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A previous short time span study related to the effectiveness of a teaching pack (TP) in improving the adherence to the Mediterranean Diet (MD) showed positive results. The present study was aimed at investigating and confirming those results, with a follow up data collection, in the same sample, a year after the baseline intervention. Pre- and post-intervention assessments were conducted. Weight and height were measured. Eating patterns/lifestyle were assessed by the KIDMED test and questionnaires. Thirteen schools in three areas with low, medium and high prevalence of overweight/obesity (North, Center and South respectively) were involved, with a representative baseline cluster sample of 494 fourth class children (8–10 years old) in 2015. An intervention group and a control group were recruited in each school; the intervention group (n = 395) got the intervention, the control group (n = 99) did not. The children’s KIDMED score changes were the main outcome measures. Differences in percentages of adherence and in yes/no answers on the KIDMED test, at baseline and after one year, for both the intervention and the control groups, were assessed through contingency tables and statistical tests. Improvements in the high and low adherence rates to MD were observed (high adherence: 24.4% to 43.3%; low adherence: 15.0% to 3.9%, p < 0.0001). The percentages of subjects with optimal adherence improved in both sexes (females: 25.5% to 49.5%, p < 0.0001; males: 23.1% to 36.6%, p < 0.0001) in all the geographical areas and ponderal status classes. Accompanying free distribution of fruit and vegetables with a nutritional intervention led by trained teachers with a cross-curricular approach can be successful in promoting healthy eating in children. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: the Mediterranean diet has been associated with a lower prevalence of obesity and metabolic syndrome, and with healthier lifestyles in adults and children, but data is scarce in younger ages. The Mediterranean-type ecosystem of the central region of Chile as well as its traditional gastronomy would facilitate the adoption of this dietary pattern. Objectives: to assess the adherence to Mediterranean diet in preschoolers and their parents, and to evaluate the impact of a nutrition education intervention and diet implementation. Methods: prospective cohort study. The KidMed index was applied to children older than 18 months, and the Mediterranean Dietary Index in Chile (Chilean-MDI) to their parents, before and after a remote educational intervention. Results: one hundred and thirty-nine families participated, with 95 preschoolers; 56 % were girls, aged 26.2 ± 8.7 months. The basal mean KidMed score was 7.4 ± 1.9 and increased to 7.9 ± 1.9 after the intervention (p = 0.1). The Chilean-MDI score was 6.9 ± 1.8 and 7.1 ± 1.7, respectively (p = 0.09). When separated by categories, there was improvement from low and moderate adherence to optimal adherence in both children and their parents (Chi2, p = 0.009 y p = 0.04). In 58 dyads, there was a positive correlation between the KidMed and the Chilean-MDI index, pre- and post-intervention (Pearson R = 0.3 y 0.34; p = 0.004 y 0.003, respectively). Conclusions: most of these sample of preschoolers and their parents had a moderate adherence to Mediterranean diet, with an improvement after an educational intervention. [ABSTRACT FROM AUTHOR]

Introduction. Obesity has become one of the most prevalent nutritional disor-ders, characterized by excess adipose tissue with physical and psychosocial conse-quences, affecting negatively quality of life. Objectives. To study the diet quality and identify eating disorders (TCA) in a pediatric population suffering from overweight. Population and methods. Thirty patients (16 girls/14 boys), aged 5 to 17 years, were recruited from the Pediatric Department of Oran University Hospital. Anthropometric parameters were measured. Physical activity level as well as diet quality by the KIDMED index were evaluated. The Binge Eating Scale (ADO-BED), and the Child-Three Factor Eating Questionnaire (CTFEQ) were used to identify possible eating disorders. Results. Obesity was noted in 77% of the pediatric population, while 23% were overweight. Only 40% of patients practiced sporting activity, while 60% had sedentary behavior on weekends. The KIDMED score calculation showed low adherence to the Mediterranean diet (RM), in 83% of the population. Although the ADO-BED questionnaire indicated a low risk of binge episodes in 97% of patients, CTFEQ data revealed that 67% had signs of loss of eating control, 7% had cognitive restriction, and 7% had emotional eating. Conclusion. Poor dietary habits, associated with sedentary lifestyle, are observed in the studied overweight pediatric population. These results highlight the need for nutritional intervention and psychological care for these patients. [Introduction. L'obésité est devenue l'un des troubles nutritionnels les plus répandus, caractérisé par un excès de tissu adipeux avec des conséquences physiques et psychosociales, affectant négativement la qualité de vie. Objectif. Etudier la qualité de l’alimentation et identifier les troubles des conduites alimentaires (TCA) chez une population pédiatrique, souffrant de surcharge pondérale. Population et méthodes. Trente patients (16 filles/14 garçons), âgés de 5 à 17 ans, ont été recrutés au niveau du Service de Pédiatrie du CHU d’Oran. Les paramètres anthropométriques ont été mesurés. Le niveau d'activité physique (NAP) ainsi que la qualité de l'alimentation par l’indice KIDMED ont été évalués. Le Binge Eating Scale (ADO-BED) et le Child-Three Factor Eating Questionnaire (CTFEQ) ont été utilisés afin d’identifier d’éventuels TCA. Résultats. L'obésité était observée chez 77% de la population pédiatrique, alors que 23% présentaient un surpoids. Seuls 40% des patients pratiquaient une activité sportive, tandis que 60% avaient un comportement sédentaire le week-end. Le calcul du score KIDMED a montré une adhésion faible au régime méditerranéen (RM) chez 83% de la population. Bien que le questionnaire ADO-BED ait indiqué un faible risque d'épisodes hyperphagiques chez 97% des patients, les données du CTFEQ ont révélé que 67% présentaient des signes de perte de contrôle alimentaire, 7% une restriction cognitive, et 7% une alimentation émotionnelle. Conclusion. De mauvaises habitudes alimentaires, associées à un mode de vie sédentaire, sont observées chez la population pédiatrique en surcharge pondérale. Ces résultats soulignent la nécessité d'une intervention nutri-tionnelle et d'une prise en charge psychologique pour ces patients.]

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.

A previous short time span study related to the effectiveness of a teaching pack (TP) in improving the adherence to the Mediterranean Diet (MD) showed positive results. The present study was aimed at investigating and confirming those results, with a follow up data collection, in the same sample, a year after the baseline intervention. Pre- and post-intervention assessments were conducted. Weight and height were measured. Eating patterns/lifestyle were assessed by the KIDMED test and questionnaires. Thirteen schools in three areas with low, medium and high prevalence of overweight/obesity (North, Center and South respectively) were involved, with a representative baseline cluster sample of 494 fourth class children (8–10 years old) in 2015. An intervention group and a control group were recruited in each school; the intervention group (n = 395) got the intervention, the control group (n = 99) did not. The children’s KIDMED score changes were the main outcome measures. Differences in percentages of adherence and in yes/no answers on the KIDMED test, at baseline and after one year, for both the intervention and the control groups, were assessed through contingency tables and statistical tests. Improvements in the high and low adherence rates to MD were observed (high adherence: 24.4% to 43.3%; low adherence: 15.0% to 3.9%, p < 0.0001). The percentages of subjects with optimal adherence improved in both sexes (females: 25.5% to 49.5%, p < 0.0001; males: 23.1% to 36.6%, p < 0.0001) in all the geographical areas and ponderal status classes. Accompanying free distribution of fruit and vegetables with a nutritional intervention led by trained teachers with a cross-curricular approach can be successful in promoting healthy eating in children.

The objective was to analyse the associations between anthropometric characteristics and diet in male rugby players according to the playing position. A cross-sectional study was developed. The forwards had higher body weight (107 kg) and fat mass (FM; 12%) than the backs (87.8 kg and 8.47%, respectively) (p < 0.05). The quality of diet needs to improve (KIDMED value of 5.87 and 6.36 for forwards and backs, respectively). Nutritional imbalances, such as deficits in carbohydrates, fibre, calcium, magnesium and vitamin D, and excess of fats, saturated fatty acid, cholesterol and sugars were found. Carbohydrates and proteins intake were significant associated (p < 0.05) with a minor FM. Forwards with a KIDMED index of less than 8 had a significantly higher FM than those who maintained an optimal diet (p < 0.05). The diet of rugby players should be more in line with dietary recommendations and take into account the player position to optimise sports performance. [ABSTRACT FROM AUTHOR]

The aims of the present study were twofold: to determine the association between adherence to the Mediterranean diet (MedDiet) and psychological problems and to assess the relationship between different food groups of the MedDiet and different patterns of psychosocial health problems in a sample of Spanish adolescents from the Valle de Ricote (Region of Murcia, Spain). This cross-sectional study included a representative sample of 700 adolescents (57% girls) between 12 and 17 years of age. Adherence to the MedDiet was assessed by the Mediterranean Diet Quality Index for Children and Teenagers (KIDMED). Psychosocial health problems were measured by the 25-item self-report version of the Strengths and Difficulties Questionnaire (SDQ). ANCOVA models were used to test the mean differences in psychosocial health problems (SDQ subscales) by adherence to MedDiet categories (low, medium, and high). Multiple linear regression was used to determine the association between different food groups of the MedDiet and psychosocial health problems. Adolescents with low adherence to the MedDiet had significantly higher scores in SDQ total difficulties, conduct problems, and hyperactivity problems and lower scores in pro-social behavior (p < 0.05) than their peers with medium and high adherence to the MedDiet. In relation to specific MedDiet food groups, fruit, nut, and legume intake were associated with higher psychosocial health. However, sweets, skipping breakfast, or high consumption of pasta or rice (≥5 weeks) were associated to higher psychosocial health problems. Our results show that adolescents with higher adherence to the MedDiet could benefit from greater psychosocial health. Individually, some patterns of MedDiet, such as fruit, nut, and legume intake, may reduce psychosocial health problems. These cross-sectional results should be confirmed in longitudinal and intervention studies. [ABSTRACT FROM AUTHOR]

Children today are constantly exposed to several risk factors and high levels of stress that can impact their mental, emotional, and physical health, which can trigger burnout. The objective of this study was to determine the prevalence and frequency of burnout in young amateur athletes and to study the role of the Mediterranean diet on burnout risk. An observational, cross-sectional, and descriptive study of 183 basketball players between 8 and 15 years old was carried out. Adherence to the Mediterranean diet was assessed using the KIDMED questionnaire and the risk of burnout was assessed with the Athlete Burnout Questionnaire. Medians, minimums and maximum values for quantitative variables and absolute frequencies and percentages for qualitative variables were obtained. The results show a higher percentage of burnout among girls. The children who meet the established threshold for burnout spend more time watching television. Participants with better adherence to the Mediterranean diet have lower burnout values in both genders and those with a higher risk of burnout have a worse adherence to the Mediterranean diet. Therefore, it is important to implement a balanced diet appropriate to the individual needs of the athlete. [ABSTRACT FROM AUTHOR]

The Mediterranean Dietary Pattern (MDP) is currently accepted as being protective against some of the most worrisome chronic non-communicable diseases in today's society. It is important to instil this nutritional pattern in young people as it is at this point in life that healthy eating habits are created and later maintained. Assessing the adherence of students to the Mediterranean Dietary Pattern (MDP). A case study was carried out with 463 students aged between 14 and 20 years old. Parents of the youngsters were also surveyed to find out about the accuracy of the youth's answers and to determine the type of food preparation practiced in the family. Those who participated in this study had an informed consent, previously signed by their parents and voluntarily expressed their willingness to participate, although they could drop out at any time if they so wished. The results showed a good adherence to the Mediterranean Dietary Pattern (MDP) by the respondents (46.47%) and their knowledge about the concept of the Mediterranean Diet can be classified as “good” (39.7%) and “reasonable” (36.6%). The main conclusions of the study are that the students participating in the study have a good knowledge about the Mediterranean Food Pattern and show a high level of adherence to it. [ABSTRACT FROM AUTHOR]

Diet is one of the most important modifiable lifestyle factors for preventing and treating obesity. In this respect, the Mediterranean diet (MD) has proven to be a rich source of a myriad of micronutrients with positive repercussions on human health. Herein, we studied an observational cohort of children and adolescents with obesity (N = 26) to explore the association between circulating blood trace elements and the degree of MD adherence, as assessed through the KIDMED questionnaire. Participants with higher MD adherence showed better glycemic/insulinemic control and a healthier lipid profile, as well as raised plasma levels of selenium, zinc, cobalt, molybdenum, and arsenic, and increased erythroid content of selenium. Interestingly, we found that these MD-related mineral alterations were closely correlated with the characteristic metabolic complications behind childhood obesity, namely hyperglycemia, hyperinsulinemia, and dyslipidemia (p < 0.05, |r| > 0.35). These findings highlight the pivotal role that dietary trace elements may play in the pathogenesis of obesity and related disorders.

Background: Poor dietary habits and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The Mediterranean Diet (MD) is known to be extremely healthy, associated with lower BMI and a lower risk of obesity in children and adolescents. Therefore, adherence to the MD was compared between Spanish (n = 182) and German (n = 152) children aged 10 to 13 years to examine a possible more "westernized" diet in Spain with a non-Mediterranean country, that traditionally prefers a "Western diet" and to determine the association between adherence to the MD and gender, body composition, and PA levels. Methods: In the German observational longitudinal cohort study and the Spanish cohort study, body composition and questionnaires (KIDMED, Diet Quality (IAES)) were obtained, and accelerometers (Actigraph) were applied to detect PA. Results: Girls had higher BMI-standard deviation score (SDS) than boys and Spanish girls were less active than boys. Differences were detected in MD habits, such as favorable fruit-, vegetables-, fish-intakes, and dairy products in Spanish children and unfavorable consumptions of fast food, processed bakery goods, candies, and sweet beverages in German children. Independently of country, girls, children with lower BMI-SDS and children with higher PA level were related with better diet quality. Conclusion: Spanish children showed higher adherence to MD and diet quality (IAES) compared to German children, but there was a trend toward a more "westernized" diet. Gender, body composition, and PA influenced nutrition regardless of country. [ABSTRACT FROM AUTHOR]

Background and aimsAs children and adolescents' eating patterns have changed over the last few years, researchers have found inconsistencies in the current questionnaires. Therefore, this research aims to (i) update the 2019 KIDMED questionnaire; and (ii) test the psychometric properties of this new questionnaire.MethodA study with 419 children and adolescents in southwestern Spain was conducted in 2021. The new version of the KIDMED 2.0 was tested, which measures adherence to the Mediterranean diet through 16 items, of which 12 are positive, and 4 are negative. Content validation involved consultation with nutritionists, experts, and adolescents to assess whether the questionnaire was reliable and valid regarding dietary patterns associated with the Mediterranean diet. The expert assessment provided content validity indices for the clarity and representativeness of the questionnaire. Construct validity and test-retest reliability involved 419 students (Mage = 14.40 ± 2.00) from southwestern Spain. Students responded twice (one week apart) to the KIDMED developed in the previous stage and completed a 7-day dietary record.ResultsRegarding validity, results show a moderate agreement for 10 items (ranging between 0.21 and 0.47) of the KIDMED and the 7-day dietary record. Concerning Items 3, 4, 5, and 6, the agreement was slight (ranging between 0.08 and 0.17), whereas the agreement for Item 8 was low. Cohen's kappa showed that most items had moderate to substantial test-retest reliability. Also, kappa showed significant test-retest values for all items (p < 0.001).ConclusionThe new version of the KIDMED 2.0 was shown to be a reliable and valid instrument to measure adherence to the Mediterranean diet in children and adolescents.

Children who show better eating practices are less likely to suffer from severe caries than those who eat a diet rich in sugars. In the present study, we aimed to establish the relationship between the severity of dental caries and adherence to the Mediterranean diet. A cross-sectional study was carried out in which 263 children aged 2 to 14 years old were examined intraorally to analyze the presence and severity of caries. Children's parents/caregivers completed the KIDMED questionnaire to determine their degree of adherence to the Mediterranean diet. The results showed that the prevalence of caries is greater than 80% in children with medium or low adherence to the Mediterranean diet, and remains significant at 67% in the high adherence group (p = 0.010). A statistically significant negative correlation of weak magnitude (r = −0.29; p < 0.001) was found between adherence and the number of carious teeth. Caries severity in the first molars is also influenced by adherence to the diet in a statistically significant way. In conclusion, there is an association between adherence to the Mediterranean diet and the prevalence, extension, and severity of caries in the pediatric population. [ABSTRACT FROM AUTHOR]

The aims of the present study were twofold: to determine the association between adherence to the Mediterranean diet (MedDiet) and psychological problems and to assess the relationship between different food groups of the MedDiet and different patterns of psychosocial health problems in a sample of Spanish adolescents from the Valle de Ricote (Region of Murcia, Spain). This cross-sectional study included a representative sample of 700 adolescents (57% girls) between 12 and 17 years of age. Adherence to the MedDiet was assessed by the Mediterranean Diet Quality Index for Children and Teenagers (KIDMED). Psychosocial health problems were measured by the 25-item self-report version of the Strengths and Difficulties Questionnaire (SDQ). ANCOVA models were used to test the mean differences in psychosocial health problems (SDQ subscales) by adherence to MedDiet categories (low, medium, and high). Multiple linear regression was used to determine the association between different food groups of the MedDiet and psychosocial health problems. Adolescents with low adherence to the MedDiet had significantly higher scores in SDQ total difficulties, conduct problems, and hyperactivity problems and lower scores in pro-social behavior (p < 0.05) than their peers with medium and high adherence to the MedDiet. In relation to specific MedDiet food groups, fruit, nut, and legume intake were associated with higher psychosocial health. However, sweets, skipping breakfast, or high consumption of pasta or rice (≥5 weeks) were associated to higher psychosocial health problems. Our results show that adolescents with higher adherence to the MedDiet could benefit from greater psychosocial health. Individually, some patterns of MedDiet, such as fruit, nut, and legume intake, may reduce psychosocial health problems. These cross-sectional results should be confirmed in longitudinal and intervention studies.

Children today are constantly exposed to several risk factors and high levels of stress that can impact their mental, emotional, and physical health, which can trigger burnout. The objective of this study was to determine the prevalence and frequency of burnout in young amateur athletes and to study the role of the Mediterranean diet on burnout risk. An observational, cross-sectional, and descriptive study of 183 basketball players between 8 and 15 years old was carried out. Adherence to the Mediterranean diet was assessed using the KIDMED questionnaire and the risk of burnout was assessed with the Athlete Burnout Questionnaire. Medians, minimums and maximum values for quantitative variables and absolute frequencies and percentages for qualitative variables were obtained. The results show a higher percentage of burnout among girls. The children who meet the established threshold for burnout spend more time watching television. Participants with better adherence to the Mediterranean diet have lower burnout values in both genders and those with a higher risk of burnout have a worse adherence to the Mediterranean diet. Therefore, it is important to implement a balanced diet appropriate to the individual needs of the athlete.

The purpose of this study is to evaluate the relationship between adolescents' nutritional attitudes, obesity awareness, and diet quality with their self-reported anthropometric measurements taken during the COVID-19 pandemic. This cross-sectional type of study was conducted in a district in the south of Turkey. The research was carried out online with 907 adolescents who agreed to participate voluntarily. Among the adolescents, 28.5% considered themselves overweight, and 32.1% were currently trying to lose weight. According to BMI, 16.1% were affected by overweight/obesity. Adolescents' nutritional attitudes and obesity awareness levels were moderate, while their KIDMED nutritional habits were also moderate. In this study, a negative relationship was found between the adolescents' ASHN mean scores and their body weight, waist circumference, hip circumference, neck circumference, waist/hip ratio and waist/height ratio measurements; and between their OAS mean scores and their body weight, waist circumference, waist/hip ratio and waist/height ratio measurements; and between their KIDMED index scores and their waist/height ratio measurements (p < 0.001). The rate of adolescents who perceive themselves as overweight is higher than the results obtained from the measurement values. BMI levels and other anthropometric measurement values of adolescents with positive nutrition attitudes and physical activity behaviours are also positively affected. This study may have a significant impact on the formulation and implementation of interventions to prevent obesity and increase physical activity for school health nurses. Since the pandemic is still continuing, healthcare providers must stress the risk of obesity in adolescence. • 37.7% of the adolescents had an overweight person in their family and 28.5% considered themselves overweight. • A negative relationship was found between adolescents' measurements and their nutrition attitudes and obesity awareness • A negative relationship was found between adolescents' measurements and their nutrition attitudes and obesity awareness. [ABSTRACT FROM AUTHOR]

Peláez Barrios, E.M. y Vernetta Santana M. (2021). Adherencia a la dieta mediterránea en niños y adolescentes deportistas: revisión sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(1 ), 1- 19. El objetivo de esta revisión fue analizar los estudios realizados en niños y adolescentes deportistas que utilizaban el índice KIDMED para conocer la adherencia a la dieta mediterránea (ADM). Se realizó una búsqueda en diferentes bases de datos: WOS, Scopus, Google Scholar, Pubmed y Sport Discuss, entre el 1 de enero de 2010 y el 1 de junio de 2020, siguiendo la guía PRISMA. De los 82 estudios identificados, 10 analizaron la ADM y cumplieron con todos los criterios de inclusión. Los resultados obtenidos indicaron que los mayores porcentajes de ADM óptima se evidencian en piragüistas masculinos, seguidos de futbolistas masculinos, gimnastas de rítmica y kayakistas femeninas (66%, 54.8%, 52.2% y 51%, respectivamente). En todos los deportistas analizados, los resultados son mejorables, principalmente en el caso de las jugadoras de futbol sala. En la mayoría de los estudios no existe una relación entre ADM y las medidas antropométricas.Como conclusión, se destaca que la mayoría de los deportistas se encuentran entre una mejorable y óptima adherencia a la dieta mediterránea y son pocos los que obtienen porcentajes bajos de adherencia a la dieta mediterránea; destaca un patrón de adherencia a la dieta mediterránea aceptable casi en su totalidad, pero no óptimo. Además, la mayoría de los estudios incluidos en la revisión sistemática obtienen una alta calidad según las directrices STROBE.

Purpose: To compare the adherence to the Mediterranean diet (MD) in Israeli adolescents in 2003–4 and in 2015–6, and associated factors. Methods: Adolescents (aged 11–19 years) from two cross-sectional, school-based, nationally representative surveys, Mabat Youth I (2003–4, n 5005) and II (2015–6, n 3906), completed self-administered questionnaires on food frequency, eating behaviors and lifestyle. The Mediterranean Diet Quality Index for Children and Adolescents (KIDMED index), derived from these questionnaires, was used; higher scores indicate better diet quality. The samples comprised eight subgroups, according to population group (Jews/Arabs), school level (middle/high) and sex. Results: The percentages with poor, average and good KIDMED scores were 11.6, 45.3 and 43.1% in 2015–6, compared to 25.5, 55.2 and 19.3%, respectively, in 2003–4. Significant improvement was seen in all subgroups (all p < 0.001), and was attributed to increased consumption of fruits, vegetables, cereals, dairy products, and decreased negative eating behaviors. In Mabat Youth II, physical activity at least 1 h/day was positively associated with good KIDMED scores among Jewish adolescents; dieting and sleeping at least 7 h/day were associated with good MD adherence in Jewish boys; always/often reading food labels predicted good MD adherence among Jewish boys and Arab girls. Overweight and obesity were negatively associated with better KIDMED scores in Jewish boys. Conclusion: MD adherence in Israeli adolescents has improved overall. The changes in MD components and the associated behavioral factors indicate the initiatives, relevant to the different subgroups, that are necessary to promote healthier nutrition and lifestyles. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Poor dietary habits and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The Mediterranean Diet (MD) is known to be extremely healthy, associated with lower BMI and a lower risk of obesity in children and adolescents. Therefore, adherence to the MD was compared between Spanish (n = 182) and German (n = 152) children aged 10 to 13 years to examine a possible more “westernized” diet in Spain with a non-Mediterranean country, that traditionally prefers a “Western diet” and to determine the association between adherence to the MD and gender, body composition, and PA levels. Methods: In the German observational longitudinal cohort study and the Spanish cohort study, body composition and questionnaires (KIDMED, Diet Quality (IAES)) were obtained, and accelerometers (Actigraph) were applied to detect PA. Results: Girls had higher BMI-standard deviation score (SDS) than boys and Spanish girls were less active than boys. Differences were detected in MD habits, such as favorable fruit-, vegetables-, fish-intakes, and dairy products in Spanish children and unfavorable consumptions of fast food, processed bakery goods, candies, and sweet beverages in German children. Independently of country, girls, children with lower BMI-SDS and children with higher PA level were related with better diet quality. Conclusion: Spanish children showed higher adherence to MD and diet quality (IAES) compared to German children, but there was a trend toward a more “westernized” diet. Gender, body composition, and PA influenced nutrition regardless of country.

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Children who show better eating practices are less likely to suffer from severe caries than those who eat a diet rich in sugars. In the present study, we aimed to establish the relationship between the severity of dental caries and adherence to the Mediterranean diet. A cross-sectional study was carried out in which 263 children aged 2 to 14 years old were examined intraorally to analyze the presence and severity of caries. Children’s parents/caregivers completed the KIDMED questionnaire to determine their degree of adherence to the Mediterranean diet. The results showed that the prevalence of caries is greater than 80% in children with medium or low adherence to the Mediterranean diet, and remains significant at 67% in the high adherence group (p = 0.010). A statistically significant negative correlation of weak magnitude (r = −0.29; p < 0.001) was found between adherence and the number of carious teeth. Caries severity in the first molars is also influenced by adherence to the diet in a statistically significant way. In conclusion, there is an association between adherence to the Mediterranean diet and the prevalence, extension, and severity of caries in the pediatric population.

The effect of parents on nutritional habits in preschool children is undeniable. It is known that parental control in child nutrition can affect the child's eating habits, and bodyweight. Mediterranean Diet (MD) adherence of children (KIDMED), parents' beliefs, attitudes and practices (Preschool Feeding Questionnaire-PFQ2) were investigated. The questionnaire prepared was applied by researchers face-to-face to 1413 families who agreed to participate voluntarily in the research with preschool children. Parental beliefs, attitudes, and practices regarding child nutrition status of parents were evaluated using 39-item PFQ2 and their child's eating habits using the 16-item KIDMED index. Children's KIDMED scores were found optimal in 34.1%, average in 57.0%, very low in 8.9%. The KIDMED scores of children whose parents are together (6.6 ± 2.1) were found to be significantly higher than children whose parents are separated (4.9 ± 2.2) (p <.001). A correlation was found between the KIDMED scores of the children, the parental control (r = 0.156, p <.001), maternal restriction (r = 0.104, p <.001), and structured feeding (r = 0.162, p <.001). Unfortunately, the adherence of most preschool children with the MD which considered a healthy diet pattern was found below the optimal level. [ABSTRACT FROM AUTHOR]

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

During the last decades, an important modification of dietary habits has been observed in the Mediterranean countries, especially among young people. The aim of this study was to evaluate adherence to the Mediterranean diet (MedDiet) and its relationship with weight status in a group of Italian middle school adolescents by using the KIDMED test. The evaluation of weight status revealed that 61.5, 26.8, and 11.7% were normal weight, overweight, and obese, respectively. MedDiet adherence was high in 13.3%, average in 27.1%, and low in 59.6% of the students with no differences by gender and age. MedDiet adherence was found significatively higher in normal weight and in played sport adolescents, in comparison to the overweight and obese ones (p <.001) who showed incorrect nutritional habits. This cross-sectional study shows a very low MedDiet adherence among adolescent living in the Mediterranean basin and highlights the role of Mediterranean dietary pattern in the fight against obesity. [ABSTRACT FROM AUTHOR]

Objective: Unhealthy lifestyle habits during adolescence are linked to a higher risk of chronic degenerative disease during adulthood. The aim of this study was to assess the lifestyle habits among Italian adolescents, considering the potential influence of sex. Methods: Data were collected from 1707 eligible students. Demographic, dietary, and lifestyle data were collected, by using KIDMED and PAQ-C instruments. Results: The overall population had a medium adherence to a Mediterranean diet (58%, KIDMED score: 2.11 ± 0.64). There was no statistically significant difference in adherence by sex. We found boys to be more physically active than girls (p < .001). Considering ponderal index status, boys had turned out to be more overweight and obese respectively (13% and 4% respect to 10% and 2% in female population, p < .05, respectively), due to the presence of only one risk factor (medium or low both in diet and in physical activity score). Conclusions: Our results showed that our population stands at average levels both for its adherence to the Mediterranean diet and for physical activity, with males having a higher percentage of overweight and obesity. Importantly, in contrast to girls, boys have a higher risk of obesity, also in the presence of a single risk factor. [ABSTRACT FROM AUTHOR]

Abstract: The Mediterranean Diet is considered one of the healthiest and important models diet to follow to ensure prevention of diseases. The current society is leading to changes in the monitoring and quality of the patterns that make up the Mediterranean Diet (DM). The main objective of the study is to test the degree of adhesion of the population schooled in Guadix (Granada) to the DM. The study involved a total of 210 people, randomly selected, of the 7 schools in the city of Guadix (Granada), who completed the validated questionnaire KIDMED, distributed in a period of 3 months. Data from the questionnaire, both the issues raised as its analysis, was carried out according to what is established in the study of Serra et al. (2004) on the development of KIDMED in childhood and adolescence. The results do not indicate a low quality of the Mediterranean Diet but adjustments must be made particularly in the consumption of vegetables, fruits, vegetables, nuts, fish, sweets, and food items of the breakfast.

Soccer is the most practiced team sport in the world. Due to the importance of nutrition in soccer performance, controlling the body composition and dietary guidelines of players takes place starting from lower categories. The objective of this study was to evaluate body composition and adherence to the Mediterranean diet of U12 players from a professional soccer team and to identify their dietary weak points. Seventy-one U12 male soccer players participated in the study. Weight, height, percentiles, skinfolds, and body fat were measured by a certified anthropometrist following the procedures recommended by the International Society for the Advancement of Kinanthropometry. The Mediterranean diet adherence test (KIDMED) was the questionnaire used to evaluate eating habits. In addition, a comparison was made among field positions. The results showed percentiles and body fat percentages appropriate for their age. Furthermore, the average score on the KIDMED test showed that the players generally adhered well to the Mediterranean diet, although they should improve their consumption of fruits and vegetables, as well as avoid skipping breakfast. Moreover, goalkeepers and defenders had a higher percentile BMI and percentage of fat than midfielders and forwards. In addition, these players had lower KIDMED values than midfielders and forwards. Although U12 soccer players have an appropriate body composition and adherence to the Mediterranean diet, there are differences between the different field positions that should be assessed by coaches, doctors, and nutritionists/dietitians.

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A cross-sectional study was conducted in the primary schools of five small villages of Salento Peninsula to evaluate the adherence to the Mediterranean Diet (MD) of 282 6-8-years old children in relation to lifestyles and socio-economic factors. The parents of children completed a self-administered questionnaire to evaluate the prevalence of personal, behavioural and socio-economic factors of their sons. Children's anthropometric measurements were also taken. The adherence to the MD was assessed using the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED). The chi-square test was used to detect any differences among groups of children. Overall, 27.0% of children showed low adherence to the MD (KIDMED ≤3), 59.6% medium adherence (KIDMED 4-7) and 13.5% high adherence (KIDMED ≥8). The adherence to the MD was associated with the educational level (whether graduated or not) of the mother and the occupational status (whether employed or not) of both parents. [ABSTRACT FROM AUTHOR]

Social frailty is a warring phenomenon in Europe, negatively impacting children's health and nutrition. We present the results of a social programme facilitating access to physical activities for vulnerable children in Italy. 311 school-age children enrolled in the programme between 2015 and 2017 were assessed for health and lifestyle, anthropometric and nutritional status. Data were compared by origin (Italians vs. immigrants) and then immigrants were split into sub-groups: first- and second-generation. Poor socio-economic status exposed children to a lack of access to health services, and drove imbalanced eating behaviour. 20.8% of children were not registered with the National Health Services (immigrants p < .0001); 22% were not fully vaccinated (no differences between groups). A double burden of malnutrition coexisted: overweight was higher for Italians, underweight and poor linear growth for immigrants. Nearly 40% of children had a poor Mediterranean Diet adequacy (KIDMED index). Our findings show that when social programmes, besides their main scope of inclusion and integration, holistically approach their beneficiaries, they can play an important role in monitoring lifestyle conditions and facilitating access to primary health care. [ABSTRACT FROM AUTHOR]

Background: Celiac disease is an autoimmune disease induced by gluten in genetically predisposed individuals. However, celiac disease is generally associated to malnutrition especially in children and adolescents. Materials and Method: The survey was carried out on 132 celiac patients in the region of Rabat between the year 2015 and 2018. Weekly dietary frequency and Mediterranean index KIDMED was used to evaluate the dietary balance. Results: A 132 children and adolescents with celiac disease participated in the study of which 59.8% (n = 79) of the respondents were female and 40.2% (n = 53) were male. The average age of patients was 14.34 ± 0.2 years, with a minimum age of 10 years and a maximum age of 16 years. The result of KIDMED classification (crombach alpha = 0.80) showed that 28.8% (n = 38) of children had a very poor level of adherence to Mediterranean diet, 57.6% (n = 76) in need of improvement and 13.6% % (n = 18) were in optimal Mediterranean diet. In the other hand, 84.26%, 86.04% and 54,45% of respondents reported consuming maize, sorghum and rice more than 4 times/week respectively. Conclusion: It has been found that the diet of most of the individuals surveyed during this study having followed a diet consisting of cereal (maize, sorghum, millet and rice) without gluten allows them having a growth and a more or less correct corpulence. Consequently, these celiac patients manage to meet their nutritional needs in an acceptable way. [ABSTRACT FROM AUTHOR]

It is a well-established fact that nutrition is one of the most important factors affecting growth and development, with important consequences for adolescents. The contemporary life style in the industrial countries gave way to the establishment of the so-called western or American diet, a diet consisting mostly of industrially processed, fast-food, rich in sugar and saturated fats. Opposed to the western diet there is the so-called Mediterranean diet, a diet presently accepted as a standard for a healthy life style, its health benefits being universally recognized today by medical professionals. This paper's purpose is to study the evolution of mediterraneanisation of diet in Romanian adolescents both during the last period of time, as well as from the standpoint of differences existing in different regions of the country (socio-economic differences, education, opportunities etc.) In order to establish the characteristics of the diet, the Kidmed test was applied as a questionnaire, on two adolescent cohorts from Bucharest and Iasi, in 2014 and 2017. The purpose of applying the same questionnaire on the same individuals in 2014 and 2017 was to enable a comparative analysis of the diet from the two different regions of Romania. At the same time, the data obtained in Bucharest in 2017 on 18 years old adolescents, was compared with similar data from 2011 in order to emphasize the changes taking place in the diet pattern of Romanian adolescents during the last decade. [ABSTRACT FROM AUTHOR]

Objective: The KIDMED questionnaire was published in 2004 to evaluate adherence to the Mediterranean diet (MD) in children and adolescents. In the last 14 years, several respected official dietetics and health organizations have recommended appropriate dietary habits, including eating whole grains and consuming whole fruit rather than fruit juice. We propose an update of the KIDMED questionnaire.Design: Based on the scientific evidence, the present commentary suggests some changes to the KIDMED questionnaire.Results: We suggest deleting 'or fruit juice' from the first question of the questionnaire, rewording the question as 'Takes a fruit every day', and assigning a positive value of +1. We suggest adding 'whole-grain' to the eighth question of the questionnaire, rewording the question as 'Consumes whole-grain pasta or whole-grain rice almost every day (5 or more times per week)', and assigning a positive value of +1. Further, we propose to add 'whole cereals or whole grains' to the ninth question of the questionnaire, reword the question as 'Has whole cereals or whole grains (whole-meal bread, etc.) for breakfast', and assign a positive value of +1.Conclusions: The present commentary examines some signs of a paradigm shift about fruit juice and whole grains after the development of the KIDMED questionnaire. The changes are of paramount importance in order to make the questionnaire an updated tool to evaluate adherence to the MD. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Mediterranean diet (MD), despite its multiple benefits, presents low levels of adherence among children. Moreover, childhood is a key stage in the acquisition of healthy habits. The aim of this study was to describe adherence to MD in school-age children from Asturias, Spain, and to evaluate the association with weight status and several lifestyle behaviors. A cross-sectional study was conducted on 309 children aged between 8 and 13 years old. The level of adherence to MD was evaluated through the KIDMED questionnaire. Descriptive analysis and logistic regression models were used to analyze the association between adherence to MD and weight status, frequency of out-of-school exercise, frequency of school canteen attendance, and sleep habits. We found that 54.4% of children had optimal adherence to MD and 29.9% of the sample was overweight or obese. Frequency of exercise practice was positively associated with optimal adherence to MD (95% CI: 1.02, 1.33). A positive association was found between some KIDMED items and frequency of out-of-school exercise practice and attendance at the school canteen. This study shows the need for an improvement in the adherence to MD in youth considering the concomitant occurrence of other related healthy behaviors.

Objective: This study aimed to evaluate the adolescent obesity and its association with Mediterranean Diet Quality Index (KIDMED) and cardiovascular risk factors in adolescents. Method: This cross sectional study included 95 adolescents aged between 10 and 18 who visited a Primary Health Service Center in Turkey. Participants' biochemical parameters, anthropometric measurements and blood pressures were measured. The level of adherence to Mediterranean Diet was evaluated by a clinical questionnaire, the Mediterranean Diet Quality Index for children and adolescents (KIDMED). Results: Overweight adolescents had significantly higher systolic blood pressure, diastolic blood pressure, total cholesterol, very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, hemoglobin A1c, C-reactive protein, alanine aminotransferase, than normal-weight adolescents. Overweight/obese subjects also had significantly lower HDL cholesterol than normal-weight subjects. Results indicated that 60.0% of the adolescents had a low quality diet, 34.7% had a mid-quality/needs-improvement diet, and 5.3% had an optimal quality diet. No association was found between diet quality and obesity and cardiovascular risk factors. Conclusion: Overweight and obese children are strongly associated with multiple cardiovascular risk factors. To avoid health problems arising from obesity, adolescents should refer to global solutions. Mediterranean diet is a good measure against adverse cardiovascular risk factors in adolescence. [ABSTRACT FROM AUTHOR]

Background: The possible associations between adherence to the Mediterranean diet and micronutrient and energy intakes are unknown among Israeli adolescents. Methods: A cross‐sectional, nationally representative, school‐based study was conducted in Israeli adolescents. Schoolchildren (n = 5005), aged 11–18 years, who completed a food frequency questionnaire and had complete data to compose a 14‐item modified KIDMED score were included. Results: The nutrient intakes for all the micronutrients showed a significant monotonic increase in the poor, average and good KIDMED groups (all P < 0.001). The same monotonic increasing was also shown in nutrient densities for most micronutrients (for calcium, magnesium, potassium, copper, vitamin A, vitamin E, vitamin C, thiamin, riboflavin, vitamin B6, folate in both genders, additionally for phosphorus in girls) (all P < 0.05). A positive association was shown between the percentages of students with adequate intakes (AIs) or recommended dietary allowances (RDAs) in micronutrients and modified KIDMED scores. The positive association also existed between the number of micronutrients with AIs or RDAs and modified KIDMED scores (r = 0.495 and 0.501, P < 0.001) for boys and girls, respectively. By contrast, dietary energy density (calibrated by 1000 kcal) was negatively linearly associated with modified KIDMED scores, and a significant monotonic decrease in energy density was shown among the poor, average and good KIDMED groups (all P < 0.001). Conclusions: The modified KIDMED score was positively associated with better micronutrient profile and negatively associated with dietary energy density in Israeli adolescents, indicating that the KIDMED index is a useful tool for combating the malnutrition of micronutrient deficiency and overweight/obesity. [ABSTRACT FROM AUTHOR]

Research has suggested that university students are at risk from certain unhealthy habits, such as poor diet or alcohol abuse. At the same time, anxiety levels appear to be higher among university students, which may lead to high levels of emotional eating. The aim of this study was to analyze the degree of adherence to the Mediterranean diet (AMD), emotional eating, alcohol intake, and anxiety among Spanish university students, and the interrelationship of these variables. A total of 252 university students filled out the Mediterranean Diet Quality Index (KIDMED) questionnaire for Mediterranean diet adherence, an Alcohol Use Disorders Identification Test, a State-Trait Anxiety Inventory and the Emotional Eater Questionnaire. We analyzed descriptive data, a t-test and analysis of variance (ANOVA) for differences, a Pearson correlation, and multiple regression tests. Results showed low levels of AMD among university students (15.5%) and considerable levels of emotional eating (29%) and anxiety (23.6%). However, levels of alcohol dependence were low (2.4%). State-anxiety was a predictor of the emotional eater score and its subscales, and sex also was predictive of subscale guilt and the total score. However, AMD was predicted only by trait-anxiety. These models accounted for between 1.9% and 19%. The results suggest the need for the implementation of educational programs to promote healthy habits among university students at risk.

Background: The aim of the present cross-sectional study was to evaluate associations between pocket money, Mediterranean diet (MD) adherence and growth among Greek adolescents. Methods: A total of 319 (157 boys and 162 girls) Greek adolescents, aged 10-18 years participated in the study. Pocket money was recorded, MD adherence was assessed with the KIDMED score and growth was evaluated using the World Health Organization (WHO) growth charts. Results: Participants receiving pocket money exceeding 6.0€ daily demonstrated increased fast-food consumption and breakfast skipping. Overall, a negative relationship was revealed between pocket money and obesity. However, lower allowance receivers were less likely to be obese, consume fruit per day and more likely to consume breakfast and sweets, compared to average pocket money receivers. Increased MD adherence was associated with a lower risk of overweight and as expected, unhealthy eating habits were observed among obese adolescents. Conclusions: Interrelationships tend to exist between MD adherence, pocket money and growth among adolescents. [ABSTRACT FROM AUTHOR]

Introduction: The adoption of healthy eating habits is important for the healthy development and the promotion of children's health. However, nowadays Mediterranean countries, such as Greece have experienced rapid social changes in the last decade. These community changes affect nutritional habits and there is a tendency for the traditional healthy Mediterranean diet to be abandoned. Purpose: The purpose of this study is defining the level of adoption of the Mediterranean diet of the children of an urban and an island area, overall and comparatively. Furthermore, the purpose includes detecting if there is any correlation between BMI and KIDMED score with sociodemografic and anthropometric factors. Material and Methods: The study population included 225 students aged 10-13 years old, from schools of Attica and Kefalonia. The sample used in the study was a “convenience” sample. Information on sociodemographic and anthropometric characteristics of members has been collected from parents through a validated nutrition questionnaire. KidMed was used to evaluate the degree of adoption to Mediterranean Diet. Statistical package SPSS 19 was used. In order to test differences from qualitative variables, it was used X2 test or Fisher exact test. Apart from that, in order to control means of quantitative variables, that did not follow a normal distribution, U Mann-Whitney (t-test) was used. . Results: According to the IOTF cut-offs, overweight (OW) and obesity (OB) prevalence among all schoolchildren was 24.9%. In addition to this, 37.7% of mothers and 78.4% of fathers were overweight or obese. Moreover, the statistical analysis showed that the BMI of the children is positively correlated to the BMI of parents. Regarding KIDMED Index, it was found out that 33.5% of children had low KIDMED scores, while only 33.1% of children had high KIDMED score. Also, there were not found out differences in total KidMed score between the Kefalonia and Attica children. However, there were some significant differences in specific scores on certain KidMed questions. Also, there was no positive correlation of the KIDMED Index with the sex, the BMI and educational level of the parents. Conclusions: The results of the study show that one in four children in the study population does not feed according to the MD. Also, there is no difference in the way the children of the city eat being compared to the children of the province. The results show that the possibility of changing nutritional habits is measurable among young children not only in urban areas but also in rural areas of Greece. The study raises the question whether the Greek children may have abandoned some aspects of the traditional Mediterranean diet. Apart from that, the current findings show an increased risk for even higher rates of obesity in children and adolescents. Taking into account that the children are also abandoning the traditional cardioprotective Mediterranean Diet,the increased risk for future adverse health consequences seems obvious. [ABSTRACT FROM AUTHOR]