Lazarou Chrystalleni, Panagiotakos Demosthenes B, Matalas Antonia-Leda
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Public Health Nutr. 2009 Jul;12(7):991-1000. doi: 10.1017/S1368980008003431. Epub 2008 Aug 27.
The Mediterranean diet (MD) prototype is widely used as an educational tool in public health programmes; few studies, however, have been conducted on the adherence of children to this diet.
To evaluate the quality of Cypriot children's diet by assessing the degree of adherence to the MD.
A national cross-sectional study among 1140 children (mean age = 10.7 (SD 0.98) years), using stratified multistage sampling design, was conducted in primary schools of Cyprus. Dietary assessment was based on a 154-item semi-quantitative FFQ and the two supplementary questionnaires (a Food Groups Frequency Questionnaire and a Short Eating Habits Questionnaire). Adherence to the MD was assessed by the KIDMED index. The association between the frequencies of consumption of various food groups and the level of adherence to the MD (poor v. average v. good KIDMED score) was also evaluated. Multiple logistic regression analyses were used to adjust for potential confounders.
Only 6.7% of the sample was classified as high adherers of MD, whereas 37% had a poor KIDMED score. Multiple logistic regression analysis has shown that children with at least an average KIDMED score were more likely to eat frequently seafood and fish, legumes, nuts, bread, fruits, leafy vegetables, olives, low glycaemic index foods and unrefined foods. Effect size of associations was from medium to high.
Higher adherence to MD is associated with better diet quality in children. The MD prototype may thus represent a useful educational tool for promotion of healthy eating habits in children.
地中海饮食（MD）模式在公共卫生项目中被广泛用作一种教育工具；然而，针对儿童对这种饮食的依从性的研究却很少。
通过评估对地中海饮食的依从程度来评价塞浦路斯儿童的饮食质量。
在塞浦路斯的小学中开展了一项针对1140名儿童（平均年龄 = 10.7（标准差0.98）岁）的全国性横断面研究，采用分层多阶段抽样设计。饮食评估基于一份154项的半定量食物频率问卷以及两份补充问卷（一份食物组频率问卷和一份简短饮食习惯问卷）。通过儿童地中海饮食依从性（KIDMED）指数评估对地中海饮食的依从性。还评估了各类食物组的消费频率与地中海饮食依从水平（KIDMED评分差vs平均vs良好）之间的关联。采用多重逻辑回归分析来调整潜在的混杂因素。
样本中只有6.7%被归类为地中海饮食的高依从者，而37%的儿童KIDMED评分较差。多重逻辑回归分析表明，KIDMED评分至少为平均水平的儿童更有可能经常食用海鲜、鱼类、豆类、坚果、面包、水果、叶类蔬菜、橄榄、低血糖指数食物和未精制食物。关联的效应大小从中等到高。
对地中海饮食的更高依从性与儿童更好的饮食质量相关。因此，地中海饮食模式可能是促进儿童健康饮食习惯的一种有用的教育工具。
