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Responses to the KIDMED questionnaire (Mediterranean Diet Quality Index in Children and Adolescents) for the total sample.
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Inadequate diet, physical activity, and sleep-related behaviors are potential risk factors for overweight and obese, therefore we investigated the relations between body mass index (BMI) and behavioral factors in a sample of Italian adolescents. Four hundred nine Italian secondary school students (46% females, 12.5 ± 0.6 y.o.) were enrolled in this...
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Aim
The main cause of childhood overweight/obesity is an imbalance between energy intake and energy expenditure. The objective was to determine whether the intake by Spanish schoolchildren of sugars from habitually consumed foods and drinks can be related to overweight/obesity.
Methods
Subjects The study included 657 schoolchildren between 7–10 ye...
Citations
... Feranti R. et al. also found that adolescents who have parents with higher education or a specialized occupation are more likely to be underweight or have normal weight [15]. The existing data relate an adequate body composition with good physical fitness and/or a high rate of adherence to the Mediterranean diet (MD) [3,[19][20][21]. The results of last research showed low opportunities to imitate MD among adolescents, who belong to the group of Mediterranean or non-Mediterranean countries [6,[22][23][24]. ...
... R.Feranti et al. также обнаружили, что подростки, у которых родители имеют высшее образование или специальную профессию, чаще имеют недостаточную или нормальную массу тела [15]. Существующие данные связывают адекватный состав тела с хорошей физической подготовкой и/или высокой степенью приверженности средиземноморской диете (СД) [3,[19][20][21]. Результаты последних исследований показали низкие возможности имитации СД среди подростков, относящихся к группе средиземноморских или не средиземноморских стран [6,[22][23][24]. ...
Body weight status of adolescents depends on their dietary patterns, physical activity and sleep duration, which are crucial elements of lifestyle. Regional social conditions and modern global processes such as digitalization and westernization with their negative dimensions on the daily routine of teenagers are leading triggers for the epidemic proportions of pediatric overweight and obesity. Objective. To perform a systematic review on the role of anthropometric adiposity indices used to determine the prevalence of overweight and obesity as a result of unhealthy lifestyles in teenagers influenced by the “Western models”. Materials and methods. A systematic review was conducted on the application of anthropometric adiposity metrics in relation to the lifestyle of teenagers by using the online databases Web of Science, ScienceDirect, Scopus, ResearchGate, and PubMed. Only available original articles published in English language between January 2014 and December 2023 were included in the study. The unoriginal and unrepresentative surveys, conference abstracts and unavailable full texts were removed. Results. Body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) are the most frequent, undirect and easy applicable anthropometric measures to identify overweight and obesity associated with unhealthy behavior and sedentary lifestyle among teenagers. However, BMI cannot distinguish between fat mass and fat-free mass, it is a leader among adiposity indices used in the research. The data on adolescents’ unhealthy behavior in all examined and included studies were based on information from self-reported anonymous questionnaires combined with mentioned anthropometric measurements. Conclusion. The surrounding social environment together with the observed deviation to “Western patterns” of existence play a key role in the daily routine and well-being of adolescents. Their noticeable negative effect on health and body weight status of teenagers is easily detectable through the application of anthropometric indices such as BMI, WC and WHtR. These anthropometric measures are one of the simple, quickly applicable and reliable indicators in determining the frequency of juvenile overweight and obesity caused by unhealthy lifestyle. Key words: anthropometric indices, lifestyle, adolescents, overweight and obesity
... There were no exclusion criteria once the volunteers agreed to be enrolled in the survey. Taking into account similar studies conducted in Mediterranean countries with similar goals [28][29][30][31][32], a target of about 400 individuals per each Mediterranean country was estimated to be sufficient to detect significant differences across groups of exposed individuals. However, given the variety of variables investigated and the voluntary nature of the participation in the survey, the sample cannot be considered truly representative of a random population but, rather, indicative of the target one. ...
... Also, the importance of having correct sleep hygiene [62][63][64] and reduced screen-time-related sedentary behaviors [66] is hypothesized to potentially be associated with higher adherence to the Mediterranean diet and prevention of obesity. Some studies specifically conducted on Spanish [58,[67][68][69][70], Italian [31,71], Portuguese [43], and Lebanese [43] children and adolescents just support the hypothesis of an association between sleep quality (including sleeping time and length), reduced screen time, and higher adherence to the Mediterranean diet. ...
Background/Objectives. Traditional dietary patterns are being abandoned in Mediterranean countries, especially among younger generations. This study aimed to investigate the potential lifestyle determinants that can increase adherence to the Mediterranean diet in children and adolescents. Methods. This study is a cross-sectional analysis of data from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) within the context of the EU-funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean Diet and LIfestyle in Children and adolescents through behavIOUral change actionS). This study comprised information on 2011 children and adolescents aged 6–17 years old collected during 2023. The main background characteristics of both children and parents, including age, sex, education, and family situation, were collected. Children’s eating (i.e., breakfast, place of eating, etc.) and lifestyle habits (i.e., physical activity level, sleep, and screen time) were also investigated. The level of adherence to the Mediterranean diet was assessed using the KIDMED index. Logistic regression analyses were performed to test for likelihood of higher adherence to the Mediterranean diet. Results. Major determinants of higher adherence to the Mediterranean diet were younger age, higher physical activity level, adequate sleep duration, and, among dietary habits, having breakfast and eating with family members and at school. Parents’ younger age and higher education were also determinants of higher adherence. Multivariate adjusted analyses showed that an overall healthier lifestyle and parents’ education were the factors independently associated with higher adherence to the Mediterranean diet. Conclusions. Higher adherence to the Mediterranean diet in children and adolescents living in the Mediterranean area is part of an overall healthy lifestyle possibly depending on parents’ cultural background.
... Also, a diet more similar to the MD was associated with daytime sleepiness. Higher drowsiness was observed among those who had lower adherence to the MD [40]. Spanish adolescents who had high adherence to the MD were more likely to meet the sleep recommendations, as well as less likely to declare at least one sleep-related problem (bedtime problems, excessive daytime sleepiness, awakening during the night, regularity and duration of sleep, or sleepdisordered breathing) [41]. ...
... Among these three diets, the greatest amount of research has been conducted on the association between the MD and various sleep parameters; however, most of these studies were cross-sectional studies, with only a few prospective cohort studies or randomized clinical trials. The vast majority of available data showed a favorable relationship between the MD and sleep quality and/or sleep duration in various populations: children, adolescents, adults, the elderly, or pregnant women [24][25][26][27][28][29][30][31][32][33][34][35][37][38][39][40][41][42][44][45][46]. However, not all the results support these observations. ...
In 2022, healthy sleep was included as part of Life’s Essential 8, which are a cluster of fundamental factors for cardiovascular health. In many studies, sleep duration and/or quality have also been found to be related to human health. The purpose of this narrative review was to present the relationship between the Mediterranean diet, the DASH (Dietary Approaches to Stop Hypertension) diet, and the MIND (Mediterranean–DASH Intervention for Neurodegenerative Delay) diet and sleep quality and duration in different populations. A literature search was conducted based on the phrases “Mediterranean diet”, “DASH diet”, and “MIND diet” appearing together with “sleep” or “insomnia” in papers’ titles or abstracts. Studies on obstructive sleep apnea or shift work were excluded. The electronic databases were searched via EBSCOhost. Main results: The vast majority of studies showed that there was a beneficial association between the three diets discussed in this review and sleep duration and/or quality; however, most of these results were obtained in cross-sectional analyses. There were only a few studies in which an association between sleep parameters and these diets was not observed. Direction for future studies: Taking into account the significant role of adequate sleep quality in various diseases, even in all-cause mortality, the implementation of randomized controlled trials and prospective cohort studies seems to be necessary to provide further evidence that would allow these associations to be confirmed. In conclusion, the results obtained so far in various populations strongly suggest that healthy dietary patterns abundant in plant foods, are associated with better sleep quality, as well as with a more adequate length of sleep.
... The respondents were parents voluntarily included within the network of collaborators of the Technological Institute for Children's Products and Leisure (AIJU). Based on the recent literature aiming at the same purposes in Mediterranean countries [36][37][38][39][40], a convenience sample of 400 individuals per each Mediterranean country was set. The data collection was carried out via an electronic survey, and a total of 2011 agreed to be enrolled in the survey (a participation rate of 79%), accepting to respond to the tools administered. ...
Background/Objectives: The diet quality of younger individuals is decreasing globally, with alarming trends also in the Mediterranean region. The aim of this study was to assess diet quality and adequacy in relation to country-specific dietary recommendations for children and adolescents living in the Mediterranean area. Methods: A cross-sectional survey was conducted of 2011 parents of the target population participating in the DELICIOUS EU-PRIMA project. Dietary data and cross-references with food-based recommendations and the application of the youth healthy eating index (YHEI) was assessed through 24 h recalls and food frequency questionnaires. Results: Adherence to recommendations on plant-based foods was low (less than ∼20%), including fruit and vegetables adequacy in all countries, legume adequacy in all countries except for Italy, and cereal adequacy in all countries except for Portugal. For animal products and dietary fats, the adequacy in relation to the national food-based dietary recommendations was slightly better (∼40% on average) in most countries, although the Eastern countries reported worse rates. Higher scores on the YHEI predicted adequacy in relation to vegetables (except Egypt), fruit (except Lebanon), cereals (except Spain), and legumes (except Spain) in most countries. Younger children (p < 0.005) reporting having 8–10 h adequate sleep duration (p < 0.001), <2 h/day screen time (p < 0.001), and a medium/high physical activity level (p < 0.001) displayed a better diet quality. Moreover, older respondents (p < 0.001) with a medium/high educational level (p = 0.001) and living with a partner (p = 0.003) reported that their children had a better diet quality. Conclusions: Plant-based food groups, including fruit, vegetables, legumes, and even (whole-grain) cereals are underrepresented in the diets of Mediterranean children and adolescents. Moreover, the adequate consumption of other important dietary components, such as milk and dairy products, is rather disregarded, leading to substantially suboptimal diets and poor adequacy in relation to dietary guidelines.
... Currently, school-aged children have unhealthy habits regarding beverages consumption [3], Mediterranean diet adherence [4,5], and physical activity [6]. Studies have shown a significant rise in the consumption of sugar-sweetened beverages among children [7]. This trend, along with other factors, is contributing to the decline in adherence to the Mediterranean diet, which is known for its health benefits [7]. ...
... Studies have shown a significant rise in the consumption of sugar-sweetened beverages among children [7]. This trend, along with other factors, is contributing to the decline in adherence to the Mediterranean diet, which is known for its health benefits [7]. Additionally, there has been a notable decrease in physical activity levels along with an increase in screen time [6], exacerbating the risk of developing obesity and related health issues. ...
Background/Objectives: This study investigated the impact of the FLUYE school-based intervention on children's lifestyle behaviors, Mediterranean diet adherence, and emotional well-being in Spain. The objective was to promote healthy habits through nutrition education, physical activity, and emotional support within the school environment, with a focus on addressing the needs of both normal-weight and overweight/obese children. Methods: A total of 552 children aged 3 to 12 years participated in the study, with data collected at baseline (T0) and follow-up (T1). The intervention was designed to integrate health education into the school curriculum, emphasizing the development of personal competencies in diet, physical activity, and emotional well-being. The analysis included changes in dietary habits, screen time, physical activity, and psychosocial outcomes, with comparisons made between the normal-weight and overweight/obese groups. Results: Significant improvements were observed in water consumption and reductions in sugar-sweetened beverage intake across both weight groups. However, an increase in screen time, particularly among normal-weight children, highlighted ongoing challenges in reducing sedentary behavior. Adherence to the Mediterranean diet improved more significantly in the overweight/obese group, suggesting the program's effectiveness in promoting healthier eating patterns among at-risk children. Emotional well-being and self-esteem also saw significant enhancements, with children reporting increased feelings of pride and positivity post-intervention. Conclusions: The FLUYE program effectively improved various aspects of children's lifestyle behaviors, particularly in dietary habits and emotional well-being. These findings underscore the importance of comprehensive, school-based interventions that address both physical and psychosocial aspects of health, especially for children at higher risk for obesity.
... In addition, significant differences in adherence to the MD categories and daytime sleepiness were reported. [29] Interesting associations were noticed between sleep behaviors and adherence to the MD. Good sleep habits had been associated with healthier food manners [30] and higher adherence to the MD, [31] while alterations in sleep quality (sleep patterns and sleep efficiency) had often been associated with unhealthy habits and lifestyle modifications, such as consumption of high-calorie foods and beverages and sedentary lifestyle. ...
BACKGROUND
We examined the inter-correlation between diet quality, objectively measured sleep duration, and subjectively measured sleep quality with flash glucose monitoring (FGM)-measured glycemia among young patients with type 1 diabetes (T1D).
MATERIALS AND METHODS
Following cross-sectional design, Fitbit ® accelerometers were used to objectively assess sleep duration, while the validated questionnaires Pittsburgh sleep quality index and Mediterranean diet (MD) adherence were used to subjectively assess sleep quality and diet quality, respectively. Glycated hemoglobin (HbA1c) and FGM-reported glycemia components among children with T1D were assessed as well.
RESULTS
Of the 47 participants surveyed (25 boys, 22 girls, 9.31 ± 2.88 years), the majority reported high HbA1c, good sleep quality, and high adherence to the MD. However, only one-third of the participants reported a healthy sleep duration. Only the sleep latency was significantly ( P < 0.05) associated with the time above range level 2 and time below range level 2 ( P = 0.048) components of the FGM. A positive correlation ( r = 0.309, P = 0.035) was reported between adherence to MD and time in range of the FGM.
CONCLUSIONS
Diet quality and sleep quality are variably inter-correlated with FGM-measured glycemia among young patients with T1D and are suggested to be considered influential factors in FGM-monitored diabetes research on this age group.
... In this regard, it was observed that an adherence to the Mediterranean diet and vigorous or medium physical activity were negative predictors for overweight/obesity. These findings are supported by previous studies using conventional statistical analysis techniques and machine learning techniques [62,63]. On the other hand, the proposed model in the present study revealed that toxic habits also seem to play an important role in predicting overweight/obesity. ...
(1) Background: Artificial intelligence using machine learning techniques may help us to predict and prevent obesity. The aim was to design an interpretable prediction algorithm for overweight/obesity risk based on a combination of different machine learning techniques. (2) Methods: 38 variables related to sociodemographic, lifestyle, and health aspects from 1179 residents in Madrid were collected and used to train predictive models. Accuracy, precision, and recall metrics were tested and compared between nine classical machine learning techniques and the predictive model based on a combination of those classical machine learning techniques. Statistical validation was performed. The shapely additive explanation technique was used to identify the variables with the greatest impact on weight gain. (3) Results: Cascade classifier model combining gradient boosting, random forest, and logistic regression models showed the best predictive results for overweight/obesity compared to all machine learning techniques tested, reaching an accuracy of 79%, precision of 84%, and recall of 89% for predictions for weight gain. Age, sex, academic level, profession, smoking habits, wine consumption, and Mediterranean diet adherence had the highest impact on predicting obesity. (4) Conclusions: A combination of machine learning techniques showed a significant improvement in accuracy to predict risk of overweight/obesity than machine learning techniques separately.
... Another case in point is that although many variables that may be associated with poor sleep quality have been studied by researchers to date, there have been few studies on academic stress. Previous studies, have examined sleep habits and depression, eating habits, physical activity, and internet addiction together (Koo et al. 2020;Bhurosy and Thiagarajah 2020;Rosi et al. 2020;Celebioglu et al. 2020). ...
... (Gillen-O'Neel et al. 2013). In a study conducted with Italian middle school students, it was found that 82% of the students had moderate and high sleep quality (Rosi et al. 2020). ...
Background: Poor sleep quality and academic expectations stress are common health problems in adolescents. Objective: The objective of this research was to determine the relationship between adolescents' academic expectations stress and sleep quality. Methodology: The study was a cross-sectional survey among adolescents aged 10-17 years. Results: The average age of the adolescents in the study was 14.37±2.19. The participants of this study were middle school (52.3%) and high school students (47.7%). The study was completed with a total of 1161 adolescents. Data were collected through data collection form, Pittsburgh Sleep Quality Index, and Academic Expectations Stress Inventory between March and May 2017. This study found that both sleep quality scores (7.27±3.15) and stress scores related to academic expectations (32.13 ± 7.77) of high school students were significantly higher than that of middle school students, (5.69±3.22;17.06±5.65), p<0.05. The stressful situations of the students regarding academic expectations and the age variable together showed a significant relationship on sleep quality (R² = 0.137, F (2, 1158) = 90.532), and it was observed that it caused a 13.7% change in the sleep quality score. Conclusions: This study showed that adolescents are more likely to experience poor sleep quality and academic expectations stress as they get older.
... Rosi and coworkers [48] reported only 14% of participants were breakfast skippers, while in our sample this percentage is 44.9%. The percentage of breakfast skippers is like the results produced by Nardone and colleagues [45] showing 4 out of 10 adolescents skipped breakfast, while a recent systematic review on 286,804 children and adolescents living in 33 countries [49] reported extremely wide variability, ranging from 0.7% to 74.7% of prevalence of breakfast skippers, according to the definition of breakfast skipping used. ...
... The main characteristics of the 18 studies included in this systematic review [16e18,24,25,36e46] are shown in Table 1. Ten studies were conducted in Spain [16,18,36,37,39e43,47], three in Italy [38,44,45], two in Greece [17,46], one in Portugal [24], one in Chile [26], and one in Lebanon [25]. Regarding the measurement of adherence to the MedDiet, the Mediterranean Diet Quality Index in children and adolescents (KIDMED) was the tool most used in 16 out of the 18 studies [16e18,24e26,36,37,39e46]. ...
... Furthermore, most of the studies reported academic performance with data provided by the schools [16e18,24e26, 36,37,39e44,46,47] rather than reported by the participants [45]. Most of the studies reported information about adherence to the MedDiet as a continuous variable [16e18, 24,25,36,38e43,45,46] rather than a categorical variable [26,37,44]. Moreover, most of the studies presented information about academic performance by continuous variables [16e18,24e26,36,38e44, 46,47] instead of categorical variables [37,45]. ...
... Two studies were excluded from the metaanalysis: the study by Santomauro et al. [45] because it assessed academic performance in a self-reported manner by adolescents, and the study by Alfonso Rosa et al. [37] because it reported academic performance categorically (i.e., pass, good, merit) rather than continuously. Twelve of the 16 studies showed results adjusted for other covariates [16e18, 25,26,36,39e42,46,47], while four studies showed unadjusted results [24,38,43,44]. ...
