Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents

Public Health Nutr. 2004 Oct;7(7):931-5. doi: 10.1079/phn2004556.


Objective: To evaluate dietary habits in Spanish children and adolescents based on a Mediterranean Diet Quality Index tool, which considers certain principles sustaining and challenging traditional healthy Mediterranean dietary patterns.

Design: Observational population-based cross-sectional study. A 16-item Mediterranean Diet Quality Index was included in data gathered for the EnKid study (in which two 24-hour recalls, a quantitative 169-item food-frequency questionnaire and a general questionnaire about socio-economic, demographic and lifestyle items were administered).

Setting: Spain.

Subjects: In total, 3850 children and youths aged 2-24 years residing in Spain.

Results: Of the sample, 4.2% showed very low KIDMED index results, 49.4% had intermediate values and 46.4% had high index results. Important geographical differences were seen, with subjects from the Northeast showing the most favourable outcomes (52% with elevated scores vs. 37.5% of those from the North). Lower percentages of high diet quality were observed in low socio-economic groups, compared with middle and upper income cohorts (42.8%, 47.6% and 54.9%, respectively). Large cities had more positive results and only slight variations were seen for gender and age.

Conclusions: The KIDMED index, the first to evaluate the adequacy of Mediterranean dietary patterns in children and youth, confirms that this collective is undergoing important changes, which makes them a priority target for nutrition interventions. Results challenge certain commonly perceived notions tied to income level, population size and diet quality.

MeSH terms

  • Adolescent
  • Adolescent Nutritional Physiological Phenomena / physiology*
  • Adult
  • Age Distribution
  • Child
  • Child Nutritional Physiological Phenomena / physiology*
  • Child, Preschool
  • Cohort Studies
  • Cross-Sectional Studies
  • Diet Surveys*
  • Diet, Mediterranean*
  • Feeding Behavior*
  • Female
  • Humans
  • Life Style
  • Male
  • Population Density
  • Population Surveillance
  • Sex Distribution
  • Socioeconomic Factors
  • Spain
  • Surveys and Questionnaires