Adherence to the Mediterranean Diet Among Primary School Children in the Tagus Lezíria Region, Portugal: A Study on Eating Habits.

Poor dietary habits remain a significant public health concern, highlighting the need to promote healthy and sustainable eating patterns, especially in childhood and adolescence. This study assessed the eating habits of primary school children in the Tagus Lezíria region, focusing on adherence to the Mediterranean Diet (MD), recognized for its health and environmental benefits. The KIDMED index (Mediterranean Diet Quality Index for children and adolescents) was applied to 435 children, the vast majority (97.7%) aged 6-10 years. The data showed that 64.6% of participants exhibited high adherence to the MD, 32.0% medium, and 3.5% low adherence. Despite these encouraging levels, several gaps were identified: 80% of the children did not meet the recommendation for regular nut consumption (≥2-3 times/week), 44% consumed legumes less than once a week, and 43% failed to eat vegetables more than once a day. Regarding demographic factors, no significant differences were observed in overall adherence categories; however, differences emerged in specific eating behaviours. For example, girls consumed more vegetables and cereals than boys, and children in rural areas consumed less dairy than those living in urban settings. These findings emphasize the importance of reinforcing targeted school-based educational interventions to promote healthier dietary behaviours, particularly increased consumption of fruits, vegetables, fish, pulses, and nuts. Strengthening children's adherence to the MD from an early age may contribute to improving their health and fostering sustainable eating practices.