title: Mediterranean diet and physical activity impact on metabolic syndrome among children and adolescents from Southern Italy: Contribution from the Calabrian Sierras Community Study (CSCS).
abstract: OBJECTIVE
  The aim of this study was to assess the impact of Mediterranean diet (MD) and physical activity on metabolic syndrome (MS) prevalence in children and adolescents.
  
  
  METHODS
  This cross-sectional study was carried out in 863 boys and 780 girls, 6-14years old, from primary and secondary schools in a 14-town Southern Italian community. We modified the KIDMED questionnaire to adapt it to the local reality.
  
  
  RESULTS
  Poor adherence to MD was seen in 18.4% of children and adolescents, while 81.6% had a medium-high compliance and the prevalence of MS was 6.6% and 3.7% respectively (OR: 1.8; 95% C.I.: 1.06-3.11; p=0.013). When participants had less physical activity, MS was more frequent as compared to those more active (5.3% versus 2.3%; OR: 2.3; 95% C.I.: 1.3-4.3; p=0.0068) which had a parallel counterpart when comparing those accustomed to seeing television for less or more than 5h per day and MS prevalence was 12.3% versus 3.8% (OR: 3.38; 95% C.I.: 1.66-6.86, p=0.0008), respectively. Finally, there was a specific abnormality in triglyceride levels, both in girls and boys, when participants were classified according to bad lifestyles, based on the combined evaluation of scarce adherence to MD and less extracurricular physical activity, accompanied by a 7-fold increased prevalence of MS as compared to those with the best lifestyle (11.0% versus 1.6%; p=0.025).
  
  
  CONCLUSIONS
  There is an apparent importance of healthier lifestyle habits including physical activity and adherence to the MD also among children and adolescents.
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy. Electronic address: francesco.martino30@tin.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Martino
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: paoloemilio.puddu@uniroma1.it.
authors.forename: Paolo Emilio
authors.initials: PE
authors.lastname: Puddu
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy. Electronic address: lamacchia.feliciana@gmail.com.
authors.forename: Feliciana
authors.initials: F
authors.lastname: Lamacchia
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy. Electronic address: chiara.colantoni@gmail.com.
authors.forename: Chiara
authors.initials: C
authors.lastname: Colantoni
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy. Electronic address: cristina.zanoni@yahoo.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Zanoni
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: francesco.barilla@uniroma1.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Barillà
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy. Electronic address: elianamartino@inwind.it.
authors.forename: Eliana
authors.initials: E
authors.lastname: Martino
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy. Electronic address: francesco.angelico@uniroma1.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Angelico
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D038441:Diet, Mediterranean; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000178:diet therapy* / Q000453:epidemiology*; D012111:Residence Characteristics; D011795:Surveys and Questionnaires
keywords: 6–14years; Adolescents; Children; Lifestyle; Mediterranean diet; Metabolic syndrome