Adherence to the Mediterranean Diet in Children and Adolescents in the Mediterranean and Continental Regions of Croatia

Adherence to the Mediterranean diet (MD) has been found beneficial for the prevention and treatment of various chronic non-communicable diseases; however, adherence to MD is declining, especially in the Mediterranean countries. Croatia is characteristic for having both traditionally continental and Mediterranean regions, with distinct dietary features. The aim of this study was to compare difference in adherence to MD and overall dietary intake between children and adolescents from continental and Mediterranean part of Croatia. Participants were randomly recruited children and adolescents (n=838, mean age 9.96 ± 2.09 years) located in continental and Mediterranean parts of Croatia. Three different questionnaires were distributed and collected: general questionnaire (age and gender), the Mediterranean Diet Quality Index for children and adolescents (KIDMED) and 3-day food records (3DFR). Statistical analysis was performed using SPSS 260 (IBM Corporation, Chicago, Illinois, USA) statistical software. P values less than 0.05 were considered significant. Overall, low adherence to MD was evident in 23.1% of participants, while only 15.8% of children and adolescents had good compliance with MD. A significant difference in KIDMED score has been found between the continental (mean score 4.91 ± 2.33) and Mediterranean (mean score 5.57 ± 2.12) part of Croatia (p<0.001), as well as in the intake of energy and some nutrients. Moreover, participants from the Mediterranean part of Croatia had better compliance with D-A-CH recommendations for some nutrients compared to those from the continental part. Although children and adolescents from the Mediterranean part of Croatia had better adherence to MD than those from the continental part, overall, relatively poor adherence to MD was evident for both regions. Therefore, a healthy, balanced diet should be encouraged in both regions, preferably taking into account traditionally consumed and locally available foods.