Author, publication year | Country | Study design | Total subjects | Inclusion criteria | Characteristics of participants | MD adherence scoring system ‡ | MD adherence dimensions | HRQoL measure ‡ | HRQoL dimensions | Adjusted variables | Funding | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Gender and age | BMI (kg/m2) | Physical activity | Weight † | |||||||||||
Costarelli et al., 2012 [14] | Greece | Cross-sectional | 359 (13–16 years old) | Participants signed consent forms and received a full verbal and written explanation of the purpose of the study and its anonymous nature | 46.2% boys Median age: 13.1 years (IQR: 0.5) | 19.9 (SD, 3.2) | NR | Normal weight: 80.6% Overweight: 15.6% Obesity: 2.5% | KIDMED index | 16 dichotomous items (yes/no): 12 items: behaviors consistent with the Mediterranean diet 4 items: behaviors inconsistent with the Mediterranean diet | KIDSCREEN-27 | 5 Dimensions: 1. Physical well-being (5 items) 2. Psychological well-being (7 items) 3. Parent relations and autonomy (7 items) 4. Social support and peers (4 items) 5. School environment (4 items) | Number of meals, number of meals (with family), BMI, obesity, father’s education level, mother’s education level, gender | Institutional support. Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University of Athens |
Muros et al., 2017 [15] | Spain | Cross-sectional | 456 (11–14 years old) | Twenty-four adolescents were excluded for failing to complete some testing element or failing to attend class on their testing day | 48.5% boys Mean age: 12.57 years (SD, 1.17) | 19.75 (SD, 3.85) | PAQ-C score: 2.92 (SD, 0.64) | Normal weight: 75.7% Overweight: 16.7% Obesity: 5.5% | KIDMED index | 16 dichotomous items (yes/no): 12 items: behaviors consistent with the Mediterranean diet 4 items: behaviors inconsistent with the Mediterranean diet | KIDSCREEN-27 | 5 Dimensions: 1. Physical well-being (5 items) 2. Psychological well-being (7 items) 3. Parent relations and autonomy (7 items) 4. Social support and peers (4 items) 5. School environment (4 items) | BMI, physical activity | NR |
Zervaki et al., 2017 [16] | Greece | Cross-sectional | 400 (14–17 years old) | Participants that signed consent forms received a full verbal and written explanation of the purpose of the study and its anonymous nature | 49.5% boys Median age: 15.8 years (IQR: 1.03) | 21.7 (SD, 3.1) | NR | Normal weight: 75.0 Overweight: 21.5 Obesity: 3.5% | KIDMED index | 16 dichotomous items (yes/no): 12 items: behaviors consistent with the Mediterranean diet 4 items: behaviors inconsistent with the Mediterranean diet | KIDSCREEN-27 | 5 Dimensions: 1. Physical well-being (5 items) 2. Psychological well-being (7 items) 3. Parent relations and autonomy (7 items) 4. Social support and peers (4 items) 5. School environment (4 items) | Number of meals, number of meals (with family), age, obesity, father’s education level, mother’s education level, BMI | NR |
Evaristo et al., 2018 [17] | Portugal | Cross-Sectional | 946 (12–18 years old) | All students that agreed to participate in the study | 53.3% boys Mean age: 14.5 years (SD, 1.8) | 21.1 (SD, 3.8) | NR | NR | KIDMED index | 16 dichotomous items (yes/no): 12 items: behaviors consistent with the Mediterranean diet 4 items: behaviors inconsistent with the Mediterranean diet | KIDSCREEN-10 | It contains 10 items regarding family life, peers, and school life | Physical fitness, age, sex, pubertal stage (Tanners A and B), socioeconomic status, sleep duration, BMI | Portuguese Foundation for Science and Technology (FCT) grants |
Esteban-Gonzalo et al., 2019* [18] | Spain | Cross-Sectional | (a) 536 children at primary school (6–7 and 9–10 years old) (b) 987 adolescents at secondary school (12–13 and 15–16 years old) | (i) To study in the first/fourth grades (6–7 and 9–10 years old, respectively) for children and seventh/tenth grades (12–13 and 15–16 years old, respectively) for adolescents at baseline and (ii) to not have physical disability or health problems, which may limit the levels of physical activity | Primary school: 49.8% boys Mean age: 8 years (SD, 1.5) Secondary school: 51.3% boys Mean age: 8.2 years (SD, 1.5) | NR | NR | Overweight and obesity Primary school: Boys: 35.6% Girls: 36.9% Secondary school: Boys: 39.0% Girls: 21.9% | KIDMED index | 16 dichotomous items (yes/no): 12 items: behaviors consistent with the Mediterranean diet 4 items: behaviors inconsistent with the Mediterranean diet | KIDSCREEN-10 | It contains 10 items regarding family life, peers, and school life | Age, socio-economic status, prevalence of overweight, and obesity | DEP 2010- 21,662-C04-00 grant from the National Plan for Research, Development and Innovation (R + D + i) |
Ferrer-Cascales et al., 2019 [19] | Spain | Cross-Sectional | 527 (12–17 years old) | NR | 45.5% boys Mean age: 14.43 years (SD, 1.52) | NR | NR | NR | KIDMED index | 16 dichotomous items (yes/no): 12 items: behaviors consistent with the Mediterranean diet 4 items: behaviors inconsistent with the Mediterranean diet | KIDSCREEN-52 | 10 Subscales: 1. Physical Well-Being 2. Psychological Well-Being 3. Mood and Emotions 4. Self-Perception 5. Autonomy 6. Parent Relations and Home Life 7. Financial Resources 8. Social Support and Peers 9. School Environment 10. Social Acceptance | NR | Self-funded |
Delgado-Floody et al., 2020 [20] | Chile | Cross-Sectional | 619 (10–13 years old) | (i) To be a student of a public school in the La Araucanía region, (ii) to have a regular physical education class and (iii) to be aged between 10 and 13 years. The exclusion criteria were as follows; (i) having musculoskeletal disorders or (ii) any other known medical condition, which may alter the participant’s health and PA levels; and (iii) to have scholars commitment that they could be interrupted by the study measurements | 55.9% boys Mean age: 11.72 years (SD: 1.07) | 21.57 (SD, 4.68) | NR | Normal weight: 50.4% Overweight: 25.2% Obesity: 24.4% | Krece Plus test | The questionnaire contains 15 items, where the maximum possible score was + 11 and the minimum was − 5. Each item has a score of + 1 or − 1, depending on whether it approximates the ideal of the MD. The total points are accounted and, according to the score, the nutritional status is classified as follows: (1) “low” nutritional level, ≤ 5; (2) “moderate” nutritional level, 6–8; and (3) “high” nutritional level, ≥ 9 | KIDSCREEN-10 | It contains 10 items regarding family life, peers, and school life | Age, sex | Research Project R01/18 from the Universidad de Los Lagos and by private fundings |
Rodriguez-Rosado et al., 2020 [21] | Spain | Cross-Sectional | 114 (8–10 years old) | Parents/tutors of participants signed informed consent | Male: 9.53 years (SD, 0.64) Female: 9.54 years (SD, 0.6) | Male: 18.8 (SD, 4.52) Female:18.4 (SD, 4.19) | PAQ-A: Male: 3.82(0.76) Female:3.56 (0.83) | NR | KIDMED index | 16 dichotomous items (yes/no): 12 items: behaviors consistent with the Mediterranean diet 4 items: behaviors inconsistent with the Mediterranean diet | KIDSCREEN-27 | 5 Dimensions: 1. Physical well-being 2. Psychological well-being 3. Autonomy and relationship with parents 4. Social relationships and Peer pressure 5. School environment | NR | NR |
Caamaño-Navarrete et al., 2021 [22] | Chile | Cross-Sectional | 634 (11–13 years old) | Chilean schoolchildren aged between 11 and 13, without musculoskeletal disorders or any other known medical conditions that may alter the participants’ health and PA levels | 55.5% boys Mean age: 11.95 years (SD, 0.85) | 21.6 (SD, 4.58) | 2.64 h/week (1.42) | NR | KIDMED index** | Each item has a score of + 1 or – 1, depending on whether it approximates the ideal of the MD. The sum of all values from the administered test is categorized into three different levels: (1) > 8, optimal MD; (2) 4–7, improvement needed to adjust intake to Mediterranean patterns; and (3) ≤ 3, very low diet quality | KIDSCREEN-10 | It contains 10 items regarding family life, peers, and school life | NR | NR |
Mitri et al., 2021 [23] | Lebanon | Cross-Sectional | 798 (11–18 years old) | Students suffering from physical disabilities or who were absent on the days of the data collection were not invited to participate in the study | 52.9% boys Mean age: 15 years (SD, 2.07) | NR | PAQ C/A: 2.46 (0.75) | Normal weight: 55.4% Overweight: 20.2% Obesity: 19.3% | KIDMED index | 16 dichotomous items (yes/no): 12 items: behaviors consistent with the Mediterranean diet 4 items: behaviors inconsistent with the Mediterranean diet | KIDSCREEN-27 | 5 Dimensions: 1. Physical well-being 2. Psychological well-being 3. Autonomy and relationship with parents 4. Social relationships and Peer pressure 5. School environment | School type, grade, age, skipping meals, father's education level, number of meals, number of meals with family, and physical activity | Self-funded |
Mozzillo et al., 2021 [24] | Italy | Cross-sectional | 420 (13–17 years old) | Age 13.0–17.0 years; Caucasian ethnicity; overweight or obesity; first visit at the outpatient clinic. The exclusion criteria were secondary causes of obesity (genetic, endocrine, or iatrogenic forms) and other chronic diseases or mental illnesses | 44.5% boys Median age: 14.0 years (IQR: 13.2; 15.0) | 31.2 (IQR: 28.7; 34.2) | 0 h/week (0–3) | 82.3 (IQR: 73.6; 93.2) | KIDMED index | 16 dichotomous items (yes/no): 12 items: behaviors consistent with the Mediterranean diet 4 items: behaviors inconsistent with the Mediterranean diet | Pediatric Quality of Life Inventory (PedsQL) | 4 Dimensions: 1. Physical functioning 2. Emotional functioning 3. Social functioning 4. School functioning | BMI, father’s education level (year), mother’s education level (year), exercise (hours/week) | Self-funded |