Mediterranean diet adherence in children and adolescents in southern European countries

BackgroundOver the last decades, a progressive shifting away from traditional healthy dietary patterns, such as the Mediterranean diet, has been observed. The aim of this review was to evaluate evidence on extent and determinants of adherence to the Mediterranean diet among children and adolescents living in southern European countries.MethodsA review of scientific articles published over the last 15 years conducted on dietary habits and determinants of adherence to the Mediterranean diet in the target population was performed. Cross-sectional surveys conducted in Spain, Greece, and Italy were selected.ResultsIrrespectively of the tool used, adherence to the Mediterranean diet was mainly poor in roughly half of the populations investigated. Major determinants of adherence were social and demographic factors. Among the former, high socioeconomic and cultural status of participants' parents (especially mothers) were associated with higher adherence. In most of countries, also living in rural areas was a determinant of high adherence. There was no consistent association with metabolic status, as most of the associations with health-related outcomes were mediated by other key variables, such as sedentary behaviors and engagement in physical activities.ConclusionsThere is a need for nutrition education programs to establish healthy eating habits at a young age. Targets for such intervention should not be limited to children and adolescents but also include parents, teachers, and physicians.