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Mediterranean diet adherence has been decreasing during the last few decades, and non-appropriate snacking habits have also been identified among Mediterranean children and adolescents. To co-create new snacks and to explore children's interests and preferences, a multi-method approach was used in the present study, including some qualitative and quantitative research phases. Conducted in collaboration with schools in Lebanon, Egypt, Portugal, Italy, and Spain, different snack prototypes were designed and tested in a Mediterranean cross-cultural context. The results showed significant differences among countries in snacking preferences and general food-related attitudes. Italian children exhibited higher levels of neophobia, resulting in lower acceptance of all proposed snacks. Some sensory and contextual insights were collected, such as Egyptian children favoring sweet and crunchy textures and "At school", "With my friends", and "As a morning/afternoon snack" being identified as linked to snack acceptance in some countries. The present study underscores the value of co-creation processes involving children to address non-recommended dietary patterns, highlighting the critical role of sensory properties, cultural differences, and contextual factors in designing healthy snacks that meet the Mediterranean diet's principles but are highly appreciated by the young segment of the population. [ABSTRACT FROM AUTHOR]

Background/Objectives. Traditional dietary patterns are being abandoned in Mediterranean countries, especially among younger generations. This study aimed to investigate the potential lifestyle determinants that can increase adherence to the Mediterranean diet in children and adolescents. Methods. This study is a cross-sectional analysis of data from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) within the context of the EU-funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean Diet and LIfestyle in Children and adolescents through behavIOUral change actionS). This study comprised information on 2011 children and adolescents aged 6–17 years old collected during 2023. The main background characteristics of both children and parents, including age, sex, education, and family situation, were collected. Children's eating (i.e., breakfast, place of eating, etc.) and lifestyle habits (i.e., physical activity level, sleep, and screen time) were also investigated. The level of adherence to the Mediterranean diet was assessed using the KIDMED index. Logistic regression analyses were performed to test for likelihood of higher adherence to the Mediterranean diet. Results. Major determinants of higher adherence to the Mediterranean diet were younger age, higher physical activity level, adequate sleep duration, and, among dietary habits, having breakfast and eating with family members and at school. Parents' younger age and higher education were also determinants of higher adherence. Multivariate adjusted analyses showed that an overall healthier lifestyle and parents' education were the factors independently associated with higher adherence to the Mediterranean diet. Conclusions. Higher adherence to the Mediterranean diet in children and adolescents living in the Mediterranean area is part of an overall healthy lifestyle possibly depending on parents' cultural background. [ABSTRACT FROM AUTHOR]

Background: The Mediterranean diet is considered a healthy dietary pattern associated with substantial health benefits. While its application at global level is rather difficult due to the intricate features eradicated into the cultural heritage of populations living in countries facing the Mediterranean basin, its preservation in such areas is considered crucial to maintain a good health status of current and future generations. Objective: To assess the level of adherence to the Mediterranean diet in children and adolescents living in 5 Mediterranean countries participating in the DELICIOUS project. Methods: An online survey was conducted involving 2011 parents of children and adolescents from Spain, Italy, Lebanon, Egypt, and Portugal. The KIDMED score applied to 24-h recalls of their children's diets was used to assess the level of adherence to the Mediterranean diet and cross-references with background and lifestyle variables. Results: Children and adolescents living in Lebanon and Portugal are more adherent than their counterparts in other countries. Some specific aspects related to the Mediterranean diet were rather common, such as olive oil consumption, daily fruit and vegetable intake, as well as lifestyle habits including having breakfast and limited sweets. Others, including having a second portion of fruit and vegetable, adequate consumption of fish, nuts, and cereals (for breakfast), as well as frequent consumption of fast foods underscored substantial abandonment of certain other Mediterranean diet features. Older adolescents with inadequate sleep duration, longer screen time, and low physical activity levels, as well as children of older parents with lower educational level, lower family income, and living in rural areas had significantly lower KIDMED scores. Conclusions: This study provides important information on the current status of adherence to the Mediterranean among children and adolescents in the Mediterranean region and may help setting specific targets for nutrition interventions aiming at its promotion. [ABSTRACT FROM AUTHOR]

Background/Objectives: The diet quality of younger individuals is decreasing globally, with alarming trends also in the Mediterranean region. The aim of this study was to assess diet quality and adequacy in relation to country-specific dietary recommendations for children and adolescents living in the Mediterranean area. Methods: A cross-sectional survey was conducted of 2011 parents of the target population participating in the DELICIOUS EU-PRIMA project. Dietary data and cross-references with food-based recommendations and the application of the youth healthy eating index (YHEI) was assessed through 24 h recalls and food frequency questionnaires. Results: Adherence to recommendations on plant-based foods was low (less than ∼20%), including fruit and vegetables adequacy in all countries, legume adequacy in all countries except for Italy, and cereal adequacy in all countries except for Portugal. For animal products and dietary fats, the adequacy in relation to the national food-based dietary recommendations was slightly better (∼40% on average) in most countries, although the Eastern countries reported worse rates. Higher scores on the YHEI predicted adequacy in relation to vegetables (except Egypt), fruit (except Lebanon), cereals (except Spain), and legumes (except Spain) in most countries. Younger children (p < 0.005) reporting having 8–10 h adequate sleep duration (p < 0.001), <2 h/day screen time (p < 0.001), and a medium/high physical activity level (p < 0.001) displayed a better diet quality. Moreover, older respondents (p < 0.001) with a medium/high educational level (p = 0.001) and living with a partner (p = 0.003) reported that their children had a better diet quality. Conclusions: Plant-based food groups, including fruit, vegetables, legumes, and even (whole-grain) cereals are underrepresented in the diets of Mediterranean children and adolescents. Moreover, the adequate consumption of other important dietary components, such as milk and dairy products, is rather disregarded, leading to substantially suboptimal diets and poor adequacy in relation to dietary guidelines. [ABSTRACT FROM AUTHOR]

Background/Objectives. Traditional dietary patterns are being abandoned in Mediterranean countries, especially among younger generations. This study aimed to investigate the potential lifestyle determinants that can increase adherence to the Mediterranean diet in children and adolescents. Methods. This study is a cross-sectional analysis of data from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) within the context of the EU-funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean Diet and LIfestyle in Children and adolescents through behavIOUral change actionS). This study comprised information on 2011 children and adolescents aged 6-17 years old collected during 2023. The main background characteristics of both children and parents, including age, sex, education, and family situation, were collected. Children's eating (i.e., breakfast, place of eating, etc.) and lifestyle habits (i.e., physical activity level, sleep, and screen time) were also investigated. The level of adherence to the Mediterranean diet was assessed using the KIDMED index. Logistic regression analyses were performed to test for likelihood of higher adherence to the Mediterranean diet. Results. Major determinants of higher adherence to the Mediterranean diet were younger age, higher physical activity level, adequate sleep duration, and, among dietary habits, having breakfast and eating with family members and at school. Parents' younger age and higher education were also determinants of higher adherence. Multivariate adjusted analyses showed that an overall healthier lifestyle and parents' education were the factors independently associated with higher adherence to the Mediterranean diet. Conclusions. Higher adherence to the Mediterranean diet in children and adolescents living in the Mediterranean area is part of an overall healthy lifestyle possibly depending on parents' cultural background.