Adherence to Mediterranean diet in Moroccan school-age adolescents: sociodemographic, socioeconomic and lifestyle determinants

Background: Despite its benefits, the Mediterranean diet (MD) is abandoned or not adopted by the younger generations in most Mediterranean countries.

Objective: The aim here was to examine some factors determining adherence to MD in Moroccan school-age adolescents.

Material and methods: A cross-sectional survey was conducted in a school setting among 386 students (148 boys and 238 girls), aged 14 to 18 years, randomly selected and from different socioeconomic strata. A structured questionnaire was used to collect sociodemographic, socioeconomic and lifestyle data. Physical activity was assessed using the short French version of the IPAQ questionnaire. The KIDMED test was used to assess adherence to the Mediterranean diet. Weight, height and waist circumference were measured according to WHO standards. Body mass index (BMI) and waist�to-height ratio (WHtR) were calculated. Statistical ANOVA test was used for to compare multiple means, Student's t-test for independent samples, Chi² test for categorical variables and multinomial logistic regression analysis to identify factors associated with adherence to the MD amongst adolescents sample.

Results: Adherence to the MD in this population was very low, with nearly 53% having poor adherence and only 7.7% reporting optimal adherence. Multinomial regression analyses showed that poor adherence is correlated with female gender (p=0.042), low paternal education (p=0.004), limited number of meals (p=0.006), advanced age (p=0.005) and inadequate sleep duration (p=0.027). In contrast, better adherence appears to be correlated with a high number of meals per day (p<0.001) and a better socio-professional class of the father (p<0.001).

Conclusions: This study revealed a low prevalence of good adherence to MD confirming a transition of the study adolescents towards a Westernized diet. Targeted nutritional intervention programs should be implemented to improve adherence to the MD among Moroccan adolescents, by promoting healthy eating habits.