Mediterranean diet and adiposity in children and adolescents: A systematic review

Our aim was to summarize, through a systematic review, the current evidence from dietary intervention and observational studies on the impact of adherence to the Mediterranean diet on adiposity markers and obesity in children and adolescents. We searched Medline up to June 1, 2021 for the identification of intervention and observational studies meeting the inclusion criteria, following the PRISMA statement. We included 55 articles: 8 intervention studies and 47 observational studies. Three trials report a beneficial effect of the dietary intervention, whereas two did not, and three did not compare with a control. All observational studies were cross-sectional, and only five studies also included a longitudinal analysis. More than half of the cross-sectional studies found no significant association between adherence to Mediterranean diet and adiposity. Three out of the five longitudinal studies found a negative association. The majority of both observational and intervention studies was of low quality. Despite a large number of published studies, overall, there is only limited evidence of a beneficial effect of following a traditional Mediterranean diet to maintain a healthy body weight in childhood. More high-quality intervention and longitudinal data are needed to form the base of large-scale health programs to prevent childhood obesity.This paper and this supplement issue on Determinants of Childhood Obesity is an ancillary endeavour of the Science & Technology in childhood Obesity Policy (STOP) project (H2020 SC2; ref. 774548). Dr Camille Lassale received the support of a fellowship from “La Caixa” Foundation (ID 100010434). The fellowship code is LCF/BQ/PR21/11840003. Dr Andrés Moya is supported by the Ministerio de Ciencia e Innovacion (project PID2019-105969GB-I00), Generalitat Valenciana (project PrometeoII/2014/065), co-financed by the European Regional Development Fund (ERDF). Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutricion (CIBEROBN) and Centro de Investigacion Biomédica en Red Epidemiologia y Salud Publica are initiatives of the Instituto de Salud Carlos III (ISCIII) of Spain, which is financed by the European Regional Development Fund (ERDF), “A way to make Europe”/“Investing in your future” (CB06/03). It is supported by the official funding agency for biomedical research of the Spanish government, ISCIII, Spain.Peer reviewe