Association between adherence to the Mediterranean diet and metabolic syndrome in children and adolescents: A systematic review and meta-analysis

Background: The Mediterranean diet has been associated with improved metabolic health among adults. This meta-analysis aimed to evaluate the association between adherence to a Mediterranean diet and metabolic syndrome among children and adolescents. Methods: A systematic review of the literature was conducted by searching PubMed, the Excerpta Medica Database (Embase, via OvidSP), Scopus and Web of Science, covering publications from inception to April 2024. Studies were included if they evaluated the association between adherence to a Mediterranean diet and metabolic syndrome among children and adolescents. A random-effects model was used to estimate the summary effect size. Results: A total of eight studies involving children and adolescents aged 6 to 19 years were included in the meta-analysis (n=6562, 50% girls). Low adherence to the Mediterranean diet was associated with greater odds of metabolic syndrome than was medium/high adherence (odds ratio [OR] = 2.18, 95% confidence interval [CI] 1.45 to 3.28; p < 0.001; inconsistency index [I²] = 64.15%). Conclusion: This meta-analysis suggested that increased adherence to a Mediterranean diet is associated with lower probabilities of having cardiometabolic risk among children and adolescents. Thus, our findings suggest that public health strategies are needed to implement and promote effective actions toward healthy eating habits in children and adolescents.