Influence of Parental Lifestyle and Dietary Patterns on Mediterranean Diet Adherence in Children and Adolescents: A Cross-Sectional Study
Abstract
Background/Objectives: Adherence to the Mediterranean diet (MD) is associated with reduced risk of non-communicable diseases but has declined among children, even in traditionally high-adherence settings such as Greece. As parental lifestyle behaviors strongly influence children’s dietary patterns, this study examined the associations between parental lifestyle factors and children’s MD adherence in Crete, Greece. Methods: A total of 760 parent–child dyads participated in this cross-sectional study. Children’s adherence to the MD was assessed using the KIDMED index. Parents completed validated instruments, including the MEDAS (MD adherence), IPAQ (physical activity), PSQI (sleep quality), and NLS (nutrition literacy), along with questions on dietary habits and screen time behaviors. ANOVA/Kruskal–Wallis tests and multivariable linear regression identified predictors of KIDMED scores. Results: Mean KIDMED score was 5.95 ± 2.65; 32% achieved optimal adherence. Younger children showed higher adherence. Higher children’s adherence to MD was positively associated with parental MD adherence (β = 0.493), urban residence (β = 0.544), higher parental education (β = 0.493), consistent daily meal routines (breakfast and mid-morning and mid-afternoon snacks), higher water intake, and fresh juice consumption (all p < 0.05) were positively associated with parental MD adherence. Conversely, lower adherence was associated with parental age ≥ 45 years (β = 0.987), higher parental BMI (β =…
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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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