Association between leisure screen time and adherence to the Mediterranean diet in a representative sample of Spanish children: A cross-sectional study

The aim of this study was to assess the association between adherence to the Mediterranean diet and daily leisure screen time. We carried out a cross-sectional study using a representative sample of the Spanish population aged from 3 to 14 years recruited for the 2017 Spanish National Health Survey (n = 4,633). We derived the adherence to the Mediterranean diet according to a modified Mediterranean Diet Score and computed daily leisure screen time. We estimated crude and adjusted prevalence ratios, and 95% confidence intervals (95% CI) of high versus low, high versus medium and medium versus low adherence to the Mediterranean diet, according to categories of daily leisure screen time, using Poisson regression models. We found that the adjusted probabilities of having high adherence to the Mediterranean diet, versus low and medium adherence, were 23% (aPR 0.77; 95% CI 0.69, 0.86) and 14% (aPR 0.86; 95% CI 0.76, 0.97) lower, respectively, in children spending at least 180 minutes of daily leisure screen time in comparison with children spending less than one hour of daily screen time. This association was also observed when stratifying by age, except for children 12–14 years. In conclusion, high leisure screen time may be associated with lower adherence to the Mediterranean diet.