Adherence to the Mediterranean Diet among School Children and Adolescents Living in Northern Italy and Unhealthy Food Behaviors Associated to Overweight

Abstract

The purposes of this study were to evaluate the differences in Mediterranean diet and its components among primary and secondary school children and adolescents living in northern Italy, and the associations with the weight status. Adherence was assessed by the KIDMED (Mediterranean Diet Quality Index) questionnaire on 669 subjects (6–16 years) attending five schools of Novara. The adherence was poor in 16.7%, average in 63.7%, and high in 19.6% of the students. Poor adherence was more frequent in primary than in secondary schools (20.7% vs. 13.7%, p < 0.04). Some unhealthy behaviors were more prevalent in younger children. Children of other ethnic origins had a mixed behavior, choosing both traditional healthy and unhealthy foods. Besides male gender and primary school, in Italian children, the risk of overweight was directly associated with eating at fast-food restaurants (OR: 1.890, CI 95% 1.002–3.563), and inversely with consumption of vegetables more than once a day (OR: 0.588, CI 95% 0.349–0.991), and olive oil at home (OR: 0.382, CI 95% 0.176–0.826). In children of other ethnic origins, this risk was associated with skipping breakfast (OR: 16.046, CI 95% 1.933–133.266), or consuming commercial baked good or pastries for breakfast (OR: 10.255, CI 95% 1.052–99.927). The overall KIDMED score correlated with height (β: 0.108; p < 0.005). Poor food quality is replacing the Mediterranean dietary pattern in children and adolescents, in particular among younger children. Because the risk of overweight was associated with different components of the Mediterranean diet depending on ethnic origins, tailored nutritional programs remain a need.

Association between Adherence to the Mediterranean Diet and Physical Fitness with Body Composition Parameters in 1717 European Adolescents: The AdolesHealth Study

“…Numerous systematic reviews and meta-analyses attribute a lower incidence of diseases and a better health to fish consumption [51,52], but few relate this to a better body composition in adolescents. Although the consumption of fish, together with vegetables and fruit, seems to be a pending task in adolescence, the results found for N-O waist boys coincide with similar studies where children and adolescents had a regular consumption of fish [35,38]. On the other hand, although more research is needed to examine the types of dairy products in relation to the risk of childhood and adolescent overweight, the accumulated evidence from studies suggests that dairy consumption is associated inversely and longitudinally with the risk of overweight and obesity in these ages [53,54].…”

“…In this aspect, the MD is revealed to be an appropriate dietary pattern [17]. Most recently reviewed studies conducted in southern European countries reported that approximately half the children and adolescents show a low adherence to MD [38]. The participants of the current study presented a medium level of adherence to the MD (5-6) [39].…”

Adherence to Mediterranean Diet Related with Physical Fitness and Physical Activity in Schoolchildren Aged 6–13

“…MD has justified its efficacy in the primary and secondary prevention of cardiovascular diseases, with the highest level of scientific evidence [43]. In addition to this, it has recently been demonstrated that better adherence to the MD is associated with a better lipid profile and adiposity measures and, in the case of women, with the reduction of some cardiovascular risk factors [44]. In spite of these enormous health benefits, among the participants of the current study, it is observed that only one out of four presents an optimal adherence to the MD.…”

Mediterranean Diet Nutrients to Turn the Tide against Insulin Resistance and Related Diseases

“…The consumption of fish, nuts and dairy products, representing a fundamental aspect in the MedDiet, can be related to a better body composition and fitness performance in adolescents, in terms of speed/agility and cardiorespiratory endurance [23]. Nonetheless, even in European countries surrounding the Mediterranean Sea, half of the children and adolescents show only a low adherence to this healthy dietary tradition [24], with a high rate of pediatric overweight and development of obesity and related complications in adult life. Rising obesity rates will contribute to large healthcare expenditure increases, and this would require future cost containment efforts through large-scale health promotion programs and weight loss interventions, fostering a combination of diet quality changes and physical activity [25].…”