TY - JOUR
T1 - High and moderate adherence to Mediterranean lifestyle is inversely associated with overweight, general and abdominal obesity in children and adolescents
T2 - The MediLIFE-index
AU - the ΕΥΖΗΝ Study Group
AU - Katsagoni, Christina N.
AU - Psarra, Glykeria
AU - Georgoulis, Michael
AU - Tambalis, Konstantinos
AU - Panagiotakos, Demosthenes B.
AU - Sidossis, Labros S.
N1 - Funding Information:
The authors would like to thank all the participants who took part in the study. L.S. and D.B.P. contributed to the study concept and design; G.P., M.G. and K.T. contributed to the acquisition of the data; C. N. K. performed the statistical analyses and drafted the manuscript; L.S. and D.B.P critically revised the manuscript and all authors read and approved the final manuscript. The study was funded by OPAP SA-Greece . The authors declare that there are no conflicts of interest.
Publisher Copyright:
© 2019
PY - 2020/1
Y1 - 2020/1
N2 - Several lifestyle factors, such as diet and exercise, have been linked to pediatric obesity. However, relatively few studies have considered them simultaneously, as a pattern. To investigate the associations between students' lifestyle and overweight, general, and abdominal obesity, an a priori Mediterranean lifestyle index (ie, MediLIFE-index ) was created. We hypothesized that students' characteristics and their probability to be overweight or obese would be lower towards a better adherence to a Mediterranean lifestyle pattern. This study included 174 209 students aged 6 to 18 years from all geographical regions of Greece who participated in the 2014-2015 EYZHN study. The total range of MediLIFE-index was 0– 8 (higher values indicating greater adherence to the Mediterranean lifestyle). Index values were thereafter divided into three groups according to its tertiles (a) ‘non-adherent’; (b) ‘moderately adherent’; and (c) “highly adherent” to the Mediterranean lifestyle. The mean ± standard deviation of the MediLIFE-index was 5.1 ± 1.6. Students with higher scores had lower BMI and waist circumference (all P <.001). Those who were “highly adherent” compared to those who were “non-adherent” were associated with lower likelihood of being overweight, obese or abdominal obese, by 6% (OR 0.94, 95% CI 0.92, 0.98), 30% (OR 0.70, 95% CI 0.67, 0.75) and 20% (OR 0.80, 95% CI 0.77, 0.83), respectively. The optimal discriminating value of the index for overweight was 4.5 (78% sensitivity and 80% specificity), while for obese/abdominal obese was 3.5 (82% sensitivity and 85% specificity). A useful tool was developed in order to identify children and adolescents with increased odds of being overweight, obese, or abdominal obese based on their lifestyle.
AB - Several lifestyle factors, such as diet and exercise, have been linked to pediatric obesity. However, relatively few studies have considered them simultaneously, as a pattern. To investigate the associations between students' lifestyle and overweight, general, and abdominal obesity, an a priori Mediterranean lifestyle index (ie, MediLIFE-index ) was created. We hypothesized that students' characteristics and their probability to be overweight or obese would be lower towards a better adherence to a Mediterranean lifestyle pattern. This study included 174 209 students aged 6 to 18 years from all geographical regions of Greece who participated in the 2014-2015 EYZHN study. The total range of MediLIFE-index was 0– 8 (higher values indicating greater adherence to the Mediterranean lifestyle). Index values were thereafter divided into three groups according to its tertiles (a) ‘non-adherent’; (b) ‘moderately adherent’; and (c) “highly adherent” to the Mediterranean lifestyle. The mean ± standard deviation of the MediLIFE-index was 5.1 ± 1.6. Students with higher scores had lower BMI and waist circumference (all P <.001). Those who were “highly adherent” compared to those who were “non-adherent” were associated with lower likelihood of being overweight, obese or abdominal obese, by 6% (OR 0.94, 95% CI 0.92, 0.98), 30% (OR 0.70, 95% CI 0.67, 0.75) and 20% (OR 0.80, 95% CI 0.77, 0.83), respectively. The optimal discriminating value of the index for overweight was 4.5 (78% sensitivity and 80% specificity), while for obese/abdominal obese was 3.5 (82% sensitivity and 85% specificity). A useful tool was developed in order to identify children and adolescents with increased odds of being overweight, obese, or abdominal obese based on their lifestyle.
KW - Children
KW - Cross-Sectional Nationwide School-Based Survey
KW - Lifestyle Index
KW - Mediterranean diet
KW - Obesity
UR - http://www.scopus.com/inward/record.url?scp=85076237623&partnerID=8YFLogxK
U2 - 10.1016/j.nutres.2019.09.009
DO - 10.1016/j.nutres.2019.09.009
M3 - Article
C2 - 31841746
AN - SCOPUS:85076237623
SN - 0271-5317
VL - 73
SP - 38
EP - 47
JO - Nutrition Research
JF - Nutrition Research
ER -
