Health behaviours as predictors of the Mediterranean Diet adherence: a decision tree approach

Objective: This study aimed to identify health behaviours that determine adolescent’s adherence to the Mediterranean Diet through a decision tree statistical approach Design: Cross-sectional study, with data collected through a self-fulfilment questionnaire with five sections: 1) eating habits; 2) adherence to the Mediterranean Diet (KIDMED Index); 3) physical activity; 4) health habits; 5) sociodemographic characteristics. Anthropometric and blood pressure data were collected by a trained research team. The Automatic Chi-square Interaction Detection (CHAID) method was used to identify health behaviours that contribute to a better adherence to the Mediterranean Diet. Setting: Eight public secondary schools, in Algarve, Portugal. Participants: Adolescents with ages between 15 and 19 years old (n 325). Results: According to the KIDMED Index, we found a low adherence to MD in 9.0% of the participants, an intermediate adherence in 45.5% and a high adherence in 45.5%. Participants that regularly have breakfast, eat vegetable soup, have a second piece of fruit per day, eat fresh or cooked vegetables one or more times a day, eat oleaginous fruits at least 2 to 3 times a week, and practice sports and leisure physical activities outside school show higher adherence to the MD (P <0.001). Conclusions: The daily intake of two pieces of fruit and vegetables proved to be a determinant health behaviour for high adherence to MD. Strategies to promote the intake of these foods among adolescents must be developed and implemented.

Adherence to the Mediterranean diet and risk of functional constipation in children in Turkey: case–control study

Background: Functional constipation is often seen in children, affecting quality of life and imposing a considerable burden on health care services. The Mediterranean diet is associated with a lower risk of functional gastrointestinal disorders. Aims: This study aimed to evaluate the relationship between functional constipation and adherence to the Mediterranean diet in Turkish children aged 6–18 years. Methods: In this case–control study, 221 children with functional constipation (cases) were selected from a paediatric gastroenterology clinic between May 2018 and September 2019, and 230 children without constipation (controls) were randomly selected from those attending a well-child check-up. Cases and controls were matched on sex, age and socioeconomic characteristics. Compliance with the Mediterranean diet was assessed using the KIDMED index score. Multivariable logistic regression analysis was used to analyses the data. Results: KIDMED index scores in cases and controls were 4.0 (SD = 2.5) and 6.3 (SD = 2.4), respectively (P < 0.001). Odds ratios for functional constipation were 0.23 (95% confidence interval (CI): 0.13–0.38) for KIDMED index score 4–7 and 0.05 (95% CI: 0.03–0.11) for score ≥ 8 compared with the lowest category (score ≤ 3; P < 0.001). A negative correlation was observed between age and adherence to the Mediterranean diet. Conclusion: Good adherence to the Mediterranean diet was associated with a lower risk of functional constipation, and adherence to the Mediterranean diet decreased with age. Education on nutrition and health is warranted to help maintain and improve the health of young people in Turkey.

Mediterranean diet adherence among adolescents in North Lebanon: the role of skipping meals, meals with the family, physical activity, and physical wellbeing

The Mediterranean diet (MD) is a model of a healthy diet and healthy lifestyle. Adherence to the MD has been correlated with a reduction in many metabolic disorders including cancers. The factors associated with adolescents’ adherence to the MD in North Lebanon using the KIDMED index have never been explored. Therefore, we thought to examine these factors among a sample of them. A cross-sectional survey was conducted in the city of Tripoli, North Lebanon. A total of 798 adolescents aged 11-18 years were randomly selected to participate in this study. All participants completed a questionnaire assessing adherence to the MD (KIDMED index), physical activity (physical activity questionnaires for older children [PAQ-C] and adolescents [PAQ-A]), health-related quality of life (KIDSCREEN-27 index) and sociodemographic characteristics (age, gender, grade level and parents’ educational status). Anthropometric measurements, including weight, height and waist circumference, were also collected. Adherence to the MD was good among only 13.3% of the adolescents. The prevalence rate of overweight and obesity was elevated, affecting 36.9% of the students. Lower adherence to the MD was significantly correlated with skipping meals (p=0.001). Meanwhile, adolescents who were engaged in a high level of physical activity, those who consumed more meals with their families and those who benefited from better physical wellbeing had a better diet quality (p<0.001). Nutrition intervention programmes, as well as public health policies, would be of interest in order to improve diet quality among Lebanese adolescents.

Reproducibility and Validity of the KIDMED Index in a sample of Portuguese adolescents

ABSTRACT The KIDMED Index is frequently used to evaluate adherence to the Mediterranean Dietary Pattern among children and adolescents, through 16 questions with the associated total score ranging from -4 to 12. However, in the authors’ best knowledge, the psychometric properties of this index had not yet been investigated in Portugal. Thus, the main purpose of the present study was to investigate the reproducibility and the validity of the KIDMED Index in a sample of 185 Portuguese adolescents. The reproducibility was tested by comparing the application of the KIDMED Index at two different times (two-week interval), using McNemar test and Kappa statistics. There was moderate agreement (κw = 0.591, 95% CI = 0.485-0.696) and no significant change (p-value = 0.201) in the KIDMED Index classification, between the two applications. The validity was explored by comparing the results obtained by the KIDMED Index and by the average of 3-days Dietary-Record (DR), using Spearman’s correlation coefficient and Kappa statistics. There was weak correlation (ρ = 0.317; p-value < 0.001) and slight agreement (κw = 0.167, 95% CI = 0.071-0.262) between the KIDMED Index classification and the 3-days DR-derived KIDMED score; and moderate correlation (ρ = 0.423; p-value < 0.001) and fair agreement (κw = 0.344, 95% CI = 0.202-0.486) between the terciles of the KIDMED Index and the Mediterranean Adequacy Index scores. The results suggested an acceptable reproducibility and validity of the Portuguese version of the KIDMED Index, in alignment with the few studies investigating psychometric properties of this index in other countries.

Nutritional intervention promoting Mediterranean diet improves dietary intake and enhances score adherence in adolescent athletes

BACKGROUND: Appropriate nutrition is important to maintain health, growth, and development of adolescent athlete performance. OBJECTIVE: To evaluate the impact of nutritional intervention (NI) promoting Mediterranean diet (MD), on food consumption, and adherence to MD, in scholar adolescent athletes. METHODS: Eighty athletes (Females/Males, 39/41) aged 15±1 years participated to NI. MD Adherence was assessed, using Kidmed index, at baseline, and at 6 months. Food intake was evaluated by 24-hour recall at baseline, and at four NI times. RESULTS: At baseline, 61% of athletes had poor MD adherence, and after NI, this value decreased to 10%. At 6 months of NI, 73% of males vs 46% of females had good MD adherence (≥8). Energy intake represented 2369 Kcal/d, at baseline, and was less than recommended value. After NI, significant increase was observed in energy intake (p = 0.001). Mean fiber intake (19 and 21 g/d in females and males, respectively) was less than adequate intake (26/38 g/d), but increased after NI (p = 0.000). Enhancement was noted in total, and complex carbohydrates, and total proteins, and values were increased with time (p = 0.000, p = 0.000, p = 0.003). CONCLUSION: Nutritional intervention, based on Mediterranean diet, improves total energy, and macronutrients intake, and increases MD adherence scores in adolescents athletes.

Diet Quality and Mental Health Amongst Acute Inpatient Psychiatric Patients

Background: Poor diet quality has been found to be prevalent in people with mental illness [71] and even contribute to mental illness [71]. The purpose of this exploratory study is to examine the relationship between diet quality, mental health problems, socioeconomic variables, physical activity level, and body mass index amongst acute psychiatric inpatients.Method: The study sample were 100 adult inpatients. Tools administered were Eating Habit Questionnaires (Dana Farber Institute) and the KIDMed index to assess food compliance in accordance with a Mediterranean diet. The Index marks all individuals as either having an “unhealthy score” or “healthy score”. The study utilized a descriptive correlation research design.Results: The results showed that 75% of the patients displayed an unhealthy score as per the KIDMed index. The findings displayed an inverse relationship of BMI and the KIDMed score. There was a significant positive correlation between the level of education and the KIDMed score. There is a positive correlation towards increased consumption of sugar in schizophrenic patients. There was no statistical significance between age, gender, income and physical activity with regards to the KIDMed score.Conclusion: Psychiatric inpatients display unhealthy eating habits which is likely both an effect of and a contributing factor to the various mental illnesses. Prospective interventional randomized controlled studies are necessary for clarification of cause-effect relationships.

Diet Quality and Mental Health Amongst Acute Inpatient Psychiatric Patients

Background: Poor diet quality has been found to be prevalent in people with mental illness [71] and even contribute to mental illness [71]. The purpose of this exploratory study is to examine the relationship between diet quality, mental health problems, socioeconomic variables, physical activity level, and body mass index amongst acute psychiatric inpatients.Method: The study sample were 100 adult inpatients. Tools administered were Eating Habit Questionnaires (Dana Farber Institute) and the KIDMed index to assess food compliance in accordance with a Mediterranean diet. The Index marks all individuals as either having an “unhealthy score” or “healthy score”. The study utilized a descriptive correlation research design.Results: The results showed that 75% of the patients displayed an unhealthy score as per the KIDMed index. The findings displayed an inverse relationship of BMI and the KIDMed score. There was a significant positive correlation between the level of education and the KIDMed score. There is a positive correlation towards increased consumption of sugar in schizophrenic patients. There was no statistical significance between age, gender, income and physical activity with regards to the KIDMed score.Conclusion: psychiatric inpatients display unhealthy eating habits which is likely both an effect of and a contributing factor to the various mental illnesses. Prospective interventional randomized controlled studies are necessary for clarification of cause-effect relationships.

Diet Quality and Mental Health Amongst Acute Inpatient Psychiatric Patients

BackgroundPoor diet quality has been found to be prevalent in people with mental illness [71] and even contribute to mental illness [71]. The purpose of this exploratory study is to examine the relationship between diet quality, mental health problems, socioeconomic variables, physical activity level, and body mass index amongst acute psychiatric inpatients.MethodThe study sample were 100 adult inpatients. Tools administered were Eating Habit Questionnaires (Dana Farber Institute) and the KIDMed index to assess food compliance in accordance with a Mediterranean diet. The Index marks all individuals as either having an “unhealthy score” or “healthy score”. The study utilized a descriptive correlation research design.ResultsThe results showed that 75% of the patients displayed an unhealthy score as per the KIDMed index. The findings displayed an inverse relationship of BMI and the KIDMed score. There was a significant positive correlation between the level of education and the KIDMed score. There is a positive correlation towards increased consumption of sugar in schizophrenic patients. There was no statistical significance between age, gender, income and physical activity with regards to the KIDMed score.ConclusionPsychiatric inpatients display unhealthy eating habits which is likely both an effect of and a contributing factor to the various mental illnesses. Prospective interventional randomized controlled studies are necessary for clarification of cause-effect relationships.

Diet Quality and Mental Health Amongst Acute Inpatient Psychiatric Patients

BackgroundPoor diet quality has been found to be prevalent in people with mental illness [71] and even contribute to mental illness [71]. The purpose of this exploratory study is to examine the relationship between diet quality, mental health problems, socioeconomic variables, physical activity level, and body mass index amongst acute psychiatric inpatients.MethodThe study sample were 100 adult inpatients. Tools administered were Eating Habit Questionnaires (Dana Farber Institute) and the KIDMed index to assess food compliance in accordance with a Mediterranean diet. The Index marks all individuals as either having an “unhealthy score” or “healthy score”. The study utilized a descriptive correlation research design.ResultsThe results showed that 75% of the patients displayed an unhealthy score as per the KIDMed index. The findings displayed an inverse relationship of BMI and the KIDMed score. There was a significant positive correlation between the level of education and the KIDMed score. There is a positive correlation towards increased consumption of sugar in schizophrenic patients. There was no statistical significance between age, gender, income and physical activity with regards to the KIDMed score.Conclusionpsychiatric inpatients display unhealthy eating habits which is likely both an effect of and a contributing factor to the various mental illnesses. Prospective interventional randomized controlled studies are necessary for clarification of cause-effect relationships.

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

Background: The relationship between adherence to the Mediterranean Diet (MD) and both physical fitness (PF) and physical activity (PA) level has been analysed in several studies. The aim of this research was to describe, compare and analyse the level of PF and PA in schoolchildren aged 6-13 in the Region of Murcia, according to adherence to the MD. Methods: A descriptive and cross-sectional study was performed. A total of 370 schoolchildren (44.9% girls) aged 6-13 (8.7&plusmn;1.8) from six primary schools in the Region of Murcia (Spain). Results: Only 25.9% of the schoolchildren had optimal adherence to the MD. Regarding the scores of the different PF tests in MD groups, only statistically significant differences were found for CRF (p=0.048) in boys. PA level, showed statistically significant differences in both boys (p=0.040) and girls (p=0.016). A positive relationship was found between the KIDMED index and CRF (&rho;=.127), standing broad jump (&rho;=.133) and PA level (&rho;=.235). A higher probability of having a greater CRF (OR=1.17; CI95%=1.02&ndash;1.34) and PA level (OR=7.84; CI95%=2.84&ndash;21.60) was found in High MD group. Conclusion: These results suggest that an optimal adherence to the MD is associated with higher CRF and PA level in the selected schoolchildren.