Adherence to the Mediterranean Diet among Children and Youth in the Mediterranean Region in Croatia: A Comparative Study

Abstract

The Mediterranean diet (MD) is considered one of the healthiest dietary patterns. The aim of this study was to assess MD adherence in children and youth living in the Mediterranean region in Croatia and evaluate the differences in adherence to the MD among different educational stages. In total, 2722 individuals aged 2 to 24 years were enrolled in this study. Subjects were divided into different groups according to the Croatian educational system. Mediterranean Diet Quality Index (KIDMED) was used to assess adherence to the MD. In the total sample, the adherence to the MD was poor in 19.2%, average in 60.8%, and good in 20.1% of the study participants. The prevalence rate of poor adherence to the MD increased with higher educational stage, i.e., the highest prevalence rate of poor MD adherence was observed for college students (39.3%). Children having a higher number of snacks on days-off, those with lower physical activity, and not having breakfast together with a family are more likely to have poor MD adherence, while children having a higher number of snacks on working days are less likely to have a poor MD. The results of this study showed low adherence to the principles of the MD, confirming the need for improvement of adherence to the MD pattern in the studied population.

Determinants of Adherence to the Mediterranean Diet in Spanish Children and Adolescents: The PASOS Study

“…However, there was significant variability in the samples analyzed, and direct comparisons could not be made between studies. Primary school students had a higher degree of adherence to MedDiet than secondary school students, which is in line with previous research [8,9,12,28]. This could be explained by adult supervision and control over children's diets, which is associated with following a healthy dietary pattern.…”

“…Optimal adherence to MedDiet was positively associated with meeting recommendations on physical activity and screen time. Optimal adherence to MedDiet was previously associated with physical activity practice [6,11,28,29], and it was inversely associated with screen time [6,11,[28][29][30]. High levels of physical fitness were associated with high adherence to MedDiet [28,29,31,32].…”

“…Optimal adherence to MedDiet was previously associated with physical activity practice [6,11,28,29], and it was inversely associated with screen time [6,11,[28][29][30]. High levels of physical fitness were associated with high adherence to MedDiet [28,29,31,32]. Therefore, strategies are needed that target increasing physical activity and decreasing screen time, as these two habitual behaviors have demonstrated a relationship with MedDiet.…”

Adherence to the Mediterranean Diet: Impact of Geographical Location of the Observations

“…In this context, it is important to emphasize that, in order to be most effective, nutritional guidelines need to be developed according to several specific factors, such as local cultural, ethnic and traditional features, and geographic and socioeconomic components, as well as to the availability of specific local food products [ 9 ]. Among these features, the geographical location (i.e., a specific country, different areas in a country, such as seaside or mountainside or plains far from both, and specific latitude and climate, including climate changes, as well as the related social features) appears to be a crucial factor that may affect to a large extent the actual applicability of the Mediterranean diet or some of its principles as well as the actual adherence to it [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. An additional dynamic component affecting personal nutritional choices, also regarding adherence to the Mediterranean diet and its principles, is the individual life-long trajectory of food preference and nutrition habits and awareness, including feeding behavior aspects [ 19 ].…”

Mediterranean Diet and Physical Activity as Healthy Lifestyles for Human Health

“…A comparative study carried out among 2722 individuals aged 2 to 24 years living in Croatia showed low adherence to the MD over the entire sample [8]. Specifically, Matana et al, found that the prevalence rate of poor adherence to the increased with higher education stage, while the lowest rate was observed for the children enrolled in kindergartens [8].…”