Adherence trends to the Mediterranean Diet in Spanish youth: A systematic review and meta-analysis

Young people are consuming less healthy diets such as Mediterranean diet (MedDiet), which is associated with an increased risk of chronic diseases, including obesity. This systematic review aimed to synthesize the literature concerning the prevalence and trends of adherence to the (MedDiet) in a young Spanish population (aged 2-24 years) from 2004 to 2023.

The present review included observational studies and final assessments of longitudinal studies to assess the prevalence or trend in adherence to the MedDiet using the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) in three categories (low (≤3), medium (4-7), and high (≥8)). Subgroup analyses were conducted by sex, age group (2-12 years and 12-24 years), and four time periods. A total of 70 studies (n = 84,281) were included. Overall, the pooled prevalence estimate of high adherence to the MedDiet in the young Spanish population (aged 2-24 years) was 38 % (95 % CI: 34-41), the prevalence of medium adherence to the MedDiet was 51 % (95 % CI: 47-54), and low adherence to the MedDiet was 11 % (95 % CI: 9-13). From 2011-2014 to 2019-2023, there was a decrease in high adherence to the MedDiet and an increase in low adherence to the MedDiet. Finally, meta-regression analyses revealed a nonsignificant negative association between the total KIDMED score and body mass index (BMI), age, and data collection year. Variables such as, socioeconomic status and parental education level have not been including in this study.

These results will facilitate a more comprehensive understanding of the importance of reinforcing initiatives to enhance adherence to the MedDiet in young populations, such as increasing education interventions.