Quality of dietary habits (adherence to a mediterranean diet) in pupils of compulsory secondary education
Keywords:
Adolescentes. Dieta mediterránea. Hábitos dietéticos.Abstract
Background. The Mediterranean diet is considered to be a prototype of a healthy diet. The modernization of society implies sociological and cultural changes that affect feeding preferences and habits. The aim of this paper is to determine the quality index of the dietary habits in pupils of compulsory secondary education (CSE). Material and methods. By distributing a 16 item questionnaire (kidmed test) to a random sample of 1,956 pupils of CSE (966 males and 990 females). The final score or kidmed index (range 0-12) indicates whether the degree of adherence to the Mediterranean diet is low (0-3), medium (4-7) or high (8-12). Results. A low kidmed index value was registered in 6.7% of the pupils of CSE, whereas medium values corresponded to 50.4% and low values to 42.9%, showing no significant statistical differences between the sexes. The kidmed index decreases progressively with age (p<0.05). At age 13 (first year of CSE), 49.5% of the pupils had an optimal score on the kidmed index, whereas at 16 (fourth year of CSE), this score reached 37.2%. There were statistical differences (p<0.05) regarding consumption of fruit, fish, nuts and dried foods, sweets and factory produced baked foodstuffs; pupils also frequently went without breakfast and ate at fast food restaurants. Conclusions. By the end of CSE, 62.8% of pupils showed a low-medium degree of adherence to the Mediterranean diet. Applicable food advice for these adolescents would be to increase consumption of fruit, vegetables, nuts, pasta and rice, yogurt and cheese, pulses and fish; and to reduce consumption of factory produced baked foodstuffs and sweets and to eat less at fast food restaurants; besides insisting on the importance of daily breakfast and the use olive oil for cooking. In addition, it would be convenient to develop nutrition education programs during compulsory education.Downloads
References
1. HELSING E. Traditional diets and disease patterns of the mediterranean, circa 1960. Am J Clin Nutr 1995; 61 (Suppl): 1329-1337.
https://doi.org/10.1093/ajcn/61.6.1329S
2. WILLET WC, SACKS F, TRICHOPOULOU A, DRESCHER G, FERRO-LUZZI A, HELSING E. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 1995; 61 (Suppl): 1402-1406.
https://doi.org/10.1093/ajcn/61.6.1402S
3. TRICHOPOULOU A, LAGIOU P. Healthy traditional mediterranean diet: an expression of culture, history, and lifestyle. Nutr Rev 1997; 55: 383-389.
https://doi.org/10.1111/j.1753-4887.1997.tb01578.x
4. DÍAZ I, GASCÓN E, LÁZARO S, MAXIMIANO C. Guía de la alimentación mediterránea. Ed. Empresa pública desarrollo agrario y pesquero. Consejería de agricultura y pesca. Junta de Andalucía 2007.
5. SÁNCHEZ-VILLEGAS A, BES-RASTROLLO M, MARTÍNEZ-GONZÁLEZ, JA, SERRA-MAJEM L. Adherence to a mediterranean dietary pattern and weight gain in a follow-up study: the SUN cohort. Int J Obes 2006; 30: 350-358.
https://doi.org/10.1038/sj.ijo.0803118
6. HU FB. The Mediterranean diet and mortality - olive oil and beyond. New Engl J Med 2003; 348: 2595-2596.
https://doi.org/10.1056/NEJMp030069
7. TRICHOPOULOU A, COSTACOU T, CHRISTINA B, TRICHOPOULOU D. Adherence to a mediterranean diet and survival in a greek population. New Engl J Med 2003; 348: 2599-2608.
https://doi.org/10.1056/NEJMoa025039
8. TUR JA, SERRA-MAJEM L, ROMAGUERA D, POUS A. Does the diet of the Balearic population, a mediterranean type diet, still provide adequate antioxidant nutrient intakes? Eur J Nutr 2005, 44: 204-213.
https://doi.org/10.1007/s00394-004-0512-0
9. KRIS-ETHERTON P, ECKEL RH, HOWARD BV, ST JEOR S, BAZZARRE TL. Lyon diet heart study. Benefits of a mediterranean-style, national cholesterol education program/american heart association step I dietary pattern on cardiovascular disease. Circulation 2001; 103: 1823-1825.
https://doi.org/10.1161/01.CIR.103.13.1823
10. FERRARA LA, RAIMONDI S, D'EPISCOPO L, GUILDA L, DELLO RUSSO A, MAROTTA T. Olive oil and reduced need for antihypertensive medications. Arch Intern Med 2000; 160: 837-842.
https://doi.org/10.1001/archinte.160.6.837
11. ESTRUCH R, MARTÍNEZ-GONZÁLEZ MA, CORELLA D, SALAS-SALVADÓ J, RUIZ-GUTIÉRREZ V, COVAS MI et al. PREDIMED study investigators. Effects of a mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med 2006; 145: 1-11.
https://doi.org/10.7326/0003-4819-145-1-200607040-00004
12. HU FB, RIMM EB, STAMPFER MJ, ASCHERIO A, SPIEGELMAN D, WILLET WC. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr 2000; 72: 912-921.
https://doi.org/10.1093/ajcn/72.4.912
13. TERRY P, HU FB, HANSEN H, WOLK A. Prospective study of major dietary patterns and colorectal risk in women. Am J Epidemiol 2001; 154: 1143-1149.
https://doi.org/10.1093/aje/154.12.1143
14. TRICHOPOULOU A, NASKA A, ANTONIOU A, FRIEL S, TRYGG K, TURRINI A. Vegetable and fruit: the evidence in their favour and the public health perspective. Int J Vitam Nutr Res 2003; 73: 63-69.
https://doi.org/10.1024/0300-9831.73.2.63
15. RODRÍGUEZ F, BANEGAS JR, GRACIANI MA, HERNÁNDEZ R, REY J. El consumo de alimentos y nutrientes en España en el período 1940-1988. Análisis de su consistencia con la dieta mediterránea. Med Clin (Barc) 1996; 106: 161-168.
16. DURÁ T. Ingesta de energía y nutrientes en los alumnos de educación secundaria obligatoria. An Esp Pediatr 2001; 54: 547-554.
https://doi.org/10.1016/S1695-4033(01)77592-3
17. ARANCETA J. Spanish food patterns. Public Health Nutr 2001; 4: 1399-1402.
https://doi.org/10.1079/PHN2001227
18. SÁNCHEZ-VILLEGAS A, MARTÍNEZ JA, DE IRALA J, MARTÍNEZ-GONZÁLEZ MA. Determinants of the adherence to an "a priori" defined mediterranean dietary pattern. Eur J Nutr 2002; 41: 249-257.
https://doi.org/10.1007/s00394-002-0382-2
19. MORENO LA, SARRÍA A, POPKIN BM. The nutrition transition in Spain: a european mediterranean country. Eur J Clin Nutr 2002; 56: 992-1003.
https://doi.org/10.1038/sj.ejcn.1601414
20. ITURBE A, EMPARANZA J, PERALES A. Modelo dietético de los adolescentes de Guipúzcoa. An Esp Pediatr 1999; 50: 471-478.
21. SAMUELSON G, BRATTEBY LE, ENGHARDT H, HEDGREN M. Food habits and energy and nutrient in swedish adolescents approaching the year 2000. Acta Paediatr 1996 (Suppl 415): 1-20.
https://doi.org/10.1111/j.1651-2227.1996.tb14268.x
22. SERRA-MAJEM L, GARCÍA-CLOSAS R, RIBAS L, PÉREZ-RODRIGO C, ARANCETA J. Food patterns of spanish schoolchildren and adolescents: The enKid study. Public Health Nutrition 2001; 4: 1433-1438.
https://doi.org/10.1079/PHN2001234
23. TUR JA, ROMAGUERA D, PONS A. Food consumption patterns in a mediterranean region: does the mediterranean diet still exist? Ann Nutr Metab 2004; 48: 193-201.
https://doi.org/10.1159/000079754
24. FERNÁNDEZ P. Determinación del tamaño muestral. Cad Aten Primaria 1996; 3: 138-141 (actualización 06/03/2001).
Disponible en: http://www.fisterra.com
25. SERRA-MAJEM L, RIBAS L, NGO J, ORTEGA RM, GARCÍA A, PÉREZ-RODRIGO C et al. Food, youth and the mediterranean diet in Spain. Development of kidmed, mediterranean diet quality index in children and adolescents. Public Health Nutrition 2004; 7: 931-935.
https://doi.org/10.1079/PHN2004556
26. MARTÍNEZ MI, HERNÁNDEZ MD, OJEDA M, MENA R, ALEGRE A, ALFONSO JL. Desarrollo de un programa de educación nutricional y valoración del cambio de hábitos alimentarios saludables en una población de estudiantes de enseñanza secundaria obligatoria. Nutr Hosp 2009; 24: 504-510.
27. KIM S, HAINES PS, SIEGA-RIZ AM, POPKIN BM. The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr 2003; 133: 3476-3484.
https://doi.org/10.1093/jn/133.11.3476
28. TUR JA, ROMAGUERA D, PONS A. The diet quality index-international (DQI-I): is it a useful tool to evaluate the quality of the mediterranean diet? Br J Nutr 2005; 93: 369-376.
https://doi.org/10.1079/BJN20041363
29. GONZÁLEZ CA, ARGILAGA S, AGUDO A, AMIANO P, BARRICARTE A, BEGUIRISTÁIN JM et al. Diferencias sociodemográficas en la adhesión al patrón de dieta mediterránea en poblaciones de España. Gac Sanit 2002; 16: 214-221.
https://doi.org/10.1016/S0213-9111(02)71664-6
30. TUR JA, ROMAGUERA D, PONS A. Adherence to the mediterranean dietary pattern among the population of the balearic islands. Br J Nutr 2004; 92: 341-346.
https://doi.org/10.1079/BJN20041209
31. SERRA-MAJEM LI, RIBAS L, GARCÍA A, PÉREZ-RODRIGO C, ARANCETA J. Nutrient adequacy and mediterranean diet in spanish school children and adolescents. Eur J Clin Nutr 2003; 57 (Suppl 1): S35-S39.
https://doi.org/10.1038/sj.ejcn.1601812
32. LÓPEZ J, GÓMEZ P, CASTRO P, MARÍN C, PAZ E, BRAVO MD et al. La dieta mediterránea mejora la resistencia a la oxidación de las lipoproteínas de baja densidad (LDL). Med Clin (Barc) 2000; 115: 361-365.
https://doi.org/10.1016/S0025-7753(00)71561-2
33. GUERRA A, FELDL F, KOLETZKO B. Fatty acid composition of plasma lipids in healthy Portuguese children: is the mediterranean diet disappearing? Ann Nutr Metab 2001; 45: 78-81.
https://doi.org/10.1159/000046710
34. SCHMIDHUBER J. The european diet - evolution, evaluation and impacts of the CAP. Organización de las Naciones Unidas para la Agricultura y la Alimentación (FAO) 2008.
35. NICKLAS TA, REGER C, MYERS, O'NEIL C. Breakfast consumption with and without vitamin-mineral supplement use favourably impacts daily nutrient intake of ninth-grade students. J Adolesc Health 2000; 27: 314-321.
https://doi.org/10.1016/S1054-139X(00)00113-0
36. DURÁ T. El desayuno de los alumnos de educación secundaria obligatoria (ESO). Nutr Hosp 2002; 17: 189-196.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
La revista Anales del Sistema Sanitario de Navarra es publicada por el Departamento de Salud del Gobierno de Navarra (España), quien conserva los derechos patrimoniales (copyright ) sobre el artículo publicado y favorece y permite la difusión del mismo bajo licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (CC BY-SA 4.0). Esta licencia permite copiar, usar, difundir, transmitir y exponer públicamente el artículo, siempre que siempre que se cite la autoría y la publicación inicial en Anales del Sistema Sanitario de Navarra, y se distinga la existencia de esta licencia de uso.
