The Mediterranean Diet (MD) is a way of eating based on the traditional cuisine of countries bordering the Mediterranean Sea. Recognized by UNESCO as an intangible cultural heritage, the MD emphasizes plant-based cooking with an emphasis on healthy fats. It has been linked to numerous health benefits for adults, including a significant reduction in overall mortality and in morbidity and mortality from cardiovascular diseases and other major chronic diseases. Given these benefits, it is important to consider the impact of the Mediterranean diet on children and adolescents, pivotal periods that shape future health outcomes.
Why the Mediterranean Diet Matters for Kids
Eating healthy during childhood and adolescence is fundamental to growth, cognitive development, overall well-being, and school performance. Early dietary habits significantly influence long-term health outcomes. Globally, there has been a reduction in the adherence to the MD since the 1960s, while the prevalence of obesity, type 2 diabetes, and other diet-related health issues among children and adolescents has been rising. This emphasizes the need for effective dietary interventions, making the exploration of the MD within the context of early life essential.
Key Components of the Mediterranean Diet
The Mediterranean diet is high in fresh vegetables, fruits, and whole grains. It also includes oily fish (i.e., salmon, mackerel, anchovies, and sardines); nuts (i.e., walnuts, pistachios, and almonds); olive oil; legumes; and white milk (for children and adolescents). The Mediterranean diet is low in processed or convenience foods, added sugars, red meat, and saturated fats. Many components and individual foods of the Mediterranean Diet are beneficial to health (for example, extra virgin olive oil), but overall, it is the combination of foods that is linked to improved health.
Benefits of the Mediterranean Diet for Children and Adolescents
Protective Role Against Asthma
Research indicates a protective role of the MD against childhood asthma due to its antioxidant-rich components. A meta-analysis confirmed an inverse significant association between MD adherence and severe current wheeze and current wheeze.
Positive Impact on Physical Activity and Fitness
A positive correlation was observed between MD adherence and increased physical activity, improved physical fitness, quality of life, and reduced sedentary behavior. Studies confirmed that MD adherence was directly associated with cardiorespiratory fitness (CRF) improvement. A meta-analysis confirmed a direct relationship between the MD and CRF.
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Anti-Inflammatory Benefits
The MD showed an inverse relationship with pro-inflammatory biomarkers, suggesting anti-inflammatory benefits.
Other Potential Benefits
Following the Mediterranean diet allows families to focus on what they're likely missing in their meals, including fruits, vegetables, and seafood.
Potential Risks and Considerations
Inconclusive Evidence on Allergic Conditions and BMI
Evidence for the MD's impact on allergic conditions like rhinitis and eczema is inconclusive. Findings regarding anthropometric outcomes, particularly BMI, are limited and inconsistent. There is only limited evidence of the value of the MD for maintaining a healthy body weight, and no consensus on BMI.
Impact on Glucose and Insulin Levels
Researchers were surprised they didn’t find evidence of any effects on glucose and insulin levels. The impact the Mediterranean diet has on these health factors could be less pronounced, or could require a longer time frame to have an effect.
Low Adherence and Metabolic Syndrome
One study found no significant association between metabolic syndrome and Mediterranean diet in adolescents. This was a surprising result, and it was speculated that perhaps the low overall adherence in the group made it difficult to ascertain a trend.
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Other Considerations
It is always important to keep in mind a child’s preferences and to incorporate cultural traditions into any guidance around food choices.
How to Adapt the Mediterranean Diet for Kids
Not every child needs to adopt a Mediterranean diet, but it is important to increase “real foods” in children’s diets and decrease highly processed foods that have added sugars and sodium.
Making it a Lifestyle
Avoid calling it a diet. Instead, call it a lifestyle and invite the entire family to join in. Make the experience positive and fun.
Gradual Introduction
Introduce the foods gradually and in ways that children will find palatable.
Consistency
It can take 15 times or more for a child to be exposed to a new food before they try it. Keep going and don't give up on picky eaters.
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Family Involvement
Go to the grocery store together and prepare meals together.
Consistent
Be consistent. It can take 15 times or more for a child to be exposed to a new food before they try it. Craven encourages parents to keep going and not give up on picky eaters.
Kid-Friendly Mediterranean Snack Recipes
- Cheese with a piece of fruit
- Fruit with low-fat yogurt
- Nuts
- Vegetables with hummus
- 100% whole wheat bread with peanut butter
Practical Tips for Incorporating the Mediterranean Diet
- Fruits and vegetables first: Focus on fruits and vegetables first.
- Whole grains: Whole grains are an excellent source of dietary fiber.
- Healthy fats: Healthy fats, like unsaturated fats and omega-3 fatty acids, help absorb vitamins and fats children need to grow and thrive.
- Eat more seafood: There are many health benefits of eating fish, and seafood takes center stage in the Mediterranean diet.
- Dairy can be good: Dairy is important for a child's growing body.
- Flavor food with spices: The Mediterranean diet emphasizes flavoring food with spices - instead of salt.
- Families eat together: Mealtimes are a social activity in the Mediterranean, an important part of the lifestyle.