ArticleEuropean journal of pediatrics2025
Validity of the MED4CHILD tool for assessing adherence to the Mediterranean diet in preschool children.
Article in European journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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Who cites it
3 citing papers in PubMed.
- A Mediterranean lifestyle obesity prevention intervention in preschoolers at risk: MELI-POP Study-a randomized controlled trial.European journal of pediatrics · 2026Trial
- Sustainable Plant-Based Diets in Children and Adolescents: Current Evidence on Metabolic Syndrome and Cardiometabolic Health.Current nutrition reports · 2026Review
- Eating Behavior and Eating Habits: From Infancy to Adolescence.Nutrients · 2026Review
Corrections and comments
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Authors and funding
23 authors.
Funding
Abstract
Most of the available tools to assess adherence to Mediterranean diet (MedDiet) were constructed for adults, having limited applicability to children and adolescents. The aim of this study is to validate a specific questionnaire to assess adherence to MedDiet in children aged 3 to 6 years (MED4CHILD questionnaire). The validation was performed in a baseline examination of a cohort of children who were recruited in schools in seven cities. Of the total sample of 1509 children, we included 858 children aged 3 to 6 years with complete information on adherence to the MedDiet, food consumption, anthropometry and cardiometabolic characteristics. Adherence to the MedDiet was assessed using an 18-item questionnaire, adapted from validated questionnaire for adults using the Delphi method. Food and beverage consumption was assessed using a validated COME-Kids Food and Beverage Frequency Questionnaire. Anthropometric measurements and cardiometabolic risk factors were assessed using standard methods. Statistical analyses included kappa agreement, ANOVA and linear regression models. Higher MED4CHILD scores were associated with higher intakes of food characteristic of the MedDiet. The MED4CHILD questionnaire showed moderate validity, especially for key items of the Mediterranean diet (kappa ranging from 0.333 to 0.665). Direct significant associations were found between MED4CHILD scores and cardiometabolic profile, including waist circumference (p), triglycerides and HOMA-IR (p < 0.05).
conclusionThe 18-item MED4CHILD questionnaire showed moderate validity for assessing adherence to the MedDiet in children aged 3 to 6 years, in terms of agreement with food and beverage consumption and favourable cardiometabolic profile. WHAT IS KNOWN: • The Mediterranean diet has been linked to a number of health benefits and the assessment of children's adherence to this diet is important for public health and research. • The tools available to assess MedDiet compliance are mainly for adults. WHAT IS NEW: • The MED4CHILD questionnaire is a simple, inexpensive and rapid tool for assessing MedDiet compliance in children. • This tool showed moderate relative validity and a high score was associated with a favourable cardiometabolic profile.
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