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Adherence to the Mediterranean dietary pattern and BMI change among US adolescents



Among adults, the Mediterranean dietary pattern (MDP) is inversely related to body mass index (BMI). Data are lacking on adherence to the MDP among youth in the United States and whether the MDP is related to weight change in that group.


To assess whether adherence to the MDP was associated with BMI change among adolescents. To examine temporality, we studied the association between baseline and 2–3-year changes in adherence to the MDP with concurrent changes in BMI, as well as subsequent changes in BMI over a 7-year period.


We prospectively followed 6002 females and 4916 males in the Growing Up Today Study II, aged 8–15 years in 2004, living across United States. Data were collected by questionnaire in 2004, 2006, 2008 and 2011. Dietary intake was assessed by the Youth/Adolescent Questionnaire. The KidMed Index was derived to measure the adherence to the MDP. We used generalized estimating equations with repeated measures within subjects to assess the association between MDP and BMI change.


A two-point increment in the KidMed Index was independently associated with a lower gain in BMI (−0.04 kg m−2; P=0.001). A greater increase in adherence to the KidMed Index was independently related to a lower gain in BMI in both the concurrent (P-for-trend<0.001) and the subsequent period (P-for-trend=0.002).


Adherence to MDP was inversely associated with change in BMI among adolescents. Two-year improvement in adherence to MDP was independently associated with less steep gain in the BMI in both the concurrent and the subsequent period.

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We thank the thousands of participants in the Growing Up Today Study II and their mothers. The Growing up Today Study II is supported by the Breast Cancer Research Foundation and the grants R01-DK084001 and R01-HL096905 from the National Institute of Health.

Author contributions

NM-C, JEC and AEF designed the research and developed the statistical methods; JEC and JF assisted with the statistical analysis. NM-C performed statistical analysis and drafted the paper; JEC, JF, FBH and AEF provided critical feedback on drafts of the manuscript. AEF had primary responsibility for final content. All authors read and approved the final manuscript.

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Correspondence to A E Field.

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Martin-Calvo, N., Chavarro, J., Falbe, J. et al. Adherence to the Mediterranean dietary pattern and BMI change among US adolescents. Int J Obes 40, 1103–1108 (2016).

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