Adherence to the Mediterranean Diet and Health-Related Quality of Life during the COVID-19 Lockdown: A Cross-Sectional Study including Preschoolers, Children, and Adolescents from Brazil and Spain

Abstract

Scientific literature has suggested positive associations between the Mediterranean diet (MD) and the health-related quality of life (HRQoL) in young populations. However, to our knowledge, this relationship is unexplored during a situation of social isolation (i.e., lockdown). The objective of the current study is to examine the relationship between the MD and HRQoL during the COVID-19 lockdown among preschoolers, children, and adolescents from Brazil and Spain. This cross-sectional study includes a sample of 1099 three- to seventeen-year-old participants (47.6% girls) who were recruited via social networks. The HRQoL was assessed with the EQ-5D-Y. The Quality Index for Children and Teenagers (KIDMED) questionnaire was applied to evaluate the relationship between the MD and HRQoL. The highest prevalence of reported problems was found for worried, sad, or unhappy participants (39.8%). Furthermore, the lowest proportion of HRQoL problems was observed for “mobility” (2.5%). The proportion of high adherence to the MD was 44.3%. Participants with greater MD adherence reported higher HRQoL mean scores when compared with those who did not adhere to the MD (83.7 ± 0.6 vs. 85.6 ± 0.7, respectively; p < 0.05). Adherence to the MD and especially daily fruit intake were related to higher HRQoL during the COVID-19 lockdown among Brazilian and Spanish young people aged three to seventeen years.

Determinants of health-related quality of life in healthy children and adolescents during the COVID-19 pandemic: results from a prospective longitudinal cohort study

“…Studies examining determinants of HRQOL since the onset of the pandemic have often focused on only a few potentially determining factors. Associations have been reported with body composition, PA and nutrition [51], Mediterranean diet [52], ST [4,53], and household education [54].…”

“…Studies examining determinants of HRQOL since the onset of the pandemic have often focused on only a few potentially determining factors. Associations have been reported with body composition, PA and nutrition [51], Mediterranean diet [52], ST [4,53], and household education [54]. International comparisons of HRQOL in children during the pandemic are however complicated by the wide range and severity of restrictions, especially school closures.…”

Association between healthy lifestyle factors and health-related quality of life among Chinese adolescents: the moderating role of gender

“…The generalizability of the findings should be considered with caution. Third, although a healthy diet has been recognized as a critical healthy lifestyle factor associated with HRQOL in adolescents [ 57 ], we did not include it in our study due to data unavailability. Fourth, we utilized the composite healthy lifestyle scores in our analyses, assuming each lifestyle factor equally impacts HRQOL.…”

Comparison and convergent validity of five Mediterranean dietary indexes applied to Brazilian adults and older adults: data from a population-based study (2015 ISA-Nutrition): a critical analysis

“…Specifically, the pandemic negatively impacted the measure of health-related quality of life, or an individual's or group's perceived perspective of their health, which provides insight into one's well-being. This could present an obstacle to following a healthier diet such as the Mediterranean diet ( 9 ) . Moreover, some studies found that the COVID-19 pandemic increased meal frequency and increased the consumption of snacks and unhealthy foods, however, other studies have found that consumption of fresh produce and increases in alcohol consumption were noted ( 10 ) .…”