Chile. Monitoring these variables and promoting healthy lifestyle habits within the educational community are essential measures.

Prevalence and severity of molar-incisor hypomineralization, is there an association with socioeconomic status? A cross-sectional study in Chilean schoolchildren.

Data about molar-incisor hypomineralization (MIH) prevalence and its severity remains limited for some Latin American countries. Furthermore, its association with socioeconomic status (SES) is still unclear. Thus, this study aims to determine the prevalence and severity of MIH in Santiago, Chile and explore its association with SES. A cross-sectional study with schoolchildren between 6 and 12 years was conducted. Children were evaluated using the European Academy of Paediatric Dentistry to diagnose MIH, and the Mathu-Muju and Wright criteria to determine its severity. A total of 1,270 children were included. The MIH prevalence was 12.8% without association with gender (p = 0.609). Prevalence was higher among schoolchildren ages 8 and 9 (p = 0.002), and in lower SES (p = 0.007). MIH mild cases were the most prevalent (63%), and severity was not related to gender (p = 0.656), age (p = 0.060), or SES (p = 0.174). The prevalence of MIH in the province of Santiago, Chile is 12.8% and was found to have a higher incidence in 8-9-year-old students and among those categorized by low SES. Furthermore, MIH prevalence was associated with low SES. Public health policies to address MIH in Chile should start with schoolchildren aged 8 to 9,and with low SES.

Actual and Perceived Motor Competence in Chilean Schoolchildren before and after COVID-19 Lockdowns: A Cohort Comparison.

(1) Background: the measures applied in Chile to reduce COVID-19 infections have been very strict, mainly for children who have experienced lockdowns and school closures for almost two years. Emerging evidence indicates that lockdowns have had several negative effects on children; therefore, the present study seeks to analyze the secular effects of COVID-19 lockdowns on Chilean students' actual motor competence (AMC) and perceived motor competence (PMC). (2) Methods: using a sequential cohort design, data from 523 fifth-grade students at nine elementary schools (46.8% girls, age M = 11.11, SD = 0.66) were assessed in 2018-19 (pre-lockdown) (n = 265) and 2022 (post-lockdown) (n = 258). (3) Results: in the domain of object control (AMC and PMC), no significant differences were found (AMC p = 0.559; PMC p = 0.682). In the self-movement domain of AMC and PMC, the significant differences found presented a small effect size (AMC p = 0.044, ηp2 = 0.01; PMC p = 0.001, ηp2 = 0.03). (4) Conclusions: although the differences encountered were not drastic, self-movement skills tended to be greatly affected by the lockdowns resulting from the COVID-19 pandemic. These findings broaden information on the negative consequences of the pandemic on students in aspects related to an active and healthy life.

The Mediating Role of the Muscle Quality Index in the Relation of Screen Time and Abdominal Obesity with Health-Related Quality of Life in Chilean Schoolchildren.

Screen time (ST) and abdominal obesity have a negative effect on health-related quality of life (HRQoL). However, there is little information regarding the mediating role of the muscle quality index (MQI) in these relationships. The aim of the present study was to investigate the association between HRQoL, physical status (i.e., anthropometrics and fitness), lifestyle (i.e., ST and physical activity), and the MQI, and then to determine the potential mediating role of the MQI in the relation of ST and abdominal obesity with HRQoL in Chilean schoolchildren. The cross-sectional study included 750 schoolchildren (girls, n = 332 and boys, n = 418) aged between 10 and 14 years (11.73 ± 1.08 y). MQI, lifestyle, fitness parameters, waist-to-height ratio (WtHR) and HRQoL were measured. HRQoL presented a significant correlation with WtHR (r: -0.19), VO2max (r: 0.20), physical activity after school (r: 0.26), ST (r: -0.26) and MQI (r: 0.15). According to MQI, the high-MQI group reported higher HRQoL than the low-MQI group (low MQI: 36.10 ± 3.63 vs. high MQI: 37.43 ± 4.00, p < 0.001). In the mediation model, ST and abdominal obesity were negatively linked to HRQoL; the indirect effect confirmed that MQI is a partial mediator in the relation between ST and HRQoL (indirect effect = -0.04; SE = 0.02; 95% CI: -0.09, -0.01) and in the relation between abdominal obesity and HRQoL (indirect effect = -1.81; SE = 0.83; 95% CI: -3.41, -0.40). In conclusion, MQI is related to better HRQoL in schoolchildren, and the negative relation of ST and abdominal obesity with HRQoL is mediated by MQI.

Reference Values of Absolute and Relative Handgrip Strength in Chilean Schoolchildren with Intellectual Disabilities.

Handgrip strength is a simple measure of general muscle strength and is related to functionality in people with intellectual disabilities. The objective of this research was to describe the normative values of absolute and relative handgrip strength in children, adolescents and adults according to sex. The sample was made up of 264 schoolchildren (n = 168 men) belonging to five special education schools in Santiago of Chile. The results show higher levels of absolute handgrip strength in males compared to females. The maximum peak of the absolute manual handgrip is reached in females in adolescence with a decrease in adulthood. Relative handgrip strength levels are similar in boys and girls. In females, the relative handgrip strength is similar in childhood and adolescence. Relative handgrip strength declines in both sexes from adolescence to adulthood. The reference values of this study can be used by professionals in the areas of health and education as a guide for interpretation, monitoring and follow-up of Chilean schooled people with intellectual disabilities.

Negative Physical Self-Concept Is Associated to Low Cardiorespiratory Fitness, Negative Lifestyle and Poor Mental Health in Chilean Schoolchildren.

Background: Evidence suggests that physical self-concept (PSC) is linked to well-being in children and adolescents. Objective: The objective was to investigate the association of PSC with mental health (i.e., depression and body image), physical status (i.e., fitness and weight status) and lifestyle (physical activity (PA) patterns and nutritional level) in Chilean schoolchildren. Methods: A total of 617 schoolchildren (n = 271 girls and n = 346 boys) aged 10–14 years participated in this study. Self-concept, depression and body image dissatisfaction were determined by questionnaires. Physical fitness, PA, screen time (ST), Mediterranean diet (MD) adherence and anthropometric parameters were also included. Results: Poor PSC was linked to bad cardiorespiratory fitness (CRF) (<42 VO2max) (OR 1.64; 95%CI 1.12–2.34; p = 0.01), severe body image dissatisfaction (OR 2.51, 95%CI 0.99–6.35; p = 0.05), ST of more than two hours a day (OR 2.1; 95%CI 1.41–3.12; p < 0.001), PA after school of no more than two hours per week (OR 1.52; 95%CI 1.08–2.13; p = 0.015) and depression (OR 1.80; 95%CI 1.1–2.92; p = 0.017). High nutritional level showed an association with general PSC and general self-concept (p < 0.05). Absence of body image dissatisfaction was related to general self-concept (p < 0.01) and physical condition dimensions (p < 0.05). Conclusions: PSC is associated with CRF, PA after school, ST and nutritional level. According to mental health variables, poor PSC is related to depression in Chilean schoolchildren. Therefore, promoting a healthy lifestyle among children should be a target of community- and school-based interventions to promote PSC.

Cross-sectional association between physical fitness and cardiometabolic risk in Chilean schoolchildren: the fat but fit paradox.

BackgroundPrevious studies have examined the “fat but fit” paradox, revealing that greater levels of physical fitness may diminish the harmful consequences of excess weight on cardiometabolic risk. Despite the above, specific information about the “fat but fit” paradox in prepuberal population is scarce. The aim of this study was to determine the relationship between cardiometabolic risk across (individual and combined) physical fitness and excess weight status and whether the “fat but fit” paradox is met in the sample of schoolchildren analyzed.MethodsA cross-sectional study was conducted including 452 children (59.1% girls), aged 7–9 years from Santiago (Chile). Physical fitness was assessed as cardiorespiratory fitness and muscular fitness. Cardiorespiratory fitness was determined by the 6-minute-walk-test and muscle strength was assessed by the handgrip and standing long jump tests. Excess weight (overweight and obesity) was computed through body mass index (z-score). Cardiometabolic risk was established by summing the z-score of the serum glucose, triglycerides, high-density lipoprotein, insulin and waist-to-height ratio.ResultsSchoolchildren with high physical fitness (individual or combined) showed the lowest cardiometabolic risk mean scores (P for trend <0.001 for all physical fitness groups). Conversely, schoolchildren with low physical fitness (individual or combined) showed the highest cardiometabolic risk mean scores (P for trend <0.001 for all categories). Additionally, schoolchildren without excess weight and with high individual or combined physical fitness status exhibits lower cardiometabolic risk mean scores compared to schoolchildren with excess weight and low physical fitness status (individual or combined) (P for trend <0.001 for all physical fitness groups). A lower odd of having high cardiometabolic risk was found in schoolchildren without excess weight and with both high physical fitness (both cardiorespiratory fitness and muscular fitness) [odds ratio (OR) =0.08; 95% confidence interval (CI): 0.04 to 0.16] in comparison to those with excess weight and low physical fitness.ConclusionsOur results suggest that improvements in both fatness and aerobic fitness could be associated with lower cardiometabolic risk.

Supplemental Material for How Did the Pandemic Affect the Socio-Emotional Well-Being of Chilean Schoolchildren? A Longitudinal Study

Supplemental Material for How Did the Pandemic Affect the Socio-Emotional Well-Being of Chilean Schoolchildren? A Longitudinal Study

Selective Attention and Concentration Are Related to Lifestyle in Chilean Schoolchildren.

The objective of this investigation was to determine the association between selective attention and concentration with physical fitness (i.e., cardiorespiratory fitness (CRF), O2max, the standing long jump test (SLJ) and handgrip muscle strength (HGS)), lifestyle parameters (i.e., physical activity (PA) level, screen time (ST), sleep duration and food habits) and anthropometric measures (i.e., body mass index (BMI) and waist circumference (WC)) among Chilean schoolchildren. Two hundred and forty-eight schoolchildren (137 boys, 111 girls, 11.80 ± 1.17 and 11.58 ± 1.09 years, respectively) participated. Selective attention, concentration and lifestyle (PA, ST, sleep duration and Mediterranean diet (MD) adherence) were determined using a standard questionnaire. CRF, SLJ, HGS and anthropometric indicators (BMI and WC) were also measured. Selective attention showed a positive association with MD adherence score (β; 5.012, p = p < 0.05). Concentration was linked inversely to ST (β; −5.498, p = p < 0.05). Likewise, concentration presented a positive association with MD adherence (β; 2.904, p = p < 0.05). In conclusion, children’s lifestyles are related to the selective attention and concentration of children; therefore, promoting healthy habits could be a cost-effective strategy in the promotion of cognitive development, as it relates to selective attention and concentration.

Lifestyle mediates the relationship between self-esteem and health-related quality of life in Chilean schoolchildren

ABSTRACT A healthy lifestyle, including food habits, physical activity (PA) and screen time (ST), is an important factor for well-being. The main purpose of this study was to analyze the association between lifestyle (i.e., PA, ST and food habits), self-esteem and health-related quality of life (HRQoL). A second objective was to determine the association between self-esteem with HRQoL, considering the mediating effect of lifestyle. A descriptive and cross-sectional study was performed, involving both girls (n = 282, 11.86 ± 0.82 years) and boys (n = 352, 12.02 ± 0.87 years). Lifestyle, self-esteem, HRQoL and anthropometrics parameters were evaluated. The study reported that self-esteem (β; 0.04, P = 0.49) and PA (β; 1.15, P < 0.001) had positive association with HRQoL. By contrast,ST was linked in an inverse way to HRQoL (β; −1.82,, P < 0.001). According to the second objective, self-esteem had a significant association with HRQoL (total effect = 0.48, p < 0.01), and ST mediated this association negatively, instead, PA and food habits positively mediated this association. In conclusion, self-esteem presented association with HRQoL and lifestyle mediates this relationship positively (PA, MD adherence) and negatively (ST). Therefore, promoting healthy lifestyle among children should be a target of community- and school-based interventions to promote well-being.

Association between Creativity and Memory with Cardiorespiratory Fitness and Lifestyle among Chilean Schoolchildren.

The objective was to investigate the association between creativity and memory with cardiorespiratory fitness (CRF; i.e., CFR classification and O2max); lifestyle parameters (i.e., physical activity (PA), sleep duration, screen time (ST), and food habits); and anthropometric measures (i.e., body mass index (BMI), waist circumference (WC)) among Chilean schoolchildren. A total of 248 schoolchildren (137 boys, 111 girls, 11.80 ± 1.17 and 11.58 ± 1.09 years, respectively) participated in the cross-sectional study. Creativity, memory, concentration, and selective attention and lifestyle (PA, ST, sleep duration, and Mediterranean diet (MD) adherence) were measured using a standard questionnaire. CRF (measured by the 20 m shuttle run test and expressed as maximum oxygen consumption O2max) and anthropometric measures (BMI and WC) were also included. Creativity showed a positive association with O2max (mL/kg/min) (β; 0.209, 95% CI; 0.02–0.40, p = p < 0.05) and MD Adherence (score) (β; 0.206, 95% CI; 0.01; 0.74, p = p < 0.05). Long-term memory reported a positive association with CRF (β; 1.076, 95% CI; 0.02–2.13, p = p < 0.05). An increase in CRF levels, together with healthy food habits and normal nutritional status, should be a target for community- and school-based interventions to promote cognitive development in creativity and memory among schoolchildren.

Nutritional Status of Diet Soft Drinks Consumption Among Chilean School Children

Nutritional Status of Diet Soft Drinks Consumption Among Chilean School Children

Muscular Strength of Upper and Lower Limbs and Self-Esteem in Chilean SchoolChildren: Independent Associations with Body Composition Indicators.

The aim of this study was to analyze the relationship between muscular strength from upper and lower limbs with self-esteem among Chilean schoolchildren, drawing independent associations with body composition indicators. The sample consisted of 1078 schoolchildren. The muscular strength of the upper and lower limbs was evaluated using a digital dynamometer and long jump performance. The general strength index was calculated based on Z-score values. Rosenberg’s test was used to determine the level of self-esteem of participants. Body fat and body mass index were employed as body composition indicators. Boys had significantly more upper and lower strength, and a general strength index higher than girls (11.7 vs. 10.6; 109.7 vs. 97.4; 0.19 vs. −0.24, respectively). For boys and girls combined, there were no significant associations between all muscular strength variables and self-esteem. In boys, upper and lower limb strength was positively associated with self-esteem. In girls, no association between muscular strength and self-esteem was found. In both sexes, the general strength index was not associated with self-esteem. Strategies and programs that promote mental health and muscular strength among schoolchildren, specifically in boys, are needed.

Cardiometabolic risk in children with severe obesity

Introduction: severe obesity has had a greater increase than non-severe obesity in Chilean schoolchildren during the last years. We do not know whether the cut-off point currently used to define severe obesity in children (BMI ≥ + 3 DE, WHO-2007 curves) is associated with a greater biological risk in our population. Objective: to describe and compare cardiometabolic risk in schoolchildren with severe vs. non-severe obesity. Methods: a secondary analysis of a sample of 3,325 schoolchildren was performed, in which cardiometabolic risk factors were studied. The prevalence of these was compared in the subsample of 589 schoolchildren with obesity according to whether it was severe or not, and the respective ORs were calculated. Results: mean age was 11.4 ± 0.98 years, 46 % were girls, and 11.5 % of the sample had severe obesity, with a higher prevalence of most of the factors studied and no differences in chronic disease, obesity or education in parents, or physical activity of the child. The risk of those with severe obesity for central obesity, insulin resistance, high blood pressure, and metabolic syndrome reached an OR of 12.9, 3.2, 2.67, and 1.92, respectively, as compared to those with non-severe obesity. Conclusion: this definition of severe obesity in childhood favors the identification of children with higher cardiometabolic comorbidity, which allows to focus the efforts of secondary prevention and its most timely treatment.

The social and psychological health of children is associated with Mediterranean diet adherence items, cardiorespiratory fitness, and lifestyle.

Background: Mediterranean diet (MD) adherence, physical activity (PA) patterns, and physical fitness are associated with physical, social, and psychological health in children. Objective: the purpose of this study was to determine the association of items of MD adherence, fitness components, and lifestyle with psychological and social health in Chilean schoolchildren. Material and methods: this cross-sectional study included 615 schoolchildren, both girls (n = 271, 11.7 ± 1.00 years old) and boys (n = 344, 11.8 ± 1.1 years old). Anthropometric parameters, fitness components, lifestyle, health-related quality of life (HRQoL), and self-esteem were measured. Results: HRQoL showed an association with cardiorespiratory fitness (β: 0.12, p < 0.001) and PA (β: 0.32, p = 0.023). Self-esteem was inversely associated with screen time (β: -1.35, p < 0.001). Moreover, social health presented a positive association with PA after school (β: 0.06, p = 0.037). In relation to MD adherence items, HRQoL was linked to the items "Takes a fruit or fruit juice every day" (β: 1.93, p = 0.004) and "Consumes fresh or cooked vegetables ˃ 1 time/day" (β: 1.12, p = 0.018). Self-esteem was associated to "Consumes a dairy product ˃ 1 time/day" (β: 3.30, p = 0.030). Social health was inversely related to "Eats at a fast food restaurant ≥ 1 time/week" (β: -0.26, p = 0.003) and positively to "Consumes pasta or rice almost every day" (β: 0.35, p = 0.049). Conclusion: MD adherence items, fitness, and lifestyle were linked to psychological and social health, therefore it is necessary to develop preventive strategies for schoolchildren to change in a positive way these modifiable lifestyle behaviors.