Anthropometric Parameters and Mediterranean Diet Adherence in Preschool Children in Split-Dalmatia County, Croatia-Are They Related?

Nutrients. 2021 Nov 26;13(12):4252. doi: 10.3390/nu13124252.


Obesity is a rapidly growing problem in European countries, Croatia being among them. According to the latest CroCOSI data, every third child in Croatia aged 8.0-8.9 years is overweight or obese. The Mediterranean diet (MeDi) and its impact on nutritional status and health has been the focus of recent research. Therefore, the aim of this cross-sectional, observational study was to determine the nutritional status and adherence to the MeDi of preschool children in Split, Croatia. We included 598 preschool children aged 3 to 7 years and, for each child, parents completed a lifestyle questionnaire and the Mediterranean Diet Quality Index (KIDMED) in order to assess adherence to the MeDi. The anthropometric assessment included the measurement of weight, height, mid-upper arm circumference (MUAC), waist circumference (WC) and the z-score was calculated. According to the z-score, 420 (70.2%) children had a healthy body weight with 54 (9%) underweight and 124 (20.8%) overweight or obese children. Almost half (49%) of the study participants had a low KIDMED index score, indicating a low MeDi adherence, 37% had an average score, while only 14% had high MeDi compliance. Statistically significant negative correlations between MUAC and WC and the consumption of a second daily serving of fruit (p = 0.04) as well as a daily serving of vegetables (p = 0.03) were found. In conclusion, low compliance to the MeDi principles in preschool children is concerning. Considering the beneficial effects of the MeDi on overall health, further education, and the adoption of healthy eating habits in preschool children in this Mediterranean region are required.

Keywords: Mediterranean diet; Split-Dalmatia County; eating habits; nutritional status; preschool children.

Publication types

  • Observational Study

MeSH terms

  • Anthropometry*
  • Child
  • Child, Preschool
  • Croatia
  • Cross-Sectional Studies
  • Diet, Mediterranean / statistics & numerical data*
  • Feeding Behavior
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Life Style
  • Male
  • Nutrition Policy
  • Nutritional Status / physiology*
  • Parents
  • Pediatric Obesity / prevention & control*
  • Surveys and Questionnaires
  • Waist Circumference