title: Adherence to the Mediterranean diet and academic performance in youth: the UP&DOWN study.
abstract: OBJECTIVE
  To examine the association between adherence to the Mediterranean diet and academic performance in children and adolescents.
  
  
  METHODS
  This is a cross-sectional study conducted with 1371 youth aged 12.04 ± 2.50 years (685 girls) in Spain during 2011-2012. Adherence to the Mediterranean diet was assessed using the KIDMED index (Mediterranean Diet Quality Index in children and adolescents), which includes 16 questions on specific dietary patterns. Levels of adherence were classified into three groups: poor adherence (0-3), average adherence (4-7), and good adherence (8-12). Academic performance was assessed through school records using four indicators: math, language, an average of math and language, and grade point average score.
  
  
  RESULTS
  Adherence to the Mediterranean diet was related to academic performance (β ranging from 0.107 to 0.148; all P < 0.001) after adjusting for confounders. The group of good adherence to the Mediterranean diet had significantly higher scores in all of the academic indicators compared with the poor group (ranging from +0.429 to 0.464; all P ≤ 0.001); as well as the group of average adherence to the Mediterranean diet had significantly higher scores in all of the academic indicators compared with the poor group (ranging from +0.292 to 0.344; all P ≤ 0.06). There were no differences between the groups of good and average adherence to the Mediterranean diet.
  
  
  CONCLUSIONS
  Adherence to the Mediterranean diet may have a beneficial influence on academic performance in youth. Importantly, the benefits of adherence to the Mediterranean diet on academic performance may be stronger as youth adhered to the optimal Mediterranean diet levels.
authors.affiliation: Department of Physical Education, Sports and Human Movement, Autonomous University of Madrid, Ctra de Colmenar km 15, 28049, Madrid, Spain. irene.esteban@uam.es.
authors.forename: Irene
authors.initials: I
authors.lastname: Esteban-Cornejo
authors.affiliation: Department of Physical Education, Sports and Human Movement, Autonomous University of Madrid, Ctra de Colmenar km 15, 28049, Madrid, Spain.
authors.forename: Rocio
authors.initials: R
authors.lastname: Izquierdo-Gomez
authors.affiliation: Institute of Food Science and Technology and Nutrition, Spanish National Research Council, Madrid, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Gómez-Martínez
authors.affiliation: Department of Physical Education, School of Education, University of Cadiz, Puerto Real, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Padilla-Moledo
authors.affiliation: Department of Physical Education, School of Education, University of Cadiz, Puerto Real, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Castro-Piñero
authors.affiliation: Institute of Food Science and Technology and Nutrition, Spanish National Research Council, Madrid, Spain.
authors.forename: Ascensión
authors.initials: A
authors.lastname: Marcos
authors.affiliation: Department of Physical Education, Sports and Human Movement, Autonomous University of Madrid, Ctra de Colmenar km 15, 28049, Madrid, Spain.
authors.forename: Oscar L
authors.initials: OL
authors.lastname: Veiga
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003430:Cross-Sectional Studies; D038441:Diet, Mediterranean; D004522:Educational Status; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D010349:Patient Compliance; D013030:Spain; D011795:Surveys and Questionnaires
keywords: Academic performance; Children and adolescents; Mediterranean diet