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Mediterranean diet, overweight and body composition in children from eight European countries: Cross-sectional and prospective results from the IDEFICS study

  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    G. Tognon
    Correspondence
    Corresponding author. Department of Public Health and Community Medicine, University of Gothenburg, Sahlgrenska Academy, Box 454, SE 405 30 Göteborg, Sweden. Tel.: +46 31 7866541; fax: +46 31 7781704.
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    A. Hebestreit
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    A. Lanfer
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    L.A. Moreno
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    V. Pala
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Nutritional Epidemiology Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    A. Siani
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Institute of Food Sciences, Unit of Epidemiology and Population Genetics, National Research Council, Avellino, Italy
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    M. Tornaritis
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Research and Education Institute of Child Health, Strovolos, Cyprus
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    S. De Henauw
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Department of Public Health, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    T. Veidebaum
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    National Institute for Health Development, Tallin, Estonia
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    D. Molnár
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Department of Pediatrics, Medical Faculty, University of Pécs, Hungary
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    W. Ahrens
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany

    University of Bremen, Bremen, Germany
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.
    L. Lissner
    Footnotes
    1 On behalf of the IDEFICS Consortium.
    Affiliations
    Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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  • Author Footnotes
    1 On behalf of the IDEFICS Consortium.

      Abstract

      Background & aims

      A Mediterranean-like dietary pattern has been shown to be inversely associated with many diseases, but its role in early obesity prevention is not clear. We aimed to determine if this pattern is common among European children and whether it is associated with overweight and obesity.

      Methods and results

      The IDEFICS study recruited 16,220 children aged 2–9 years from study centers in eight European countries. Weight, height, waist circumference, and skinfolds were measured at baseline and in 9114 children of the original cohort after two years. Diet was evaluated by a parental questionnaire reporting children's usual consumption of 43 food items. Adherence to a Mediterranean-like diet was calculated by a food frequency-based Mediterranean Diet Score (fMDS).
      The highest fMDS levels were observed in Sweden, the lowest in Cyprus. High scores were inversely associated with overweight including obesity (OR = 0.85, 95% CI: 0.77; 0.94) and percent fat mass (β = −0.22, 95% CI: −0.43; −0.01) independently of age, sex, socioeconomic status, study center and physical activity. High fMDS at baseline protected against increases 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: 0.78; 0.99) with a similar trend observed for percent fat mass (p = 0.06).

      Conclusions

      Although a Mediterranean dietary pattern is inversely associated with childhood obesity, it is not common in children living in the Mediterranean region and should therefore be advocated as part of EU obesity prevention strategies.

      Keywords

      Abbreviations:

      fMDS (frequency-based Mediterranean Diet Score), OR (Odds ratio), BMI (Body Mass Index)
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