KIDMED Score Research Articles

Mediterranean diet and waist circumference in a representative national sample of young Spaniards

Increased waist circumference (WC), a surrogate measure for abdominal fat mass, is associated with higher cardiovascular risk not only in adults but also in youth. Identifying healthy dietary patterns that prevent abdominal fat accumulation is of paramount importance for public health. This study investigated the association between adherence to Mediterranean diet guidelines and waist circumference in a representative national sample of young Spaniards (n=2513), aged 10 to 24 years. Dietary data were recorded through a 24-h recall, waist circumference measured by research staff, and adherence to Mediterranean diet guidelines determined with the 16-item KIDMED questionnaire, based on the principles sustaining Mediterranean dietary patterns. A questionnaire provided physical activity and demographic data. Higher KIDMED scoring was significantly associated with higher leisure time physical activity levels and higher maternal education. Multiple regression analysis showed that the KIDMED score was also inversely associated with age- and height-standardized residuals of waist circumference and with waist-to-height ratio (p=0.001). After multivariate adjustment, a 5-point increase in KIDMED was associated with a mean decline of 1.54 cm in sex-, age- and height-adjusted WC. These results suggest that following Mediterranean dietary principles may be important in reducing the risk of high waist circumference in young people.

Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum ALbuminuria (3L study)

Mediterranean diet has favorable effects on the cardiovascular system, whereas albuminuria is associated with atherosclerosis progression. The aim of the study was to assess the relationships of adherence rates to the Mediterranean diet with albumin to creatinine ratio (ACR), in a cohort of Greek adolescents who participated in the Leontio Lyceum ALbuminuria (3L) study. In a total of 365 adolescents 12-17 years of age included in 3L study, ACR values were determined in a morning-spot urine. The Mediterranean diet Quality Index for children and adolescents (KIDMED) was estimated and accordingly subjects were divided into those with high (≥ 8), average (4-7) and low (≤ 3) score. Adolescents with low (n=153, 42%) compared with those with average (n=187, 51.2%) and high (n=25, 6.8%) KIDMED score were characterized by greater ACR values (22.4 vs 13.4 vs 12.1 mg/g, P<0.05) even after adjustment for confounders. In the total population, KIDMED score was related to body mass index (r=0.122, P=0.02), waist circumference (r=0.118, P=0.02), systolic blood pressure (BP) (r=0.119, P=0.023), whereas it was negatively associated with ACR (r=-0.111, P=0.041). Regarding ACR, it was associated with age (r=-0.11, P=0.044), male sex (r=0.16, P=0.003), body mass index (r=-0.131, P=0.016) and systolic BP (r=-0.144, P=0.008). Adolescents who adhere to the Mediterranean diet exhibit lower levels of albuminuria, independently of demographic and hemodynamic confounders. The inverse relation of KIDMED index with ACR suggests a close link of accelerated vascular damage reflected by albuminuria with low adherence to this favorable diet of the Mediterranean basin.

Associations between Lifestyle Patterns and Body Mass Index in a Sample of Greek Children and Adolescents

Background Although eating and physical activity behaviors have been previously individually investigated with regard to overweight in children, multidimensional lifestyle patterns, based on these behaviors, have not been explored. Objective To assess lifestyle patterns in relation to body mass index (BMI), in a nationally representative sample of the Greek pediatric population Design Cross-sectional study. Data were collected from May through July 2007. Subjects The sample consisted of 1,305 children and adolescents (ages 3 to 18 years). Main outcome measures Information on participants' dietary intake, eating behaviors, physical activity habits, and BMI were collected. Adherence to the Mediterranean diet guidelines was evaluated using the KIDMED Mediterranean diet quality index; the higher the score in this index the more favorable the dietary pattern. The Goldberg cut-off limits for the ratio of energy intake/basal metabolic rate were used to evaluate dietary low energy reporting and participants were accordingly classified as low-energy reporters. Statistical analysis Principal component analysis was performed to identify participants' lifestyle patterns. Associations between BMI and lifestyle patterns were further evaluated using multiple linear regression analyses, after controlling for potential confounders. Results Principal component analysis identified seven lifestyle patterns explaining 85% of the total variance of lifestyle habits. A lifestyle pattern characterized by higher eating frequency, breakfast consumption and higher KIDMED score was negatively associated with BMI (standardized β=−.125, P<0.001), after controlling for age, sex, and parental education. The association remained significant even when low-energy reporters were excluded from the analysis. Conclusions Results from the study suggest a potential intercorrelation and protective action of selected eating behaviors, namely eating frequency, breakfast consumption, and adherence to the Mediterranean diet, against overweight and obesity in children and adolescents.

Physical activity mediates the protective effect of the Mediterranean diet on children's obesity status: The CYKIDS study

Objective There is some evidence regarding the association between adherence to the Mediterranean diet (MD) and obesity among adults; to our knowledge, however, no relevant data exist for children. We investigated the association between adherence to the MD and obesity status in children. Methods A national cross-sectional study among 1140 children (mean age 10.7 ± 0.98 y) was carried out in Cyprus using stratified multistage sampling design. Body mass index was calculated according to International Obesity Task Force criteria, from parental reference. Adherence to the MD was assessed by the Mediterranean Diet Quality Index for children and adolescents (KIDMED diet score). To test the research hypothesis, a logistic regression analysis was applied with two dependent variable categories of obesity status, normal weight (NW) versus overweight/obese (OW/OB), and the three categories of the KIDMED score independently, after controlling for several potential confounders. Results Compared with low MD adherers, children with a high KIDMED score were 80% less likely to be OW/OB (95% confidence interval 0.041–0.976), adjusted for age, gender, parental obesity status, parental educational level, and dietary beliefs and behaviors (model 2). When physical activity was taken into account, however, the aforementioned relation was not significant (model 3; odds ratio 0.20, 95% confidence interval 0.021–1.86). Furthermore, male gender, maternal obesity, and dietary beliefs and behaviors emerged as more significant in predicting obesity in children compared with their KIDMED score. Conclusion Adherence to the MD is inversely associated with obesity in this sample of 9- to 13-y-old children; however, other behaviors, and in particular physical activity, maternal obesity, dietary beliefs and behaviors, seem to be more significant.

Level of adherence to the Mediterranean diet among children from Cyprus: the CYKIDS study

The Mediterranean diet (MD) prototype is widely used as an educational tool in public health programmes; few studies, however, have been conducted on the adherence of children to this diet. To evaluate the quality of Cypriot children's diet by assessing the degree of adherence to the MD. A national cross-sectional study among 1140 children (mean age = 10.7 (SD 0.98) years), using stratified multistage sampling design, was conducted in primary schools of Cyprus. Dietary assessment was based on a 154-item semi-quantitative FFQ and the two supplementary questionnaires (a Food Groups Frequency Questionnaire and a Short Eating Habits Questionnaire). Adherence to the MD was assessed by the KIDMED index. The association between the frequencies of consumption of various food groups and the level of adherence to the MD (poor v. average v. good KIDMED score) was also evaluated. Multiple logistic regression analyses were used to adjust for potential confounders. Only 6.7% of the sample was classified as high adherers of MD, whereas 37% had a poor KIDMED score. Multiple logistic regression analysis has shown that children with at least an average KIDMED score were more likely to eat frequently seafood and fish, legumes, nuts, bread, fruits, leafy vegetables, olives, low glycaemic index foods and unrefined foods. Effect size of associations was from medium to high. Higher adherence to MD is associated with better diet quality in children. The MD prototype may thus represent a useful educational tool for promotion of healthy eating habits in children.

Lifestyle factors are determinants of children's blood pressure levels: the CYKIDS study

Elevated blood pressure (BP) levels represent an important risk factor for cardiovascular disease. Lifestyle factors associated with increased BP levels have been extensively investigated in adults, but not in children. Therefore, we aimed to explore associations among modifiable lifestyle and levels of BP in 10- to13-year-old children. A subsample of the CYKIDS (CYprus KIDS) national cross-sectional study consisting of 622 children (11.7+/-0.83 years) was used to evaluate the research hypothesis. Measurements included BP, height, weight and waist circumference. Body mass index (BMI) was calculated according to the International Obesity Task Force (IOTF) criteria. Adherence to the Mediterranean diet was assessed by the KIDMED (Mediterranean Diet Quality Index for children and adolescents) diet score, whereas physical activity was assessed through a physical activity index. Results have shown that the cutoff value of 120/80 mm Hg was significantly associated with various lifestyle indices. BMI was positively associated with systolic BP (SBP)>120 mm Hg (odds ratio (OR)=1.21, 95% confidence interval (CI) 1.11-1.32); diastolic BP (DBP)>80 mm Hg (OR=1.13, 95% CI 1.01-1.27) and SBP/DBP>120/80 mm Hg (OR=1.20, 95% CI 1.10-1.31). Moreover, children who reported that they frequently eat while watching television were about two times more likely to have elevated SBP or overall BP, whereas children with low socioeconomic status levels were more than 2.5 times more likely to have elevated BP levels. Finally, compared with those with low KIDMED score, children with at least an average [corrected] score were 75% less likely to have elevated DBP levels, whereas they exhibited a nonsignificant trend for lower SBP (by 29%) and lower overall BP levels (by 30%). Similar results emerged when the above analyses were repeated using the American reference values. Conclusively, our study suggests that lifestyle factors play an important role in determining BP levels in children; a finding that underlines the importance of lifestyle modifications in children.

Are children from Crete abandoning a Mediterranean diet?&#x0D;

Mediterranean countries such as Greece have experienced rapid social change in the last decade. These community changes affect nutritional habits and there is a tendency for the traditional healthy Mediterranean diet to be abandoned. The parents of children from one rural Greek village on Crete (Neapolis), and one rural village in Sweden (Kisa) were invited to their primary health care centers for an interview and to fill in a validated nutrition questionnaire, KidMed. There were no differences (p = 0.48) in total KidMed score between the Cretan and Swedish children, adjusted for gender and age. However, there were some significant differences in scores on certain KidMed questions. Parents of the Cretan children reported significantly higher daily use of olive oil at home and more regular nut consumption, but also more commercially baked goods or pastries for breakfast. The parents of Swedish children reported significantly higher use of cereals, grains or bread for breakfast. The mean BMIs were similar for the Cretan (Neapolis mean 16.8, 95% CI 13.5-23.0) and for the Swedish children (Kisa mean 17.4, 95% CI 13.7-25.5) The results suggest the possibility of changing nutritional habits, measurable among young children in rural areas. The study raises the question of whether Cretan children may have abandoned some aspects of the traditional Mediterranean diet. It may also be that Swedish children have changed their diet in favor of a more Mediterranean food choice. The major limitation of the study is the small sample size, and further, larger studies are warranted.

Adherence Rates to the Mediterranean Diet Are Low in a Representative Sample of Greek Children and Adolescents

Data from studies in pediatric samples exploring adherence to the Mediterranean diet are scarce. The aim of the present work was to explore adherence to a Mediterranean diet pattern in a representative sample of Greek children and adolescents. The study sample (n = 1305, 3–18 y) was representative of the Greek pediatric population in terms of sex and age. Information on participants’ sociodemographic, anthropometric, and lifestyle characteristics were collected through telephone interviews. Adherence to the Mediterranean diet guidelines for adults and to the general dietary guidelines for children was evaluated using KIDMED scores: the higher the score, the more favorable the dietary pattern. The Goldberg cut-off limits for the ratio of energy intake:basal metabolic rate were used to evaluate dietary underreporting and children were accordingly classified as low energy reporters (LER) or non-LER. Only 11.3% of children and 8.3% of adolescents had an optimal KIDMED score (≥8). In adolescents, partial correlation analysis revealed a negative weak association between KIDMED and BMI (r = −0.092; P = 0.031), which remained significant in the non-LER subgroup (r = −0.137, P = 0.011). Multiple regression analysis revealed that higher KIDMED scores were associated, in non-LER children, with less time spent on sedentary activities (P = 0.002) and higher paternal education (P = 0.050), whereas in adolescents, with younger age (P = 0.001), less time spent on sedentary activities (P = 0.015), higher maternal education (P = 0.014), and higher eating frequency (P = 0.041). In conclusion, low adherence rates to the Mediterranean diet were observed in Greek children and adolescents; this evidence needs to be further explored regarding its impact on health and disease.

Correlation Between The Androgen Deficiency In The Aging Male Questionnaire And Androgen Levels In Men

Childhood obesity rates have shown a rising trend in the past years, becoming a public health challenge and threat. The aim of this study was to examine the association between extracurricular activities and weight status, among children. A survey was performed in 1728 primary school Greek students, during school years 2014–2016. Dietary and lifestyle habits, such as engagement in a variety of extracurricular activities were evaluated. The KIDMED Score was used to assess the level of adherence to the Mediterranean diet. Children’s Body Mass Index (BMI) was calculated and classified as normal, overweight, or obese, according to the International Obesity Task Force (IOTF) classification. The prevalence of overweight was 21.7% and obesity 5.0%, with a greater proportion of overweight/obese boys than girls (32.4% vs. 23.3%; p < 0.001). Increased engagement on extracurricular activities, such as watching TV, reading out-of-school material and reduced participation in sports activities were associated with a higher likelihood of overweight/obesity (p < 0.05). Extracurricular physical activities can be promoted within the family environment and incentives or obstacles should be considered and addressed.

Why There Are So Many Children Without Health Insurance In The Us? A Study Of The 2005-2006 Nhanes

Childhood obesity rates have shown a rising trend in the past years, becoming a public health challenge and threat. The aim of this study was to examine the association between extracurricular activities and weight status, among children. A survey was performed in 1728 primary school Greek students, during school years 2014–2016. Dietary and lifestyle habits, such as engagement in a variety of extracurricular activities were evaluated. The KIDMED Score was used to assess the level of adherence to the Mediterranean diet. Children’s Body Mass Index (BMI) was calculated and classified as normal, overweight, or obese, according to the International Obesity Task Force (IOTF) classification. The prevalence of overweight was 21.7% and obesity 5.0%, with a greater proportion of overweight/obese boys than girls (32.4% vs. 23.3%; p < 0.001). Increased engagement on extracurricular activities, such as watching TV, reading out-of-school material and reduced participation in sports activities were associated with a higher likelihood of overweight/obesity (p < 0.05). Extracurricular physical activities can be promoted within the family environment and incentives or obstacles should be considered and addressed.

P37 Relationship Of Incident Hypertension And Military Deployment In A Large Cohort

Childhood obesity rates have shown a rising trend in the past years, becoming a public health challenge and threat. The aim of this study was to examine the association between extracurricular activities and weight status, among children. A survey was performed in 1728 primary school Greek students, during school years 2014–2016. Dietary and lifestyle habits, such as engagement in a variety of extracurricular activities were evaluated. The KIDMED Score was used to assess the level of adherence to the Mediterranean diet. Children’s Body Mass Index (BMI) was calculated and classified as normal, overweight, or obese, according to the International Obesity Task Force (IOTF) classification. The prevalence of overweight was 21.7% and obesity 5.0%, with a greater proportion of overweight/obese boys than girls (32.4% vs. 23.3%; p < 0.001). Increased engagement on extracurricular activities, such as watching TV, reading out-of-school material and reduced participation in sports activities were associated with a higher likelihood of overweight/obesity (p < 0.05). Extracurricular physical activities can be promoted within the family environment and incentives or obstacles should be considered and addressed.

Sexual Selection, Male Competition, And Sex Differences In Human Mortality Rates

Childhood obesity rates have shown a rising trend in the past years, becoming a public health challenge and threat. The aim of this study was to examine the association between extracurricular activities and weight status, among children. A survey was performed in 1728 primary school Greek students, during school years 2014–2016. Dietary and lifestyle habits, such as engagement in a variety of extracurricular activities were evaluated. The KIDMED Score was used to assess the level of adherence to the Mediterranean diet. Children’s Body Mass Index (BMI) was calculated and classified as normal, overweight, or obese, according to the International Obesity Task Force (IOTF) classification. The prevalence of overweight was 21.7% and obesity 5.0%, with a greater proportion of overweight/obese boys than girls (32.4% vs. 23.3%; p < 0.001). Increased engagement on extracurricular activities, such as watching TV, reading out-of-school material and reduced participation in sports activities were associated with a higher likelihood of overweight/obesity (p < 0.05). Extracurricular physical activities can be promoted within the family environment and incentives or obstacles should be considered and addressed.

A Community Trial To Test The Effectiveness Of Intervention Strategies To Improve Mammography Screening Rates Among Underserved Women

Childhood obesity rates have shown a rising trend in the past years, becoming a public health challenge and threat. The aim of this study was to examine the association between extracurricular activities and weight status, among children. A survey was performed in 1728 primary school Greek students, during school years 2014–2016. Dietary and lifestyle habits, such as engagement in a variety of extracurricular activities were evaluated. The KIDMED Score was used to assess the level of adherence to the Mediterranean diet. Children’s Body Mass Index (BMI) was calculated and classified as normal, overweight, or obese, according to the International Obesity Task Force (IOTF) classification. The prevalence of overweight was 21.7% and obesity 5.0%, with a greater proportion of overweight/obese boys than girls (32.4% vs. 23.3%; p < 0.001). Increased engagement on extracurricular activities, such as watching TV, reading out-of-school material and reduced participation in sports activities were associated with a higher likelihood of overweight/obesity (p < 0.05). Extracurricular physical activities can be promoted within the family environment and incentives or obstacles should be considered and addressed.