Mediterranean Diet may prevent childhood obesity

The Pediatric Diet is one of the 30-plus modules in our Culinary Medicine curriculum. Overweight and obesity in children can have significant long-term health outcomes that are not limited to the physical risks associated with excess weight: the psychological effects of weight stigma, which include bullying and depression, are also serious risks to a child's health.

With our program's focus on a Mediterranean-style diet, it's almost inevitable that a participant ask if a Mediterranean-style diet will be as healthful for children (that is, people under about 15 years of age) as it is for adults.

Fortunately, we have research out of Spain that looks specifically at the link between a Mediterranean-style Diet and overweight and obesity in children (In J Obes 2020;44:1906-1917).

The authors utilized data gathered for a study of children from birth through the age of 8, carried out in several regions of Spain. The study, known as INMA, or Infancia y Media Ambiente project, was established in 2003.

At the start of the study, women who were soon to give birth were recruited to participate in this long-term study of their diet and health and that of their children-to-be. The mothers responded to demographic and dietary questionnaires, and some of the details of their child's birth weight and health were recorded.

When the children were 4 years old the mothers and their children were contacted again. The mothers responded to dietary and demographic questionnaires on their own behalf as well as their child's, and the child's height, weight, and waist circumference were recorded.

This was repeated when the children were 8 years old, with a total of 1,527 children participating in all 8 years of the study.

To assess the childrens' diets according to a Mediterranean-style diet score, the authors had to modify a traditional Mediterranean Diet score to exclude alcohol intake. For a maximum of 16 points across the board, those child participants whose intake of vegetables, fruits and nuts, legumes, whole grains, fish or shellfish, and good fats such as olive oil were in the lowest third of intake were given 0 points, 1 point for intake at the middle third of intake, and 2 points for intake at the top third.

On the other hand, the consumption of dairy and land animal protein was scored in the negative: a decrease of 2 points for consumption in the top third of intake of dairy or land animal protein, -1 point for consumption in the middle third of intake, and a score of 0 (zero) for consumption in the lowest third of intake.

After assigning a score to the children's diets at both 4 and 8 years of age and correlating each child's Body Mass Index and Waist Circumference, the authors could compare the Mediterranean Diet score at the age of 4 of those children who were considered clinically overweight, clinically obese, or with abdominal obesity at 8 years of age with those who were not considered overweight, obese, or having abdominal obesity at 8 years of age.

Overall, after taking into account the mothers' demographic and lifestyle factors (including age, smoking status during pregnancy, breastfeeding duration, and more), the authors found that children with a high adherence to a Mediterranean Diet (scoring 11-16 points) at the age of 4 were 62% less likely to be overweight, 14% less likely to be obese, and 60% less likely to have abdominal obesity than those children who had a low adherence (scoring 0-6) at the age of 4.

For every 2-point increase in their overall Mediterranean Diet score at age 4, the 8-year-olds were 12% less likely to be overweight, 20% less likely to be obese, and 18% less likely to have abdominal obesity.

More detailed analysis of the children's diets revealed that "the protective effect... was mainly due to a greater intake of vegetables and olive oil, as well as a reduction in the consumption of meat."

What this means for you

Once again, this is an observational study so it can only show us association, not that eating more or less of something caused anything at all. This should emphasize that a Mediterranean-style diet is appropriate at all (food consuming) ages and that it's important to get children used to eating a wide variety of healthy foods so that they can continue the habit into adulthood.

First posted: November 18, 2020