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 DesarrolloÓptimo (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.
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