Assessment of the compliance with the Mediterranean diet using KIDMED Index in Moroccan school-aged adolescents

Background

Healthy eating habits acquired during childhood and adolescence may persist into adulthood and provide health benefits. Given the internationally reported shift away from the Mediterranean diet (MD) among young people, evaluating dietary practices and implementing nutrition education in this vulnerable population are crucial. The availability of standardized assessment tools is therefore important.

Objective

This study aimed to assess adherence to the MD among Moroccan school-aged adolescents using Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) index.

Methods

A cross-sectional school-based survey was conducted among 386 school-going adolescents, aged 14–18 years. A research-developed questionnaire was used to collect sociodemographic and socioeconomic data; the KIDMED index was applied to assess adherence to the MD. Weight, height, and waist circumference were measured; body mass index and waist-to-height ratio were calculated.

Summary

Overall, 53.6% and 7.8% of participants had low and optimal MD adherence, respectively. Poor adherence was more frequent among girls than boys (59.2% vs. 44.6%), whereas moderate and optimal adherence were more frequent among boys than girls (45.9% vs. 34.0% and 9.5% vs. 6.7%, respectively; p  = 0.019). The mean KIDMED score was 4.27 ± 2.20 and was higher in boys than girls (4.70 ± 2.01 vs. 4.00 ± 2.27; p  = 0.002).

This study revealed low adherence to the MD, possibly reflecting a dietary shift toward ultraprocessed foods. The KIDMED index was useful for assessing MD adherence, although it should be updated to align with contemporary dietary guidelines and core MD principles. Schools, parents, and policymakers should promote nutrition education and facilitate adolescents’ access to healthy Mediterranean foods.