Poor adherence to the Mediterranean diet is associated with increased risk of Metabolic Syndrome in children. The Healthy Growth Study

Objective To examine the associations between the level of adherence to the Mediterranean diet (MedDiet) with obesity, insulin resistance (IR), metabolic syndrome (MetS) and its components in schoolchildren. Design The Healthy Growth Study was a large epidemiological cross-sectional study. Setting School children that were enrolled in primary schools in four counties covering the northern, southern, western and central part of Greece were invited to participate. Participants The study was conducted with a representative sample of 9-13 years old schoolchildren (n-1,972) with full data. This study applied the KIDMed score to determine "poor" (≤ 3), "medium" (4 to 7) and "high" (≥ 8) adherence of children to the MedDiet. The research hypothesis was examined using multivariate logistic regression models, controlling for potential confounders. Results The percentage of children with "poor", "medium" and "high" adherence to the MedDiet was 64.8%, 34.2% and 1% respectively. Furthermore, the prevalence of obesity, IR and MetS was 11.6%, 28.8% and 3.4% respectively. Logistic regression analyses revealed that "poor" adherence to the MedDiet was associated with an increased likelihood for central obesity (OR 1.31; 95% C.I 1.01-1.73), hypertriglyceridemia (OR 2.80; 95% C.I 1.05-7.46) and IR (OR 1.31; 95% C.I 1.05-1.64), even after adjusting for several potential confounders. Conclusions The present study showed that approximately two thirds of the examined sample of schoolchildren in Greece have "poor" adherence to the MedDiet, which also increases the likelihood for central obesity, hypertriglyceridemia and IR. Prospective studies are needed to confirm whether these are cause-effect associations.