Mediterranean diet urged in battle against childhood obesity

Adhering to a Mediterranean diet reduces the risk for obesity in children and should be promoted as larger part of the prevention strategy in the European Union, according to findings presented at the European Congress on Obesity in Sofia, Bulgaria.

“An eating pattern rich in vegetables, fruit, nuts, cereal grains and fish, a Mediterranean-like diet, is not only inversely associated to the risk of being overweight or obese in children, but protective against an increase in BMI and waist circumference over time,” Gianluca Tognon, MD, of the University of Gothenburg in Sweden, told Endocrine Today.

Gianluca Tognon

An investigation of data from the IDEFICS study, funded by the European Commission, revealed countries with low adherence to the diet that stand to benefit.

Tognon, along with colleagues from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden, evaluated data for children from these eight countries enrolled in IDEFICS.

“The prevalence of high adherence to this dietary pattern is not necessarily the highest in the Mediterranean countries,” Tognon said. “Indeed, the Swedish children showed the highest adherence levels, while the children living in Cyprus were characterized by the lowest.”

The researchers compared weight, height, waist circumference and percent body fat mass data at baseline (n=16,220) and after 2 years (n=9,114). They analyzed the children’s diet through a parental food frequency questionnaire, including 43 foods, and a single 24-hour dietary recall. Mediterranean diet score (MDS) was calculated on food frequencies and linked to overweight and obesity indicators through cross-sectional and prospective methods. A score based on food quantities was calculated from recall data and served as an alternative.

Increased MDS resulted in a decreased likelihood for children to become overweight or obese (OR=0.85; 95% CI, 0.77-0.94) and a reduction in percent fat mass (beta=–0.22; 95% CI, –0.43 to –0.01); results were independent of age, sex, socioeconomic status and country. Having a high MDS at baseline inversely predicted high changes in BMI (OR=0.87; 95% CI, 0.78-0.98), waist circumference (OR=0.87; 95% CI, 0.77-0.98) and waist-to-height ratio (OR=0.88; 95% CI, 0.79-0.99).

When calculating the alternative score from food frequencies or quantities, countries’ classification based on adherence levels changed. Differences between weekdays and weekends were observed in both Italy and Sweden.

“A higher intake of fruit, vegetables, legumes, nuts, whole-grain cereals and fish should be recommended to children and their families,” Tognon said. “This is particularly important considering that other studies suggest this kind of diet seems to be inversely associated to other health outcomes in children, such as asthma and allergies.”

Tognon has submitted a proposal to get funding to continue research into the environmental effect of this kind of diet, in comparison to the traditional Nordic dietary pattern.

“My plan is to study the differences between the two patterns in relation to the impact on the global warming.” — by Allegra Tiver

Disclosure: Additional funding was provided by the EpiLife in Gothenburg and the Swedish Research Council.