Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents

TLDR

The study aimed to assess dietary habits of Spanish children and adolescents using the KIDMED Mediterranean Diet Quality Index in a cross‑sectional design. Data were collected from 3,850 participants aged 2–24 in the EnKid study through two 24‑hour recalls, a 169‑item food‑frequency questionnaire, and a socio‑economic questionnaire, and a 16‑item KIDMED index was applied. Results showed that 46.4 % had high KIDMED scores, with higher rates in the Northeast (52 %) than the North (37.5 %), lower high‑score prevalence among low‑income groups (42.8 %) versus middle (47.6 %) and upper (54.9 %) income, and greater positivity in large cities, indicating significant geographic, socioeconomic, and urban‑rural differences that challenge common assumptions about diet quality.

Abstract

To evaluate dietary habits in Spanish children and adolescents based on a Mediterranean Diet Quality Index tool, which considers certain principles sustaining and challenging traditional healthy Mediterranean dietary patterns.Observational population-based cross-sectional study. A 16-item Mediterranean Diet Quality Index was included in data gathered for the EnKid study (in which two 24-hour recalls, a quantitative 169-item food-frequency questionnaire and a general questionnaire about socio-economic, demographic and lifestyle items were administered).Spain.In total, 3850 children and youths aged 2-24 years residing in Spain.Of the sample, 4.2% showed very low KIDMED index results, 49.4% had intermediate values and 46.4% had high index results. Important geographical differences were seen, with subjects from the Northeast showing the most favourable outcomes (52% with elevated scores vs. 37.5% of those from the North). Lower percentages of high diet quality were observed in low socio-economic groups, compared with middle and upper income cohorts (42.8%, 47.6% and 54.9%, respectively). Large cities had more positive results and only slight variations were seen for gender and age.The KIDMED index, the first to evaluate the adequacy of Mediterranean dietary patterns in children and youth, confirms that this collective is undergoing important changes, which makes them a priority target for nutrition interventions. Results challenge certain commonly perceived notions tied to income level, population size and diet quality.