Leyre Notario-Barandiaran1,2, Desirée Valera-Gran2,3, Sandra Gonzalez-Palacios1,2, Manuela Garcia-de-la-Hera1,2,4, Silvia Fernández-Barrés4,5,6, Eva Pereda-Pereda7,8, Ana Fernández-Somoano4,9, Mònica Guxens4,5,6,10, Carmen Iñiguez4,11, Dora Romaguera5,6,12,13, Martine Vrijheid4,5,6, Adonina Tardón4,9, Loreto Santa-Marina4,8,14, Jesús Vioque15,16,17, Eva Mª Navarrete-Muñoz1,2,3,4. 1. Department of Public Health, History of Medicine and Gynaecology, Universidad Miguel Hernández, Alicante, Spain. 2. Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain. 3. Department of Pathology and Surgery, Universidad Miguel Hernández, Alicante, Spain. 4. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. 5. ISGlobal, Barcelona, Spain. 6. Universitat Pompeu Fabra (UPF), Barcelona, Spain. 7. Faculty of Psychology, University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Spain. 8. Biodonostia Health Research Institute, Donostia-San Sebastián, Spain. 9. IUOPA-Departamento de Medicina, University of Oviedo, Oviedo, Spain. 10. Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands. 11. Departamento de estadística e I.O. Universitat de València, València, Spain. 12. Balearic Islands Health Research Institute (IdISBa), Palma, Spain. 13. CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain. 14. Department of Health, Basque Government, Donostia-San Sebastián, Spain. 15. Department of Public Health, History of Medicine and Gynaecology, Universidad Miguel Hernández, Alicante, Spain. vioque@umh.es. 16. Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain. vioque@umh.es. 17. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. vioque@umh.es.
Abstract
BACKGROUND/ OBJECTIVES: A higher adherence to a Mediterranean diet has been shown to be protective against obesity in adults, but the evidence is still inconclusive in children at early ages. Our objective was to explore the association between adherence to Mediterranean Diet at the age of 4 and the prevalence of overweight, obesity, and abdominal obesity at 4 years of age, and incidence at the age of 8. SUBJECTS/ METHODS: We analyzed data from children of the INMA cohort study who attended follow-up visits at age 4 and 8 years (n = 1801 and n = 1527, respectively). Diet was assessed at the age of 4 using a validated food frequency questionnaire. The adherence to MD was evaluated by the relative Mediterranean diet (rMED) score, and categorized as low (0-6), medium (7-10), and high (11-16). Overweight and obesity were defined according to the age-sex specific BMI cutoffs proposed by the International Obesity Task Force, and abdominal obesity as waist circumference >90th percentile. We used Poisson regression models to estimate prevalence ratios at 4 years of age, and Cox regression analysis to estimate hazard ratios (HR) from 4-8 years of age. RESULTS: In cross-sectional analyses at the age of 4 no association was observed between adherence to MD and overweight, obesity, or abdominal obesity. In longitudinal analyses, a high adherence to MD at age 4 was associated with lower incidence of overweight (HR = 0.38; 95% CI: 0.21-0.67; p = 0.001), obesity (HR = 0.16; 95% CI: 0.05-0.53; p = 0.002), and abdominal obesity (HR = 0.30; 95% CI: 0.12-0.73; p = 0.008) at the age of 8. CONCLUSION: This study shows that a high adherence to MD at the age of 4 is associated with a lower risk of developing overweight, obesity, and abdominal obesity at age 8. If these results are confirmed by other studies, MD may be recommended to reduce the incidence of obesity at early ages.
BACKGROUND/ OBJECTIVES: A higher adherence to a Mediterranean diet has been shown to be protective against obesity in adults, but the evidence is still inconclusive in children at early ages. Our objective was to explore the association between adherence to Mediterranean Diet at the age of 4 and the prevalence of overweight, obesity, and abdominal obesity at 4 years of age, and incidence at the age of 8. SUBJECTS/ METHODS: We analyzed data from children of the INMA cohort study who attended follow-up visits at age 4 and 8 years (n = 1801 and n = 1527, respectively). Diet was assessed at the age of 4 using a validated food frequency questionnaire. The adherence to MD was evaluated by the relative Mediterranean diet (rMED) score, and categorized as low (0-6), medium (7-10), and high (11-16). Overweight and obesity were defined according to the age-sex specific BMI cutoffs proposed by the International Obesity Task Force, and abdominal obesity as waist circumference >90th percentile. We used Poisson regression models to estimate prevalence ratios at 4 years of age, and Cox regression analysis to estimate hazard ratios (HR) from 4-8 years of age. RESULTS: In cross-sectional analyses at the age of 4 no association was observed between adherence to MD and overweight, obesity, or abdominal obesity. In longitudinal analyses, a high adherence to MD at age 4 was associated with lower incidence of overweight (HR = 0.38; 95% CI: 0.21-0.67; p = 0.001), obesity (HR = 0.16; 95% CI: 0.05-0.53; p = 0.002), and abdominal obesity (HR = 0.30; 95% CI: 0.12-0.73; p = 0.008) at the age of 8. CONCLUSION: This study shows that a high adherence to MD at the age of 4 is associated with a lower risk of developing overweight, obesity, and abdominal obesity at age 8. If these results are confirmed by other studies, MD may be recommended to reduce the incidence of obesity at early ages.
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