Mediterranean diet and physical activity impact on metabolic syndrome among children and adolescents from Southern Italy: Contribution from the Calabrian Sierras Community Study (CSCS)

Published:October 06, 2016DOI:https://doi.org/10.1016/j.ijcard.2016.10.008

      Highlights

      • KIDMED questionnaire among 6–14 years old children was used to assess Mediterranean diet (MD) adherence.
      • Of 1643 children, 18.4% had a poor and 81.6% a medium-high adherence.
      • Metabolic syndrome (MS) prevalence was 6.6% and 3.7% respectively.
      • In children with less physical activity, MS was more frequent vs those more active.
      • Thus, healthier lifestyle habits and physical activity also impact among children.

      Abstract

      Objectives

      The aim of this study was to assess the impact of Mediterranean diet (MD) and physical activity on metabolic syndrome (MS) prevalence in children and adolescents.

      Material and methods

      This cross-sectional study was carried out in 863 boys and 780 girls, 6–14 years old, from primary and secondary schools in a 14-town Southern Italian community. We modified the KIDMED questionnaire to adapt it to the local reality.

      Results

      Poor adherence to MD was seen in 18.4% of children and adolescents, while 81.6% had a medium-high compliance and the prevalence of MS was 6.6% and 3.7% respectively (OR: 1.8; 95% C.I.: 1.06–3.11; p = 0.013). When participants had less physical activity, MS was more frequent as compared to those more active (5.3% versus 2.3%; OR: 2.3; 95% C.I.: 1.3–4.3; p = 0.0068) which had a parallel counterpart when comparing those accustomed to seeing television for less or more than 5 h per day and MS prevalence was 12.3% versus 3.8% (OR: 3.38; 95% C.I.: 1.66–6.86, p = 0.0008), respectively. Finally, there was a specific abnormality in triglyceride levels, both in girls and boys, when participants were classified according to bad lifestyles, based on the combined evaluation of scarce adherence to MD and less extracurricular physical activity, accompanied by a 7-fold increased prevalence of MS as compared to those with the best lifestyle (11.0% versus 1.6%; p = 0.025).

      Conclusions

      There is an apparent importance of healthier lifestyle habits including physical activity and adherence to the MD also among children and adolescents.

      Keywords

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to International Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Pacifico L.
        • Anania C.
        • Martino F.
        • et al.
        Management of metabolic syndrome in children and adolescents.
        Nutr. Metab. Cardiovasc. Dis. 2011; 21: 455-466
        • Noto D.
        • Niglio T.
        • Cefalù A.B.
        • et al.
        Obesity and the metabolic syndrome in a student cohort from Southern Italy.
        Nutr. Metab. Cardiovasc. Dis. 2009; 19: 620-625
        • Martino F.
        • Puddu P.E.
        • Pannarale G.
        • et al.
        Arterial blood pressure and serum lipids in a population of children and adolescents from southern Italy: the Calabrian Sierras Community Study (CSCS).
        Int. J. Cardiol. 2013; 168: 1108-1114
        • Martino F.
        • Puddu P.E.
        • Pannarale G.
        • et al.
        Metabolic syndrome among children and adolescents from Southern Italy: contribution from the Calabrian Sierras Community Study (CSCS).
        Int. J. Cardiol. 2014; 177: 455-460
        • Martino F.
        • Puddu P.E.
        • Pannarale G.
        • et al.
        Hypertension in children and adolescents attending a lipid clinic.
        Eur. J. Pediatr. 2013; 172: 1573-1579
        • Steinberger J.
        • Daniels S.R.
        • Eckel R.H.
        • et al.
        Progress and challenges in metabolic syndrome in children and adolescents: a scientific statement from the American Heart Association atherosclerosis, hypertension, and obesity in the young Committee of the Council on cardiovascular disease in the young; council on cardiovascular nursing; and council on nutrition, physical activity, and metabolism.
        Circulation. 2009; 119: 628-647
        • Goodman E.
        • Daniels S.R.
        • Meigs J.B.
        • Dolan L.M.
        Instability in the diagnosis of metabolic syndrome in adolescents.
        Circulation. 2007; 115: 2316-2322
        • Zimmet P.
        • Alberti K.G.
        • Kaufmann F.
        • et al.
        The metabolic syndrome in children and adolescents - an IDF consensus report.
        Pediatr. Diabetes. 2007; 8: 299-306
        • Cook S.
        • Weitzman M.
        • Auinger P.
        • Nguyen M.
        • Dietz W.H.
        Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994.
        Arch. Pediatr. Adolesc. Med. 2003; 157: 821-827
        • Brambilla P.
        • Lissau I.
        • Flodmark C.E.
        • et al.
        Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome.
        Int. J. Obes. 2007; 31: 591-600
        • García Cabrera S.
        • Herrera Fernández N.
        • Rodríguez Hernández C.
        • Nissensohn M.
        • Román-Viñas B.
        • Serra-Majem L.
        KIDMED test; prevalence of low adherence to the Mediterranean diet in children and young; a systematic review.
        Nutr. Hosp. 2015; 32: 2390-2399
        • Li C.
        • Ford E.S.
        • Mokdad A.H.
        • Cook S.
        Recent trends in waist circumference and waist-height ratio among US children and adolescents.
        Pediatrics. 2006; 118: e1390-e1398
        • Sarrafzadegan N.
        • Gharipour M.
        • Sadeghi M.
        • NouriF A.S.
        • Zarfeshani S.
        Differences in the prevalence of metabolic syndrome in boys and girls based on various definitions.
        ARYA Atheroscler. 2013; 9: 70-76
        • Martino F.
        • Pannarale G.
        • Puddu P.E.
        • et al.
        Is it possible a new definition of metabolic syndrome in childhood?.
        Eur. Rev. Med. Pharmacol. Sci. 2015; 19: 4324-4331
        • Menotti A.
        • Puddu P.E.
        How the Seven Countries Study contributed to the definition and development of the Mediterranean diet concept: a 50-year journey.
        Nutr. Metab. Cardiovasc. Dis. 2015; 25: 245-252
        • Kastorini C.M.
        • Panagiotakos D.B.
        • Chrysohoou C.
        • et al.
        Metabolic syndrome, adherence to Mediterranean diet and 10-year cardiovascular disease incidence: the ATTICA study.
        Atherosclerosis. 2016; 246: 87-93
        • Velázquez-López L.
        • Santiago-Díaz G.
        • Nava-Hernández J.
        • Muñoz-Torres A.V.
        • Medina-Bravo P.
        • Torres-Tamayo M.
        Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity.
        BMC Pediatr. 2014; 14: 175
        • Di Bonito P.
        • Valerio G.
        • Grugni G.
        • et al.
        Comparison of non-HDL-cholesterol versus triglycerides-to-HDL-cholesterol ratio in relation to cardiometabolic risk factors and preclinical organ damage in overweight/obese children: the CARITALY study.
        Nutr. Metab. Cardiovasc. Dis. 2015; 25: 489-494
        • Menotti A.
        • Puddu P.E.
        • Lanti M.
        • Maiani G.
        • Catasta G.
        • Alberti F.A.
        Lifestyle habits and mortality from all and specific causes of death: 40-year follow-up in the Italian rural areas of the Seven Countries Study.
        J. Nutr. Health Aging. 2014; 18: 314-321
        • Menotti A.
        • Puddu P.E.
        • Maiani G.
        • Catasta G.
        Lifestyle behaviour and lifetime incidence of heart disease.
        Int. J. Cardiol. 2015; 201: 293-299
        • Wicklow B.A.
        • Becker A.
        • Chateau D.
        • Palmer K.
        • Kozyrskij A.
        • Sellers E.A.
        Comparison of anthropometric measurements in children to predict metabolic syndrome in adolescence: analysis of prospective cohort data.
        Int. J. Obes. 2015; 39: 1070-1078
        • de Moraes A.C.
        • Carvalho H.B.
        • Siani A.
        • et al.
        Incidence of high blood pressure in children - effects of physical activity and sedentary behaviors: the IDEFICS study: high blood pressure, lifestyle and children.
        Int. J. Cardiol. 2015; 180: 165-170
        • Yannakoulia M.
        • Lykou A.
        • Kastorini C.M.
        • et al.
        Socio-economic and lifestyle parameters associated with diet quality of children and adolescents using classification and regression tree analysis: the DIATROFI study.
        Public Health Nutr. 2016; 19: 339-347