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Mediterranean diet lowers BMI in US adolescents
American adolescents who adhere to a Mediterranean dietary pattern or increase their adherence have smaller BMI increases compared with their peers, according to recent study findings.
In a prospective study, researchers analyzed questionnaire data from 10,918 children aged 8 to 15 years participating in the Growing Up Today Study II, a cohort of children of participants in the Nurses’ Health Study II established in 2004 to assess associations between diet and activity with height velocity and weight gain. Follow-up questionnaires were sent in 2006, 2008 and 2011; weight and height were self-reported. Researchers assessed dietary intake with the Youth/Adolescent Questionnaire; adherence to a Mediterranean diet was calculated with the KidMed index (modified for a U.S. population). Participants were classified as having “very low-quality dietary pattern,” “need to improve to adhere better to the Mediterranean dietary pattern” and “optimal Mediterranean dietary pattern” based on a possible 12-point score. Researchers used generalized estimating equations with repeated measures within subjects to assess the association between Mediterranean dietary pattern and BMI change.
Within the cohort, 81.4% of participants were poorly adherent to the Mediterranean diet; 17.8% were moderately adherent; 0.75% were highly adherent. Those in the poorly adherent category had a higher BMI vs. those in the optimal category (mean BMI, 20.4 kg/m² vs. 19.8 kg/m²); and exhibited more sedentary behavior vs. those in the optimal category (mean sedentary hours/week, 41 vs. 35.16).
Using KidMed score as a continuous variable, researchers found that a 2-point increase in baseline adherence was associated with a decrease in BMI during the next 2 to 3 years (beta = –0.04; 95% CI, –0.07 to –0.02). Results persisted when total energy intake was considered a potential confounder.
In assessing the association between 2- to 3-year change in the KidMed score and change in BMI in the subsequent 2- to 3-year period, researchers found that adolescents in the third and fourth quartiles of KidMed score change had smaller gains in BMI vs. those in the first quartile (P = .002 for trend) after adjusting for sex, age, physical activity, sedentary time, baseline KidMed score and change in BMI.
“Although the clinical relevance of the association we found may seem small, our results are consistent with those reported by previous cross-sectional studies in European children and adolescents that suggested an inverse association of the adherence to the [Mediterranean dietary pattern] with waist circumference, waist-to-height ratio and BMI,” the researchers wrote. “Our results suggested that promoting the [Mediterranean dietary pattern] might by a pragmatic tool to prevent excessive weight gain among adolescents.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.