Mediterranean Diet Quality Index Research Articles

Adherence to the Mediterranean Diet among high-school pupils in the North Moroccan Rif region

BACKGROUND: The traditional Moroccan diet is typical of the Mediterranean diet (MD), but there have been few studies of the adherence of Moroccans adolescents to this diet and associated factors. OBJECTIVE: To evaluate MD adherence and its association with socioeconomic factors, nutritional status and dietary intake in a sample of secondary school pupils in the Rif region of Morocco. METHODS: In a cross-sectional study of a sample (n = 302) of Moroccan Riffian adolescents (13–18 years) from three secondary schools, we measured adherence to MD with the Mediterranean Diet Quality Index for children and teenagers questionnaire (KIDMED). A score below 8 was qualified as poor to average adherence to MD, while an optimal adherence was defined as a score of 8 or higher. Bivariate analyses and a logistic regression model were used to examine associations between adherence to MD and socioeconomic factors, nutritional status and dietary intake. RESULTS: Only 14.9% of adolescents had an optimal adherence to the MD (score≥8 points), 72.8% had average adherence (score 4–7) and 12.3% had poor adherence to the MD (score≤3). The factors associated with optimal adherence to MD were female sex (OR 2.28; 95% CI 1.07 –4.85; p = 0.031), high monthly family income > 8000 MAD (OR 7.10; 95% CI 1.52 –33.1; p = 0.013) and living in an apartment (OR 3.85; 95% CI 1.43 –10.3; p = 0.007). For others factors such as nutritional status and dietary intake, no associations were observed. CONCLUSION: We found a low level of adherence to the MD among adolescents in the Rif region, supporting the hypothesis that the dietary pattern of these Moroccan adolescents is in a transitional state characterised by a shift away from the traditional MD. The findings of this study suggest that interventions to optimize MD adherence should target boys, shared residences and lower income families.

Association between breakfast consumption, breakfast quality, mental health and quality of life in Turkish adolescents: A high school-based cross-sectional study.

This study aimed to determine the frequency of breakfast consumption and breakfast quality among adolescents and to evaluate the relationships between breakfast consumption, breakfast quality, mental health, and health-related quality of life. This cross-sectional study included 449 students from 17 high schools between December 2022 and May 2023. A face-to-face questionnaire measuring the frequency of breakfast consumption, Mediterranean diet quality index (KIDMED), health-related quality of life (KIDSCREEN), and depression, anxiety and stress scales (DASS-21) was performed. Of the students, 54.1% skipped breakfast 2 or more times a week and 75.9% had poor breakfast quality. There were significant differences in breakfast quality classification according to the frequency of breakfast consumption (p = 0.003). Breakfast consumption ≤1 time/week or 2-5 times/week was associated with depression, anxiety and low adherence to the Mediterranean diet. No relationship was observed between breakfast quality and stress, depression or anxiety (p = 0.620, p = 0.586, p = 0.539, respectively) or between breakfast quality and the KIDSCREEN-27 subscales (p > 0.05). However, those eating poor-quality breakfasts had better results in physical wellbeing (p = 0.022), psychological wellbeing (p = 0.024), autonomy and parent relations (p = 0.017) than breakfast-skippers and also scored lower for depression, stress and anxiety (all p < 0.001). In conclusion, the frequency of breakfast consumption had a stronger association with reduced symptoms of stress, depression and anxiety, as well as improvements in all dimensions of health-related quality of life, compared to the quality of breakfast consumed. Given the association of breakfast consumption with mental health outcomes in adolescents, our findings are of great importance, especially to parents, clinicians and nutritional educators.

Meeting the 24-h movement recommendations and its relationship with Mediterranean dietary patterns in early childhood: the SENDO project.

The aim of this study was twofold: (1) to assess the association between meeting all three 24-h movement recommendations and adherence to the Mediterranean diet (MedDiet) in early childhood and (2) to examine whether participants who meet all three 24-h movement recommendations have greater adherence to the individual MedDiet foods/components than those who do not meet these recommendations. A cross-sectional study was conducted using a sample of 822 participants from the Seguimiento del Niño para un Desarrollo Óptimo (SENDO) project (Pamplona, Spain). Physical activity was assessed through a questionnaire that covered 17 different types of activities. Screen time was assessed by averaging the daily hours spent on activities such as watching TV, using a computer, or playing video games. Sleep duration was determined by taking the average of sleep durations during both weekdays and weekends. Adherence to the MedDiet was evaluated using the Mediterranean Diet Quality Index in children and adolescents (KIDMED). Greater odds of having an optimal adherence to the MedDiet were found for participants meeting all three 24-h movement recommendations (odds ratio (OR) = 1.96, 95% confidence interval (CI) 1.33-2.87, p = 0.001) in comparison with their counterparts not meeting these recommendations. Specifically, significant differences were found for "fruit or fruit juice every day" (p = 0.012), "second fruit every day" (p = 0.001), and "fresh or cooked vegetables regularly once a day" (p = 0.018) in relation to meeting all three 24-h movement recommendation status. Conclusions: This study provides further evidence of the potential importance of meeting all three 24-h movement recommendations to adopt a healthier eating pattern. What is Known: • Only a limited number of studies have investigated the joint connection between the 24-h movement recommendations and dietary habits. • Integrating the 24-h movement recommendations with dietary recommendations could potentially yield greater effectiveness compared to promoting these recommendations independently within public health strategies. What is New: • This is the first study in assessing the relationship between 24-h movement recommendations and adherence to the Mediterranean diet in early childhood. • These findings provide further evidence of the potential importance of meeting all three 24-h movement recommendations to adopt a healthier eating pattern.

Association between dental caries and adherence to the Mediterranean diet, dietary intake, and body mass index in children

BackgroundChildren with healthier nutritional status are less likely to develop severe caries than those with a high-sugar content diet. Studies evaluating dental caries and nutritional status in school-age children have generally focused on dietary intake, diet quality, or anthropometric measures, and the number of studies evaluating them together is limited.ObjectiveIt was aimed to evaluate the relationship between dental caries adherence to the Mediterranean Diet (MD), dietary intake, and Body Mass Index (BMI) in school-age children.Materials and methodsThis study was conducted with 300 healthy children (52.0% boys, 48.0% girls) aged between 6 and 12 years. The data collection forms included sociodemographic characteristics, oral health practices of children, Mediterranean Diet Quality Index for children and adolescents (KIDMED), and food consumption records. Anthropometric measurements (body weight and height) of the children were taken. Dental examinations were performed by a pediatric dentist.ResultsWhile the DMFT mean score of the children was 1.7 ± 2.09, the mean dft score was 2.9 ± 3.29. The mean of KIDMED scores was 5.9 ± 3.32. DMFT and dft scores decreased statistically as maternal education increased (p < 0.05). DMFT and dft scores were not statistically different between BMI groups according to gender and age (p > 0.05). DMFT scores differed statistically between KIDMED groups (p < 0.05). This difference was between low-optimal and low-improvement-needed groups. While there was a low negative correlation (r=-0.169) between calcium intake and DMFT score, a low positive correlation was found between glucose (r = 0.172) and fructose (r = 0.149) intake and dft score (p < 0.05). In regression analysis, while the children’s age related DMFT scores positively, maternal education and KIDMED scores related DMFT scores negatively. Also, children’s age and maternal education related dft scores negatively.ConclusionIn this study, adherence to the MD rather than nutrients was found to be important in dental caries. Also maternal education level was also found to be a determinant factor in dental caries in children. DMFT and dft did not differ between BMI groups.Further studies should be conducted to assess the impact of the MD on dental caries in children to develop dietary interventions for preventative purposes.

Inflammatory index score in children: its relationship with neophobia, dietary quality and anthropometric measurements

The aim of this study was to examine the correlation between the Diet Inflammatory Index (DII) scores and dietary quality in children, which was measured by the Mediterranean Diet Quality Index (KIDMED), also neophobia scores and anthropometric measurements. This study was conducted in primary schools in Famagusta, Cyprus. A total of 300 children (150 girls, 150 boys) in the 3rd, 4th and 5th grade were included in the study. The frequency of food consumption was measured to calculate the DII scores. Moreover, neophobia and KIDMED scores were obtained. The KIDMED score is a popular tool that is mostly used as a practical scale to assess adherence to the Mediterranean diet among children. Additionally, anthropometric measurements (body weight, height, waist circumference, neck circumference) were collected. Finally, DII scores were compared with KIDMED scores, neophobia scores, and anthropometric measurements. Anthropometric measurements and body mass index (BMI) values were found to be significantly different (p < 0.05) based on the DII scores. Children with DII scores in the 1st quartile had significantly different anthropometric measurements compared to those who had scores in the 2nd, 3rd, and 4th quartiles (p < 0.05). The DII scores of normal-weight children were higher than those of obese children. A significant negative correlation was observed between KIDMED scores and DII scores of the children (p < 0.05). Furthermore, a significant positive correlation was observed between neophobia scores and DII scores (p < 0.05). Additionally, DII scores were correlated with dietary quality and anthropometric measurements (p < 0.05). The MD enhances the anti-inflammatory properties of the diet; it has clearly demonstrated positive effects on diet quality and anthropometric measurements. Furthermore, the MD is suggested to reduce the risk of chronic diseases as a result of improving DII scores at an early age.

Association of Mediterranean diet with sleep quality, depression, anxiety, stress, and body mass index in university students: A cross-sectional study.

Background: The Mediterranean diet (MD) has many beneficial effects on health. However, compliance with MD is decreasing among university students. Aim: This study aims to investigate compliance with the MD and the association of MD with sleep quality, depression, anxiety, stress, and body mass index (BMI) among university students. Methods: This cross-sectional study included 750 students of Ondokuz Mayıs University, a state university in Samsun, Türkiye. Sociodemographic data and self-reported anthropometric data (weight and height) were recorded using a survey. The Mediterranean diet quality index for children and adolescents (KIDMED), the Pittsburgh sleep quality index (PSQI), and the depression anxiety stress scale-42 (DASS-42) were self-administered. Results: Most students (59.2%) had poor KIDMED adherence. Compared to poor adherers, those with good adherence to the KIDMED had significantly lower depression scores (in males and females). Higher adherence to the KIDMED was correlated with lower depression and stress levels (in males and females) and lower PSQI scores (lower sleep disturbances) in females. The KIDMED scores of overweight females were greater than those of underweight females. Conclusion: University students show poor adherence to the MD. Low adherence to the MD may have a negative impact on depression, stress, and sleep quality. This study suggests that interventions to promote MD may help improve university students' sleep disturbances and mental health.

Association of Mediterranean diet pattern with disease activity in the patients with rheumatoid arthritis: A cross-sectional study on Iranian patients

Rheumatoid arthritis is a systemic autoimmune disease that causes joint erosion, as well as damage to extra-articular organs. The aim of this study was the investigation of the association between the Mediterranean diet quality index with disease activity in patients with rheumatoid arthritis. In this cross-sectional study 184 females with rheumatoid arthritis were studied in Kermanshah, Iran. The American College of Rheumatology's 2010 criteria were used to diagnose RA. The biochemical tests including erythrocyte sedimentation rate, C-reactive protein, rheumatoid facto, anti-nuclear antibody titration, antibodies against cyclic citrulline peptide, disease activity score 28 and the food frequency questionnaire was used to assess rheumatoid arthritis activity and the Mediterranean diet quality index, respectively. To compare the dietary intakes of participants across tertiles of Mediterranean diet score, we used Analysis of Variance. Multinomial logistic regression with three adjusted models was used to investigate the association between Mediterranean diet score with disease activity. 184 eligible patients with rheumatoid arthritis participated in this study. The mean age and duration of disease, body mass index, waist circumference and percent body fat did not differ significantly among the tertiles of the Mediterranean diet score (P-value>0.05). Participants in the highest tertile of Mediterranean diet score had significantly greater intakes of fruits, vegetables, fish, legume, nuts and had lowest intake of grains (refrain grain) and red and process meats to white meat ratio (P-value<0.05). There was no significant difference in terms of variables related to disease activity among the tertiles of the Mediterranean score (P-value>0.05). In multi-adjusted models, the odds ratio of Mediterranean diet scores no significant different in the third as compared to the first tertile of Mediterranean diet score (P-value>0.05). Based on our findings there is no association between the Mediterranean diet score and disease activity of people with rheumatoid arthritis.

Determinants of the adherence to Mediterranean diet: application of the k-means cluster analysis profiling children in the Metropolitan City of Bari

The transition to sustainable food systems and the achievement of SDGs 2 and 12 entails the adoption of sustainable consumption and production patterns, such as the Mediterranean diet. The Mediterranean diet and its impact on nutritional status and health have been the focus of recent research. The aim of this study was to investigate the associations between adherence to the Mediterranean diet, lifestyle, socioeconomic status, BMI (kg/m2), and age of children. The geographical area is the Metropolitan City of Bari (Apulia region, southern Italy), which is involved in the development of an effective food policy aimed at ensuring a sustainable food transition. An online survey was filled out by parents or guardians responsible for the dietary patterns of children between 2 and 15 years of age to collect data about their Mediterranean diet adherence through the Mediterranean Diet Quality Index (KIDMED) and sociodemographic features, food habits and lifestyles, and anthropometric variables. Descriptive statistics and k-means cluster analysis were applied for profiling children, contributing to identifying the main factors that might affect individual Mediterranean diet adherence. Four clusters were characterized, taking into account food habits and lifestyle index, socioeconomic index, children’s age, and body mass index (BMI). Results showed an association between low adherence to the Mediterranean diet and high prevalence of overweight and obesity in children. The factors positively associated with following an optimal Mediterranean diet adherence were the mother’s education level and level of income; skipping breakfast is linked to low adherence to the Mediterranean diet. Therefore, targeted strategies should be put in place to improve Mediterranean diet adherence among children, promoting healthy dietary habits.

Adherence to the Mediterranean diet and depressive, anxiety, and stress symptoms in Spanish adolescents: results from the EHDLA study.

Depression and anxiety are prevalent and disabling conditions among adolescents. The aim of this study was to examine the relationship between adherence to the Mediterranean diet (MD) and depressive, anxiety, and stress symptoms in adolescents. This cross-sectional study included a sample of 698 adolescent students from a region of Spain (mean age of 13.9 ± 1.5years; 56.2% girls). Adherence to the MD was evaluated with the Mediterranean Diet Quality Index in children and adolescents (KIDMED). Mental health symptoms were measured with the Depression, Anxiety, and Stress Scale (DASS-21). Logistic regression models were performed, including a wide range of potential confounders. Compared to individuals with low adherence to the MD, those with moderate and high adherence had lower odds of experiencing depressive symptoms (odds ratio [OR] = 0.40, 95% confidence interval [CI] 0.24-0.65 and OR = 0.33, 95% CI 0.20-0.55, respectively), which were statistically significant even after adjustment. No significant associations were found regarding anxiety or stress symptoms. Therefore, according to our results, higher adherence to the MD is inversely related to having depressive symptoms among adolescents, regardless of socioeconomic, anthropometric, and lifestyle factors. Considering the deleterious effects of mental health problems in youths, further research on the role of nonpharmacological strategies for the prevention and treatment of depressive symptoms in adolescence is essential.

Evaluation of the Relationships Among Mindful Eating, Environmental Beliefs, Adherence to the Mediterranean Diet, and Obesity in Children.

This study aimed to evaluate the relationship between adherence to the Mediterranean diet (MD), mindful eating, environmental beliefs, and obesity in children. The study included 318 children (50.6% male, 49.4% female, 10.0 ± 0.73 years old). Data were obtained using survey and a face-to-face interview method. The questionnaire includes general information, anthropometric measurements, the New Ecological Paradigm Scale for Children (NEP), the Mediterranean Diet Quality Index for children and adolescents (KIDMED), and the Mindful Eating Questionnaire for Children. According to the KIDMED classification, 52.5% of the children were in the group that needs improvement, 35.2% were in the low diet quality group, and 12.3% were in the optimal MD group. The Mindless score was higher in overweight/obese children compared to the normal body mass index (BMI) group (P < .05). Awareness, NEP, and KIDMED scores were the lowest in overweight/obese children (P < .05). In regression analysis, the father's age, KIDMED, and Awareness scores related to NEP scores positively (R2 : 0.545, P < .001). Also, children's body mass index-related KIDMED scores negatively, and awareness and NEP scores related KIDMED scores positively (R2 : 0.276, P < .001). Our results show that higher adherence to the MD is associated with higher environmental beliefs. Children with higher mindful eating have higher environmental beliefs and adherence to the MD, and these scores are lower in obese children. Therefore, raising generations that adopt sustainable diet models and have high environmental awareness is necessary. This research provides significant findings for future clinical studies on children's body weight maintenance and sustainability. Cite this article as: Bozkurt O, Kocaadam-Bozkurt B, Koçyiğit E. Evaluation of the relationships among mindful eating, environmental beliefs, adherence to the mediterranean diet, and obesity in children. Turk Arch Pediatr. 2024;59(1):98-105.

Effects of Online Nutrition Training Program About Mediterranean Diet on Anthropometric Measurements and Diet Quality in Overweight and Obese Adolescent Girls

Objective: This study was conducted to evaluate the effect of an online nutrition training program about the Mediterranean diet for 8 weeks in overweight and obese female high school students on anthropometric measurements and diet quality.&#x0D; Methods: A total of 86 students between the ages of 14-18 years were included in the study, and they were divided into two groups as nutrition training (n=44) and control groups (n=42). The Mediterranean Diet Quality Index (KIDMED) scores were calculated and anthropometric measurements of groups were taken by the dietician at the beginning and at the end of the study.&#x0D; Results: The KIDMED score of the nutrition training group was 4.59±2.40 at the beginning, later on it increased to 7.43±2.57 after the program (p= .001). After the program, it was determined that the difference between the KIDMED scores of the nutrition training and control groups were statistically significant (p= .034), however the decrease in body weight (p= .09), BMI (p= .64), and waist circumference (p= .06) were similar between groups.&#x0D; Conclusion: As a result of the study, it can be said that online nutrition training program about the Mediterranean diet for 8 weeks may affect the diet quality positively of overweight and obese female adolescents, but long-term programs should be planned to determine the effects on anthropometric measurements.

Eating behavior styles and factors associated with disordered eating behaviors in early adolescents: cross-sectional study

Aims: Disordered eating attitudes and behaviors have become a global concern among adolescents. Given that eating behaviors developed during adolescence will determine lifelong adolescent health outcomes, it is important to understand the factors associated with disordered eating behaviors in early adolescents. This study aimed to assess the eating behaviors styles of early adolescents and to determine the relationship between eating behaviors and sociodemographic, lifestyle factors, and dietary patterns.&#x0D; Methods: This cross-sectional was conducted on 700 middle school students aged 10-14 years old. Sociodemographics, dietary, and lifestyle data were collected using a questionnaire. Anthropometric measurements were performed. The Dutch Eating Behavior Questionnaire Children (DEBQ-C) was used to evaluate adolescents’ restrained, emotional, and external eating styles. Mediterranean Diet Quality Index (KIDMED) was used to assess adherence to the Mediterranean diet (AMD). &#x0D; Results: Girls had higher scores in all three eating styles compared to boys. Students with overweight/obese scored higher in restrained, but lower in external and emotional eating style compared to students with normal weight. Students with excessive energy, carbohydrate, and protein intake had higher external eating but lower restrained eating scores than those with low or normal intake. Being female, higher KIDMED score, less screen time, higher BMI z score, higher waist/hip ratio, and body dissatisfaction were positively associated with restrained eating behavior. Being female (β =0.085, p=0.024), screen time &lt; 2 hours (β =-0.086, p =0.027), and BMI z score (β =-0.211, p =

Cross-Sectional Association between Perceived Physical Literacy and Mediterranean Dietary Patterns in Adolescents: The EHDLA Study.

The objective of the current study was to analyze the relationship between perceived physical literacy (PPL) and adherence to the Mediterranean Diet (MedDiet) and its specific components in a sample of Spanish adolescents. In this cross-sectional study, we examined a sample of 845 adolescents (58.1% boys) aged 12-17 years from the Valle de Ricote (Region of Murcia, Spain). PPL was assessed by the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). To assess adherence to the MedDiet, the Mediterranean Diet Quality Index in children and adolescents (KIDMED) was applied. In unadjusted analyses, adolescents with medium or high PPL were more likely to have optimal adherence to the MedDiet (medium PPL: OR = 1.69, 95% CI 1.20-2.40, p-adjusted = 0.003; high PPL: OR = 2.90, 95% CI 2.03-4.17, p-adjusted < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, body mass index, energy intake, overall sleep duration, physical activity, and sedentary behavior (medium PPL: OR = 1.51, 95% CI 1.05-2.19, p-adjusted = 0.003; high PPL: OR = 2.27, 95% CI 1.53-3.39, p-adjusted < 0.001). PPL could play a relevant role in the adoption of healthy eating habits among adolescents. Adolescents with low or medium PPL were less likely to report optimal adherence to the MedDiet. Adolescents with high PPL seem to consume more fruits, vegetables, fish, pulses, nuts, and dairies (for breakfast). Conversely, these adolescents tend to skip breakfast less, as well as to consume less commercially baked goods or pastries at this meal.

Mediterranean diet is associated with better gastrointestinal health and quality of life, and less nutrient deficiency in children/adolescents with disabilities.

Children and adolescents with disabilities face various nutritional problems. This study aimed to examine dietary characteristics, nutritional status and problems, gastrointestinal health, and quality of life in children and adolescents with disabilities. This study included 5-18 years old children and adolescents (n = 1,991) with disabilities. We used the Mediterranean Diet Quality Index (KIDMED), the Gastrointestinal Symptom Rating Scale (GSRS), and the Pediatric Quality of Life Inventory (PedsQL) to assess diet characteristics, gastrointestinal problems, and life quality. We collected retrospective 24-h food record to assess energy and nutrient intakes. The rate of stunting in children with disabilities varies between 16.5% and 19.8%. When comparing disability types, more children with physical disabilities were underweight (8.8% vs. 6.7%) and stunted (19.8% vs. 16.5%), while more children with intellectual disabilities were tall (7.9% vs. 5.5%) and overweight/obese (21.1 vs. 17.2%; p < 0.05). Wasting (9.3%) and overweight/obesity (23.8%) were more common in children with disabilities aged 5-7 years (p < 0.001). Eating problems such as loss of appetite, food refusal, food neophobia, and food selectivity were more common in children aged 5-7 years, and problems with fast eating and overeating were more common in adolescents aged 13-18 years (p < 0.05). Among children and adolescents with disabilities, the nutrients with inadequate intakes were vitamin E, vitamin B1, folate, potassium, calcium, and iron, while the nutrients with intakes above the requirements were proteins, carbohydrates, vitamins A, B2, B6, B12, and C, phosphorus, zinc, and sodium. Participants with good Mediterranean diet quality had higher energy and nutrient intakes and higher percentages of meeting nutrient requirements (p < 0.05). KIDMED scores were negatively correlated with GSRS total (r = -0.14, p < 0.001) and subcomponent scores (abdominal pain, diarrhea, reflux, indigestion, and constipation; p < 0.05), and significantly and positively correlated with PedsQL total (r = 0.12, p < 0.001). A one-unit increase in the GSRS score resulted in a 14.4 times decrease in the PedsQL score, and a one-unit increase in the KIDMED score resulted in a 10.8 times increase in the PedsQL score (p = 0.001). Overweight/obesity, stunting/wasting, nutritional problems, and deficiencies are common among disabled children and adolescents. Mediterranean diet is associated with a better quality of life, and gastrointestinal health in children with disabilities.

Children-Dietary Inflammatory Index and Adherence to the Mediterranean Diet in Children with Overweight and Obesity: Are They Associated with Cardiometabolic Risk Parameters?

Purpose: This study was planned to assess the relationship between the children’s dietary inflammatory index (cDII), adherence to the Mediterranean diet (AMD), and metabolic control parameters in children with overweight and obesity.&#x0D; Methods: This cross-sectional was conducted in children with overweight and obesity aged 7-18 years. Sociodemographic, biochemical, dietary, and lifestyle data were collected using a questionnaire. Mediterranean Diet Quality Index (KIDMED) was used to evaluate AMD. Body weight, height, neck, waist, and hip circumference were measured. Dietary intake and cDII were assessed with a three-day food consumption record. &#x0D; Results: The mean cDII score was 2.2∓0.94 (range from -0.43 to 4.39). Of the total participants, 12% had high and 38.7% had low AMD. There were no significant differences between cDII and biochemical and anthropometric parameters. The proportion of participants with high insulin levels (53.4%) was higher in participants with low AMD group than in those with high AMD (32.6%) (p=0.011). The proportion of participants with insulin resistance was higher in the low AMD group than in the medium/high adherence group (53.4% vs. 37.0%, p=0.047). There was no significant relationship between AMD and lipid profile. Logistic regression analysis showed that participants with low AMD had high insulin levels to be 2.055 times (95% CI= 1.009-4.186. OR=2.055) compared to participants with moderate/high AMD (p=0.047). cDII scores and AMD were not associated with insulin resistance.&#x0D; Conclusion: This study showed that low AMD was associated with high insulin levels, but cDII was not associated with cardiometabolic risk factors in children with overweight and obesity.

Effects of lifestyle-based interventions to improve Mediterranean diet adherence among the young population: a meta-analysis of randomized controlled trials.

Despite the large number of studies published to date, the effect of lifestyle-based interventions on improving adherence to the Mediterranean diet (MedDiet) in young people has not been meta-analyzed. The aim of the present systematic review and meta-analysis was two-fold: (1) to determine the pooled intervention effects of lifestyle-based interventions on improving adherence to the MedDiet in a young population aged 3 years-18 years and (2) to examine the potential factors related to those intervention effects. A systematic search of the MEDLINE (via PubMed), Scopus, Cochrane Library, and Web of Science databases was performed from their inception until June 15, 2023. Different meta-analyses were independently performed to observe the effect of lifestyle-based interventions on adherence to the MedDiet (according to the Mediterranean Diet Quality Index in children and adolescents [KIDMED]). Compared with the control group, the intervention group showed a small increase in KIDMED score (d = .27; 95% confidence interval [CI], .11 to .43; P < .001; I2 = 89.7%). Similarly, participants in the lifestyle-based intervention groups had a 14% higher probability of achieving optimal adherence to the MedDiet (risk difference = .14; 95% CI, .02 to .26; P = .023; I2 = 96.8%). Greater improvements in achieving optimal adherence to the MedDiet were found in interventions delivered out of school (risk difference = .24, 95% CI, .04 to .44; I2 = 88.4%), those aimed at parents or at both children and parents (risk difference = .20, 95% CI, .07 to .34; I2 = 98.2%), and those including only participants with overweight/obesity (risk difference = .34, 95% CI, .15 to .52; I2 = .0%). Healthy lifestyle-based interventions seem to be effective in increasing adherence to the MedDiet and in achieving optimal adherence to this dietary pattern among children and adolescents. PROSPERO registration no. CRD2022369409.

Adherence to the Mediterranean diet in young male soccer players

IntroductionNutrition is vital in health and sports performance by improving anthropometric-related parameters and dietary habits, especially in the youngest ages. The Mediterranean diet (MD) has been highly recognized for its positive health effects and low adverse environmental impact.ObjectivesWe aimed to characterize adherence to the MD and analyze its association with anthropometric parameters in young soccer players.MethodologyIn the present study, 132 male young soccer players from under 9 to under 15 categories (aged 7 to 15 years) from a Portuguese football club participated. The Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) questionnaire was applied to assess adherence to the MD. Anthropometric-related parameters, including body mass, height, triceps skinfold thickness (TSKF), suprailiac skinfold thickness (SISKF), body mass index (BMI) and body fat percentage (%BF), were determined. The differences between groups were performed accordingly to normal and non-normal distribution. Spearman’s correlations were performed to analyze the hypothetical correlation between KIDMED and BMI.ResultsPlayers reached an average KIDMED score of 8.36 ± 1.92, showing that 68.2% (n = 90) reached high adherence to the MD, 31.1% (n = 41) had moderate adherence to the MD, and 0.78% (n = 1) had poor adherence to the MD. When the analysis was made for age group and BMI classification, no significant differences were observed in adherence to the MD. Considering the main characteristics of the MD, 50.8% consumed fruit (vs. 49,2%), 52.3% consumed vegetables (vs. 47,7%), and only 20% consumed oleaginous dried fruits (vs. 80%). Dairy consumption throughout the day was 49,2% (vs. no: 50,8%).ConclusionData from the present study showed that many soccer players adhered to the MD, and no differences were observed for age group or BMI classification.

Parental Anxiety and Children's Mediterranean Diet Quality Index during the COVID-19 pandemic

COVID-19, which affected the whole world in 2019, caused various psychosocial disorders, especially stress and anxiety disorders in individuals. Anxiety disorder, which is very common in parents, affects children's eating behaviors. The Mediterranean diet, which is one of the healthiest diets in the world thanks to its comprehensive vitamin and mineral content, has also been reported to be protective against COVID-19. In our study, we aimed to investigate the relationship between parents' anxiety levels and KIDMED scores, which measure their children's compliance with the Mediterranean diet. The questionnaire form, which was created using the Mediterranean Diet Quality Index (KIDMED), Beck Anxiety Inventory (BAI), and Coronavirus Anxiety Scale (CAS), was delivered to the parents by snowball method. In total, 589 parents were reached. Conditions such as parental gender, relationship status, number of children, and dietary supplement use before COVID-19 were only significantly associated with BAI. (p

Nutrition literacy status and its association with adherence to the Mediterranean diet, anthropometric parameters and lifestyle behaviours among early adolescents.

To evaluate nutrition literacy status and its association with adherence to the Mediterranean diet (MD), anthropometric parameters and lifestyle behaviours among early adolescents. This is a cross-sectional study. Nutrition literacy was evaluated using the 'Adolescent Nutrition Literacy Scale'. Dietary intake was assessed by 24-h food recall. The 'Mediterranean Diet Quality Index' was used to evaluate adolescents' adherence to the MD. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Body weight, height, waist, hip and neck circumference were measured. Four secondary schools in İzmir, Türkiye. The study included 1074 secondary school students. Adolescents' nutrition literacy was at a moderate level. Nutrition literacy scores were significantly lower in those who skip main meals. Adolescents with high nutrition literacy had higher intakes of fibre, protein, protein, Ca, K, Mg, P, vitamin C, folate and Fe intake than those with low and moderate nutrition literacy (P < 0·05). According to IPAQ, active adolescents had higher nutrition literacy scores than inactive adolescents. There was no significant difference in BMI and anthropometric measurements of the adolescents according to their nutrition literacy level. Linear regression analysis showed that each unit increase in nutrition literacy increased adherence to the MD by 0·286 points (β = 0·286) and decreased total screen time by 0·182 points (β = -0·182). These findings showed that nutrition literacy among early adolescents was not optimal, and a higher nutrition literacy score was significantly associated with higher MD adherence, and healthy eating habits and lifestyle behaviours.

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

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.