Adherence to the Mediterranean diet in Greek adolescents during COVID-19: exploring determining factors through cross-sectional study

Purpose During the pandemic, people have changed their diet and lifestyle, which are highly important to maintain health and well-being. This study aims to investigate the relationship between demographic, socioeconomic, dietary and lifestyle characteristics and adolescents' adherence to the Mediterranean diet (AMD). Design/methodology/approach In all, 2088 youth from Attica, Greece, 12–18 years old, were recruited in this school-based, cross-sectional study conducted in May–December 2021. The tools Mediterranean Diet Quality Index for children and adolescents, the Family Affluence Scale III and the Godin-Shephard Leisure Time Physical Activity Questionnaire were used to estimate AMD, family affluence and the levels of physical activity (PA), respectively. Mann–Whitney U, Kruskal–Wallis, Chi-square tests, analysis of variance and multiple linear regression approaches were applied. Findings Empirical results showed that boys (p = 0.000), higher socioeconomic status (p = 0.034) and higher maternal education (p = 0.026) emerged as significant determinants for higher AMD. In addition, healthier dietary patterns (p = 0.000), PA (p = 0.000), more social lifestyle (p = 0.000) and night sleep duration (p = 0.000) were also positively correlated to diet quality. On the contrary, age (p = 0.000), screen time (p = 0.003) and the negative consequences of COVID-19 affected adversely AMD among adolescents. Originality/value To the best of the authors’ knowledge, this study was the first that highlighted the important role of several demographic, socioeconomic, dietary and lifestyle characteristics, together with the COVID-19 consequences to the AMD among secondary school children in Greece.