INMA: “Adherence to a Mediterranean diet in early childhood reduces the incidence of obesity at the age of 8”


An INMA study analyzes the weight of adhering to a Mediterranean diet at the age of 4 on the prevalence of overweight, and obesity at 4 years of age, and their incidence at the age of 8.

Childhood obesity is a key issue in public health. Spain presented one of the highest rates of childhood obesity among European countries, with prevalence of 10.5% for obesity and 33.7% for overweight (children aged 5–19 years, in 2016). Obesity in adolescence and adulthood is very difficult to reverse, therefore it is important to identify modifiable factors such as diet, at early stages, in order to prevent obesity and noncommunicable diseases later in life.

The traditional Mediterranean diet is a dietary pattern characterized by abundance of plant-based foods such as vegetables, legumes, fruits, nuts and cereals, the use of olive oil as main source of dietary fat, moderate-to-high intake of fish, low or moderate intake of dairy products, and a low consumption of meat. Antioxidant and anti-inflammatory properties of this diet have shown a protective role against overweight and obesity in adulthood.

However, the evidences on child health are still insufficient and suggest differences by sex and age. Investigating the effect of adherence to a Mediterranean diet at age 4 on overweight and obesity at both 4 and 8 years of age, the study published in International Journal of Obesity states that higher adherence to a Mediterranean diet is not associated with the prevalence of overweight nor obesity at 4 years of age but reduces the risk of overweight, obesity, and abdominal obesity at the age of 8.

Researchers used a validated semiquantitative food frequency questionnaire to assess the child’s usual daily intake of vegetables, fruit, legumes, cereals, fish, meat, dairy products, and olive oil. The adherence to a Mediterranean diet was scored as low, medium, and high. The body weight, height, and waist circumference of 1500 children were measured at the age 4 and 8 by trained personnel.

Authors reported that the protective effect of overweight, obesity, and abdominal obesity was mainly due to a greater intake of vegetables and olive oil, as well as a reduction in the consumption of meat, findings consistent with those from previous studies in adults. Leyre Notario, the lead author of the study explains that “Our study shows that a good adherence to a Mediterranean diet at 4 years of age reduces the risk of developing overweight, obesity and abdominal obesity at 8 years of age. If these results are confirmed, it would be highly recommended that parents, as far as possible, practice a Mediterranean diet with their children in order to reduce the risk of obesity from early ages.”

Reference: Notario-Barandiaran L, Valera-Gran D, Gonzalez-Palacios S, Garcia-de-la-Hera M, Fernández-Barrés S, Pereda-Pereda E, Fernández-Somoano A, Guxens M, Iñiguez C, Romaguera D, Vrijheid M, Tardón A, Santa-Marina L, Vioque J, Navarrete-Muñoz EM; INMA Project. High adherence to a mediterranean diet at age 4 reduces overweight, obesity and abdominal obesity incidence in children at the age of 8. Int J Obes (Lond). 2020 Mar 9. doi: 10.1038/s41366-020-0557-z. [Epub ahead of print]