Mediterranean diet decreases adolescent waist circumference

Background To explore the effects of a multicomponent–multilevel school‐based educational intervention on the nutritional habits and abdominal obesity indices of a representative adolescent sample. Materials and methods A representative sample of 1610 adolescents aged 12–17 years in 23 public high schools of three municipalities in the Attica region in Greece participated in a programme funded by the European Union (August 2013–August 2014). Participants underwent dietary assessment with the use of the Mediterranean Diet Quality Index in children and adolescents ( KIDMED ), blood pressure ( BP ) assessment and screening for general and abdominal obesity by measuring body mass index, waist circumference ( WC ) and waist‐to‐height ratio ( WH tR), at baseline and following a 6‐month school‐based intervention. The intervention involved nutritional education, physical activity and body image awareness using a multilevel approach to the adolescent participants, their parents, school teachers and health staff. Results Analysis included 1032 adolescents (mean age ± SD 14·1 ± 1·6 years). Following intervention, mean KIDMED score ± SD increased significantly from 5·6 ± 2·4 to 5·8 ± 2·4 ( P = 0·004). Higher percentage of boys ( P = 0·028) and younger adolescents ( P < 0·001) had optimal KIDMED scores ≥ 8. Significant decreases were observed in overweight and obesity ( P = 0·033), mean systolic ( P = 0·049) and diastolic ( P < 0·001) BP , WC ( P < 0·001) and WH tR ( P < 0·001). WC decreased as the KIDMED score increased ( P = 0·020). Living with both parents ( P = 0·036), higher maternal ( P = 0·039) and paternal ( P = 0·004) education and having a younger father ( P = 0·034) were associated with better adherence to Mediterranean diet, post‐intervention. Conclusions Increased adherence to MD was associated with decreased WC , indicating a potential of multicomponent–multilevel school‐based interventions to combat adolescent abdominal obesity.