Demographic and lifestyle factors associated with adherence to the Mediterranean diet in relation to overweight/obesity among Israeli adolescents: Findings from the Mabat Israeli national youth health and nutrition survey

Objective To investigate demographic and lifestyle factors associated with adherence to the Mediterranean diet (MD) in Israeli adolescents. Design Cross-sectional. Setting School-based. Subjects Schoolchildren (n 5268) aged 11-19 years answered self-administered questionnaires on food consumption, eating habits and lifestyle; a subset (n 578) also completed 24 h food recalls. Results Using a modified KIDMED index, 25·5 % of the students had poor, 55·2 % had average and 19·3 % had good MD adherence. Jewish middle-school children had the highest proportion (28·2 %) of poor MD adherence. Olive oil usage, derived from 24 h food recalls, was 18·1 % in Jewish families v. 71·1 % in Arab homes. In Jewish boys, the odds (OR; 95 % CI) of having poor MD adherence was higher in those who watched television/videos/listened to music for ≥2 h/d (1·25; 0·98, 1·58) and those who sometimes/don't read food labels (1·69; 1·31, 2·18). In Jewish girls, the odds for having poor MD adherence was significantly higher in those whose mother's schooling was <12 years (2·06; 1·41, 3·00) and those who sometimes/don't read food labels (1·35; 1·08, 1·69). In Arab boys, watching television/videos/listening to music for ≥2 h/d was significantly associated with poor MD adherence (1·89; 1·16, 3·07). In Arab girls, no aerobic activity or ball games weekly was associated with poor MD adherence (1·38; 0·91, 2·09). Conclusions Israeli adolescents had overall a high rate of poor MD adherence. Jewish middle-school children were at the highest risk. Interventions aimed at increasing physical activity, reducing sedentary time, improving mother's education and promoting reading of food labels are recommended.