Factors Associated with Adherence to the Mediterranean Diet among Palestinian High School females’ students in Hebron city: Cross-sectional study
DOI:
https://doi.org/10.22317/imj.v4i3.827Keywords:
KIDMED; Adolescents; Obesity, nutrition transitionAbstract
Objectives: Adopting an eating pattern complying with the Mediterranean diet not only reduces body fat mass and obesity risk, but also decreases the development of various health problems. However, Mediterranean countries have testified a reduced adherence during the past years and the adoption of a more westernized dietary pattern. The main aim of our study is to explore the Mediterranean diet adherence and to evaluate the relationship between KIDMED scores and selected variables school students in Hebron city, Palestine.
Methods: A cross-sectional study was performed on 360 voluntary female student, aged between 15-18 years. Socio-demographic data, nutritional habits, and anthropometric measurements were obtained from self-administered questionnaires. The Mediterranean Diet Quality Index for children and adolescents was used to assess the adherence to the Mediterranean diet.
Results: Results indicated that 37.5% of the students had a low adherence to Mediterranean diet, 53.1% had a moderate adherence to Mediterranean diet, and 9.40% had a high adherence to Mediterranean diet. KIDMED scores are significantly associated all dietary habits listed below, with an exception for following a diet plan. Furthermore, it was noticed that KIDMED scores are negatively associated with age, first meal, and overnight fasting. On the other hand, the scores are positively associated with last meal, and number of main meals.
Conclusions: In conclusion, results should plead for an increased awareness in Palestinian high- schools, supporting students to be more adherent to the Mediterranean diet, in order to prevent a further increase in metabolic diseases later in adulthood.
References
1. Vidal-Peracho JC, Tricás-Moreno JM, Lucha-López AC, Lucha-López MO, Camuñas-Pescador AC, Caverni-Muñoz A, et al. Adherence to Mediterranean diet pattern among Spanish adults attending a medical Center: nondiabetic subjects and type 1 and 2 diabetic patients. J Diabetes Res. 2017; 2017: 5957821.
2. Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011; 14 (12A): 2274–2284.
3. Mounayar R, Jreij R, Hachem J, Abboud F, Tueni M. Breakfast Intake and Factors Associated with Adherence to the Mediterranean Diet among Lebanese High School Adolescents. J Nutr Metab. 2019; 2019: 2714286.
4. Wu L, Sun D. Adherence to Mediterranean diet and risk of developing cognitive disorders: an updated systematic review and meta-analysis of prospective cohort studies. Sci Rep. 2017; 7: 41317.
5. August GP, Caprio S, Fennoy I, Freemark M, Kaufman FR, Lustig RH. Prevention and treatment of pediatric obesity: An endocrine society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab. 2008; 93(12): 4576–4599.
6. Salmon J, Timperio A. Prevalence, trends and environmental influences on child and youth physical activity. Med Sport Sci. 2007; 50: 183–199.
7. Cömert TK, Çerkez M, Tekin AG, Aydoğan N, Esşiz Ö. Compliance with Mediterranean diet quality index (KIDMED) and eating patterns in school-age children with Gaziantep, Turkey. Am J Food Nutr. 2015; 3(1): 28–33.
8. Mazaraki A, Tsioufis C, Dimitriadis K, Tsiachris D. Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum Albuminuria (3L study). Eur J Clin Nutr. 2011; 65(2): 219–225.
9. Roccaldo R, Censi L, D'Addezio L, Toti E, Martone D, D'Addesa D. Adherence to the Mediterranean diet in Italian school children (The ZOOM8 Study). Int J Food Sci Nutr. 2014; 65(5): 621-8.
10. Grao-Cruces A, Nuviala A, Fernández-MartÃnez A, MartÃnez-López EJ. Relationship of physical activity and sedentarism with tobacco and alcohol consumption, and Mediterranean diet in Spanish teenagers. Nutr Hosp. 2015; 31(4): 1693-700.
11. Naja F, Hwalla N, Itani L, Karam S, Sibai AM, Nasreddine L. A western dietary pattern is associated with overweight and obesity in a national sample of Lebanese adolescents (13–19 years): a cross-sectional study. Br J Nutr. 2015; 114 (11): 1909–1919.
12. Nasreddine L, Naja F, Chamieh MC, Adra N, Sibai AM, Hwalla N. Trends in overweight and obesity in Lebanon: evidence from two national cross-sectional surveys (1997 and 2009). BMC Public Health. 2012; 12: 798.
13. Serra-Majem L, Ribas L, Ngo J, Ortega RM, GarcÃa 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 Nutr. 2004; 7(7): 931–935
14. LaRowe TL, Moeller SM, Adams AK. Beverage patterns, diet quality, and body mass index of US preschool and school-aged children. J Am Diet Assoc. 2007; 107: 1124–1133
15. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012; 70(1): 3–21.
16. Cattaneo A, Monasta L, Stamatakis E, Lioret S, Castetbon K, Frenken F, et al. Overweight and obesity in infants and pre-school children in the European Union: A review of existing data. Obes Rev. 2010; 11(5): 389–398.
17. Badrasawi MM, Abu.Snouber LM, Al-Tamimi MA, Badrasawi KJ. Prevalence, Risk Factors and Psychosocial Status of Obese and Overweight Adolescents in Hebron City, Palestine. Int J Nutr Pharmacol Neurol Dis. 2019; 9(2): 72- 79.
18. Lee RD, Nieman DC. Nutritional assessment. 6th ed. New York: McGraw Hill. 2013.
19. WHO. Body Mass index – report. 2018 (http:// www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. [Assessed 10 October 2019).
20. Centers for Disease Control and Prevention. Deï¬ning Childhood Overweight and Obesity, CDC, Washington, DC, USA, 2018, (https://www.cdc.gov/obesity/childhood/index. html).
21. Lazarou C, Panagiotakos DB, Matalas AL. Level of adherence to the Mediterranean diet among children from Cyprus: the CYKIDS study. Public Health Nutr. 2009; 12(7): 991-1000.
22. Mariscal-Arcas M, Velasco J, Monteagudo C, Caballero-Plasencia MA, Lorenzo-Tovar ML, Olea-Serrano F. Comparison of methods to evaluate the quality of the Mediterranean diet in a large representative sample of young people in Southern Spain. Nutr Hosp. 2010; 25(6):1006-13.
23. Trichopoulos D, Lagiou P. Mediterranean diet and overall mortality differences in the European Union. Public Health Nutr. 2004; 7(7): 949–51.
24. Moreno LA, SarrÃa A, Popkin BM. The nutrition transition in Spain: a European Mediterranean country. Eur J Clin Nutr. 2002; 56(10): 992–1003.
25. Bargiota A, Delizona M, Tsitouras A, Koukoulis GN. Eating habits and factors affecting food choice of adolescents living in rural areas. Hormones. 2013; 12(2): 246–253.
26. Kontogianni MD, Vidra N, Farmaki AE, Koinaki S, Belogianni K, Sofrona S, et al. Adherence Rates to the Mediterranean Diet Are Low in a Representative Sample of Greek Children and Adolescents. J Nutr. 2008; 138(10): 1951–1956.
27. Rogers I, Emmett P, ALSPAC Study Team. The effect of maternal smoking status, educational level and age on food and nutrient intakes in preschool children: results from the Avon Longitudinal Study of Parents and Children. Eur J Clin Nutr. 2003; 57(7): 854–64.
28. Sausenthaler S, Kompauer I, Mielck A, Borte M, Herbarth O, Schaaf B, et al. Impact of parental education and income inequality on children’s food intake. Public Health Nutr. 2007; 10(1): 24–33.
29. Panagiotakos DB, Tzima N, Pitsavos C, et al. (2007). The association between adherence to the Mediterranean diet and fasting indices of glucose homoeostasis: the ATTICA Study. J Am Coll Nutr. 26:32–8.
30. Panagiotakos DB, Chrysohoou C, Pitsavos C, Stefanadis C. (2006). Association between the prevalence of obesity and adherence to the Mediterranean diet: the ATTICA study. Nutrition. 22(5): 449–56. 49.
31. Schröder H, Marrugat J, Vila J, Covas MI, Elosua R. Adherence to the traditional Mediterranean diet is inversely associated with body mass index and obesity in a Spanish population. J Nutr. 2004; 134(12): 3355–61.
32. Trichopoulou A, Naska A, Orfanos P, Trichopoulos D. Mediterranean diet in relation to body mass index and waist-to-hip ratio: the Greek European Prospective Investigation into Cancer and Nutrition Study. Am J Clin Nutr. 2005; 82(5): 935–40.
33. Mithra P, Unnikrishnan B, Thapar R, Kumar N, Hegde S, Kamat AM, et al. Snacking behavior and its determinants among college-going students in coastal South India. J Nutr Metab. 2018; 2018: 6785741.
34. Neumark-Sztainer D, Story M, Ackard D, Moe J, Perry C. Family meals among adolescents: findings from pilot study. J Nutr Educ Behav. 2000; 32(6): 335-340.
1. Vidal-Peracho JC, Tricás-Moreno JM, Lucha-López AC, Lucha-López MO, Camuñas-Pescador AC, Caverni-Muñoz A, et al. Adherence to Mediterranean diet pattern among Spanish adults attending a medical Center: nondiabetic subjects and type 1 and 2 diabetic patients. J Diabetes Res. 2017; 2017: 5957821.
2. Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011; 14 (12A): 2274–2284.
3. Mounayar R, Jreij R, Hachem J, Abboud F, Tueni M. Breakfast Intake and Factors Associated with Adherence to the Mediterranean Diet among Lebanese High School Adolescents. J Nutr Metab. 2019; 2019: 2714286.
4. Wu L, Sun D. Adherence to Mediterranean diet and risk of developing cognitive disorders: an updated systematic review and meta-analysis of prospective cohort studies. Sci Rep. 2017; 7: 41317.
5. August GP, Caprio S, Fennoy I, Freemark M, Kaufman FR, Lustig RH. Prevention and treatment of pediatric obesity: An endocrine society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab. 2008; 93(12): 4576–4599.
6. Salmon J, Timperio A. Prevalence, trends and environmental influences on child and youth physical activity. Med Sport Sci. 2007; 50: 183–199.
7. Cömert TK, Çerkez M, Tekin AG, Aydoğan N, Esşiz Ö. Compliance with Mediterranean diet quality index (KIDMED) and eating patterns in school-age children with Gaziantep, Turkey. Am J Food Nutr. 2015; 3(1): 28–33.
8. Mazaraki A, Tsioufis C, Dimitriadis K, Tsiachris D. Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum Albuminuria (3L study). Eur J Clin Nutr. 2011; 65(2): 219–225.
9. Roccaldo R, Censi L, D'Addezio L, Toti E, Martone D, D'Addesa D. Adherence to the Mediterranean diet in Italian school children (The ZOOM8 Study). Int J Food Sci Nutr. 2014; 65(5): 621-8.
10. Grao-Cruces A, Nuviala A, Fernández-MartÃnez A, MartÃnez-López EJ. Relationship of physical activity and sedentarism with tobacco and alcohol consumption, and Mediterranean diet in Spanish teenagers. Nutr Hosp. 2015; 31(4): 1693-700.
11. Naja F, Hwalla N, Itani L, Karam S, Sibai AM, Nasreddine L. A western dietary pattern is associated with overweight and obesity in a national sample of Lebanese adolescents (13–19 years): a cross-sectional study. Br J Nutr. 2015; 114 (11): 1909–1919.
12. Nasreddine L, Naja F, Chamieh MC, Adra N, Sibai AM, Hwalla N. Trends in overweight and obesity in Lebanon: evidence from two national cross-sectional surveys (1997 and 2009). BMC Public Health. 2012; 12: 798.
13. Serra-Majem L, Ribas L, Ngo J, Ortega RM, GarcÃa 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 Nutr. 2004; 7(7): 931–935
14. LaRowe TL, Moeller SM, Adams AK. Beverage patterns, diet quality, and body mass index of US preschool and school-aged children. J Am Diet Assoc. 2007; 107: 1124–1133
15. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012; 70(1): 3–21.
16. Cattaneo A, Monasta L, Stamatakis E, Lioret S, Castetbon K, Frenken F, et al. Overweight and obesity in infants and pre-school children in the European Union: A review of existing data. Obes Rev. 2010; 11(5): 389–398.
17. Badrasawi MM, Abu.Snouber LM, Al-Tamimi MA, Badrasawi KJ. Prevalence, Risk Factors and Psychosocial Status of Obese and Overweight Adolescents in Hebron City, Palestine. Int J Nutr Pharmacol Neurol Dis. 2019; 9(2): 72- 79.
18. Lee RD, Nieman DC. Nutritional assessment. 6th ed. New York: McGraw Hill. 2013.
19. WHO. Body Mass index – report. 2018 (http:// www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. [Assessed 10 October 2019).
20. Centers for Disease Control and Prevention. Deï¬ning Childhood Overweight and Obesity, CDC, Washington, DC, USA, 2018, (https://www.cdc.gov/obesity/childhood/index. html).
21. Lazarou C, Panagiotakos DB, Matalas AL. Level of adherence to the Mediterranean diet among children from Cyprus: the CYKIDS study. Public Health Nutr. 2009; 12(7): 991-1000.
22. Mariscal-Arcas M, Velasco J, Monteagudo C, Caballero-Plasencia MA, Lorenzo-Tovar ML, Olea-Serrano F. Comparison of methods to evaluate the quality of the Mediterranean diet in a large representative sample of young people in Southern Spain. Nutr Hosp. 2010; 25(6):1006-13.
23. Trichopoulos D, Lagiou P. Mediterranean diet and overall mortality differences in the European Union. Public Health Nutr. 2004; 7(7): 949–51.
24. Moreno LA, SarrÃa A, Popkin BM. The nutrition transition in Spain: a European Mediterranean country. Eur J Clin Nutr. 2002; 56(10): 992–1003.
25. Bargiota A, Delizona M, Tsitouras A, Koukoulis GN. Eating habits and factors affecting food choice of adolescents living in rural areas. Hormones. 2013; 12(2): 246–253.
26. Kontogianni MD, Vidra N, Farmaki AE, Koinaki S, Belogianni K, Sofrona S, et al. Adherence Rates to the Mediterranean Diet Are Low in a Representative Sample of Greek Children and Adolescents. J Nutr. 2008; 138(10): 1951–1956.
27. Rogers I, Emmett P, ALSPAC Study Team. The effect of maternal smoking status, educational level and age on food and nutrient intakes in preschool children: results from the Avon Longitudinal Study of Parents and Children. Eur J Clin Nutr. 2003; 57(7): 854–64.
28. Sausenthaler S, Kompauer I, Mielck A, Borte M, Herbarth O, Schaaf B, et al. Impact of parental education and income inequality on children’s food intake. Public Health Nutr. 2007; 10(1): 24–33.
29. Panagiotakos DB, Tzima N, Pitsavos C, et al. (2007). The association between adherence to the Mediterranean diet and fasting indices of glucose homoeostasis: the ATTICA Study. J Am Coll Nutr. 26:32–8.
30. Panagiotakos DB, Chrysohoou C, Pitsavos C, Stefanadis C. (2006). Association between the prevalence of obesity and adherence to the Mediterranean diet: the ATTICA study. Nutrition. 22(5): 449–56. 49.
31. Schröder H, Marrugat J, Vila J, Covas MI, Elosua R. Adherence to the traditional Mediterranean diet is inversely associated with body mass index and obesity in a Spanish population. J Nutr. 2004; 134(12): 3355–61.
32. Trichopoulou A, Naska A, Orfanos P, Trichopoulos D. Mediterranean diet in relation to body mass index and waist-to-hip ratio: the Greek European Prospective Investigation into Cancer and Nutrition Study. Am J Clin Nutr. 2005; 82(5): 935–40.
33. Mithra P, Unnikrishnan B, Thapar R, Kumar N, Hegde S, Kamat AM, et al. Snacking behavior and its determinants among college-going students in coastal South India. J Nutr Metab. 2018; 2018: 6785741.
34. Neumark-Sztainer D, Story M, Ackard D, Moe J, Perry C. Family meals among adolescents: findings from pilot study. J Nutr Educ Behav. 2000; 32(6): 335-340.
2. Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011; 14 (12A): 2274–2284.
3. Mounayar R, Jreij R, Hachem J, Abboud F, Tueni M. Breakfast Intake and Factors Associated with Adherence to the Mediterranean Diet among Lebanese High School Adolescents. J Nutr Metab. 2019; 2019: 2714286.
4. Wu L, Sun D. Adherence to Mediterranean diet and risk of developing cognitive disorders: an updated systematic review and meta-analysis of prospective cohort studies. Sci Rep. 2017; 7: 41317.
5. August GP, Caprio S, Fennoy I, Freemark M, Kaufman FR, Lustig RH. Prevention and treatment of pediatric obesity: An endocrine society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab. 2008; 93(12): 4576–4599.
6. Salmon J, Timperio A. Prevalence, trends and environmental influences on child and youth physical activity. Med Sport Sci. 2007; 50: 183–199.
7. Cömert TK, Çerkez M, Tekin AG, Aydoğan N, Esşiz Ö. Compliance with Mediterranean diet quality index (KIDMED) and eating patterns in school-age children with Gaziantep, Turkey. Am J Food Nutr. 2015; 3(1): 28–33.
8. Mazaraki A, Tsioufis C, Dimitriadis K, Tsiachris D. Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum Albuminuria (3L study). Eur J Clin Nutr. 2011; 65(2): 219–225.
9. Roccaldo R, Censi L, D'Addezio L, Toti E, Martone D, D'Addesa D. Adherence to the Mediterranean diet in Italian school children (The ZOOM8 Study). Int J Food Sci Nutr. 2014; 65(5): 621-8.
10. Grao-Cruces A, Nuviala A, Fernández-MartÃnez A, MartÃnez-López EJ. Relationship of physical activity and sedentarism with tobacco and alcohol consumption, and Mediterranean diet in Spanish teenagers. Nutr Hosp. 2015; 31(4): 1693-700.
11. Naja F, Hwalla N, Itani L, Karam S, Sibai AM, Nasreddine L. A western dietary pattern is associated with overweight and obesity in a national sample of Lebanese adolescents (13–19 years): a cross-sectional study. Br J Nutr. 2015; 114 (11): 1909–1919.
12. Nasreddine L, Naja F, Chamieh MC, Adra N, Sibai AM, Hwalla N. Trends in overweight and obesity in Lebanon: evidence from two national cross-sectional surveys (1997 and 2009). BMC Public Health. 2012; 12: 798.
13. Serra-Majem L, Ribas L, Ngo J, Ortega RM, GarcÃa 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 Nutr. 2004; 7(7): 931–935
14. LaRowe TL, Moeller SM, Adams AK. Beverage patterns, diet quality, and body mass index of US preschool and school-aged children. J Am Diet Assoc. 2007; 107: 1124–1133
15. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012; 70(1): 3–21.
16. Cattaneo A, Monasta L, Stamatakis E, Lioret S, Castetbon K, Frenken F, et al. Overweight and obesity in infants and pre-school children in the European Union: A review of existing data. Obes Rev. 2010; 11(5): 389–398.
17. Badrasawi MM, Abu.Snouber LM, Al-Tamimi MA, Badrasawi KJ. Prevalence, Risk Factors and Psychosocial Status of Obese and Overweight Adolescents in Hebron City, Palestine. Int J Nutr Pharmacol Neurol Dis. 2019; 9(2): 72- 79.
18. Lee RD, Nieman DC. Nutritional assessment. 6th ed. New York: McGraw Hill. 2013.
19. WHO. Body Mass index – report. 2018 (http:// www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. [Assessed 10 October 2019).
20. Centers for Disease Control and Prevention. Deï¬ning Childhood Overweight and Obesity, CDC, Washington, DC, USA, 2018, (https://www.cdc.gov/obesity/childhood/index. html).
21. Lazarou C, Panagiotakos DB, Matalas AL. Level of adherence to the Mediterranean diet among children from Cyprus: the CYKIDS study. Public Health Nutr. 2009; 12(7): 991-1000.
22. Mariscal-Arcas M, Velasco J, Monteagudo C, Caballero-Plasencia MA, Lorenzo-Tovar ML, Olea-Serrano F. Comparison of methods to evaluate the quality of the Mediterranean diet in a large representative sample of young people in Southern Spain. Nutr Hosp. 2010; 25(6):1006-13.
23. Trichopoulos D, Lagiou P. Mediterranean diet and overall mortality differences in the European Union. Public Health Nutr. 2004; 7(7): 949–51.
24. Moreno LA, SarrÃa A, Popkin BM. The nutrition transition in Spain: a European Mediterranean country. Eur J Clin Nutr. 2002; 56(10): 992–1003.
25. Bargiota A, Delizona M, Tsitouras A, Koukoulis GN. Eating habits and factors affecting food choice of adolescents living in rural areas. Hormones. 2013; 12(2): 246–253.
26. Kontogianni MD, Vidra N, Farmaki AE, Koinaki S, Belogianni K, Sofrona S, et al. Adherence Rates to the Mediterranean Diet Are Low in a Representative Sample of Greek Children and Adolescents. J Nutr. 2008; 138(10): 1951–1956.
27. Rogers I, Emmett P, ALSPAC Study Team. The effect of maternal smoking status, educational level and age on food and nutrient intakes in preschool children: results from the Avon Longitudinal Study of Parents and Children. Eur J Clin Nutr. 2003; 57(7): 854–64.
28. Sausenthaler S, Kompauer I, Mielck A, Borte M, Herbarth O, Schaaf B, et al. Impact of parental education and income inequality on children’s food intake. Public Health Nutr. 2007; 10(1): 24–33.
29. Panagiotakos DB, Tzima N, Pitsavos C, et al. (2007). The association between adherence to the Mediterranean diet and fasting indices of glucose homoeostasis: the ATTICA Study. J Am Coll Nutr. 26:32–8.
30. Panagiotakos DB, Chrysohoou C, Pitsavos C, Stefanadis C. (2006). Association between the prevalence of obesity and adherence to the Mediterranean diet: the ATTICA study. Nutrition. 22(5): 449–56. 49.
31. Schröder H, Marrugat J, Vila J, Covas MI, Elosua R. Adherence to the traditional Mediterranean diet is inversely associated with body mass index and obesity in a Spanish population. J Nutr. 2004; 134(12): 3355–61.
32. Trichopoulou A, Naska A, Orfanos P, Trichopoulos D. Mediterranean diet in relation to body mass index and waist-to-hip ratio: the Greek European Prospective Investigation into Cancer and Nutrition Study. Am J Clin Nutr. 2005; 82(5): 935–40.
33. Mithra P, Unnikrishnan B, Thapar R, Kumar N, Hegde S, Kamat AM, et al. Snacking behavior and its determinants among college-going students in coastal South India. J Nutr Metab. 2018; 2018: 6785741.
34. Neumark-Sztainer D, Story M, Ackard D, Moe J, Perry C. Family meals among adolescents: findings from pilot study. J Nutr Educ Behav. 2000; 32(6): 335-340.
1. Vidal-Peracho JC, Tricás-Moreno JM, Lucha-López AC, Lucha-López MO, Camuñas-Pescador AC, Caverni-Muñoz A, et al. Adherence to Mediterranean diet pattern among Spanish adults attending a medical Center: nondiabetic subjects and type 1 and 2 diabetic patients. J Diabetes Res. 2017; 2017: 5957821.
2. Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011; 14 (12A): 2274–2284.
3. Mounayar R, Jreij R, Hachem J, Abboud F, Tueni M. Breakfast Intake and Factors Associated with Adherence to the Mediterranean Diet among Lebanese High School Adolescents. J Nutr Metab. 2019; 2019: 2714286.
4. Wu L, Sun D. Adherence to Mediterranean diet and risk of developing cognitive disorders: an updated systematic review and meta-analysis of prospective cohort studies. Sci Rep. 2017; 7: 41317.
5. August GP, Caprio S, Fennoy I, Freemark M, Kaufman FR, Lustig RH. Prevention and treatment of pediatric obesity: An endocrine society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab. 2008; 93(12): 4576–4599.
6. Salmon J, Timperio A. Prevalence, trends and environmental influences on child and youth physical activity. Med Sport Sci. 2007; 50: 183–199.
7. Cömert TK, Çerkez M, Tekin AG, Aydoğan N, Esşiz Ö. Compliance with Mediterranean diet quality index (KIDMED) and eating patterns in school-age children with Gaziantep, Turkey. Am J Food Nutr. 2015; 3(1): 28–33.
8. Mazaraki A, Tsioufis C, Dimitriadis K, Tsiachris D. Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum Albuminuria (3L study). Eur J Clin Nutr. 2011; 65(2): 219–225.
9. Roccaldo R, Censi L, D'Addezio L, Toti E, Martone D, D'Addesa D. Adherence to the Mediterranean diet in Italian school children (The ZOOM8 Study). Int J Food Sci Nutr. 2014; 65(5): 621-8.
10. Grao-Cruces A, Nuviala A, Fernández-MartÃnez A, MartÃnez-López EJ. Relationship of physical activity and sedentarism with tobacco and alcohol consumption, and Mediterranean diet in Spanish teenagers. Nutr Hosp. 2015; 31(4): 1693-700.
11. Naja F, Hwalla N, Itani L, Karam S, Sibai AM, Nasreddine L. A western dietary pattern is associated with overweight and obesity in a national sample of Lebanese adolescents (13–19 years): a cross-sectional study. Br J Nutr. 2015; 114 (11): 1909–1919.
12. Nasreddine L, Naja F, Chamieh MC, Adra N, Sibai AM, Hwalla N. Trends in overweight and obesity in Lebanon: evidence from two national cross-sectional surveys (1997 and 2009). BMC Public Health. 2012; 12: 798.
13. Serra-Majem L, Ribas L, Ngo J, Ortega RM, GarcÃa 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 Nutr. 2004; 7(7): 931–935
14. LaRowe TL, Moeller SM, Adams AK. Beverage patterns, diet quality, and body mass index of US preschool and school-aged children. J Am Diet Assoc. 2007; 107: 1124–1133
15. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012; 70(1): 3–21.
16. Cattaneo A, Monasta L, Stamatakis E, Lioret S, Castetbon K, Frenken F, et al. Overweight and obesity in infants and pre-school children in the European Union: A review of existing data. Obes Rev. 2010; 11(5): 389–398.
17. Badrasawi MM, Abu.Snouber LM, Al-Tamimi MA, Badrasawi KJ. Prevalence, Risk Factors and Psychosocial Status of Obese and Overweight Adolescents in Hebron City, Palestine. Int J Nutr Pharmacol Neurol Dis. 2019; 9(2): 72- 79.
18. Lee RD, Nieman DC. Nutritional assessment. 6th ed. New York: McGraw Hill. 2013.
19. WHO. Body Mass index – report. 2018 (http:// www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. [Assessed 10 October 2019).
20. Centers for Disease Control and Prevention. Deï¬ning Childhood Overweight and Obesity, CDC, Washington, DC, USA, 2018, (https://www.cdc.gov/obesity/childhood/index. html).
21. Lazarou C, Panagiotakos DB, Matalas AL. Level of adherence to the Mediterranean diet among children from Cyprus: the CYKIDS study. Public Health Nutr. 2009; 12(7): 991-1000.
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2020-09-26
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Hamdan M, Badrasawi M, Zidan S. Factors Associated with Adherence to the Mediterranean Diet among Palestinian High School females’ students in Hebron city: Cross-sectional study. Iraq Med J [Internet]. 2020 Sep. 26 [cited 2024 Nov. 21];4(3). Available from: https://iraqmedj.org/index.php/imj/article/view/827
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