Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Nutrition. 2010 Jan;26(1):61-7. doi: 10.1016/j.nut.2009.05.014.
There is some evidence regarding the association between adherence to the Mediterranean diet (MD) and obesity among adults; to our knowledge, however, no relevant data exist for children. We investigated the association between adherence to the MD and obesity status in children.
A national cross-sectional study among 1140 children (mean age 10.7+/-0.98 y) was carried out in Cyprus using stratified multistage sampling design. Body mass index was calculated according to International Obesity Task Force criteria, from parental reference. Adherence to the MD was assessed by the Mediterranean Diet Quality Index for children and adolescents (KIDMED diet score). To test the research hypothesis, a logistic regression analysis was applied with two dependent variable categories of obesity status, normal weight (NW) versus overweight/obese (OW/OB), and the three categories of the KIDMED score independently, after controlling for several potential confounders.
Compared with low MD adherers, children with a high KIDMED score were 80% less likely to be OW/OB (95% confidence interval 0.041-0.976), adjusted for age, gender, parental obesity status, parental educational level, and dietary beliefs and behaviors (model 2). When physical activity was taken into account, however, the aforementioned relation was not significant (model 3; odds ratio 0.20, 95% confidence interval 0.021-1.86). Furthermore, male gender, maternal obesity, and dietary beliefs and behaviors emerged as more significant in predicting obesity in children compared with their KIDMED score.
Adherence to the MD is inversely associated with obesity in this sample of 9- to 13-y-old children; however, other behaviors, and in particular physical activity, maternal obesity, dietary beliefs and behaviors, seem to be more significant.
有一些证据表明地中海饮食（MD）的依从性与成年人肥胖之间存在关联；然而，就我们所知，儿童中没有相关数据。我们研究了儿童 MD 依从性与肥胖状况之间的关系。
在塞浦路斯，采用分层多阶段抽样设计，对 1140 名儿童（平均年龄 10.7+/-0.98 岁）进行了一项全国性横断面研究。根据国际肥胖工作组的标准，从父母的参考值计算体重指数。通过儿童和青少年地中海饮食质量指数（KIDMED 饮食评分）评估 MD 的依从性。为了检验研究假设，在控制了几个潜在的混杂因素后，我们应用逻辑回归分析，将肥胖状况的两个因变量类别（正常体重（NW）与超重/肥胖（OW/OB））和 KIDMED 评分的三个类别分别作为独立的因变量。
与 MD 低依从者相比，KIDMED 评分高的儿童 OW/OB 的可能性低 80%（95%置信区间 0.041-0.976），调整了年龄、性别、父母肥胖状况、父母教育水平以及饮食信念和行为（模型 2）。然而，当考虑到体力活动时，上述关系就不显著了（模型 3；比值比 0.20，95%置信区间 0.021-1.86）。此外，与他们的 KIDMED 评分相比，男性、母亲肥胖和饮食信念和行为在预测儿童肥胖方面更为显著。
在本研究中，9 至 13 岁儿童的 MD 依从性与肥胖呈负相关；然而，其他行为，特别是体力活动、母亲肥胖、饮食信念和行为，似乎更为重要。
