Mediterranean Diet Adherence in Italian Children: How much do Demographic Factors and Socio-Economic Status Matter?

Objectives. This cross-sectional study aimed to evaluate the degree of children's adherence to the Mediterranean Diet (MD), to estimate the weekly cost of MD, and to assess the role of food cost and demographic/socio-economic factors as potential barriers to comply with a healthy dietary model.Methods. Data collection was conducted through an online questionnaire sent to parents of children (6-11 years old) living in Italy. This survey allowed the collection of demographic/socio-economic information about the family and their dietary habits. Adherence to the MD in children was assessed through the KIDMED index. The weekly diet cost was calculated based on the food prices of two Italian supermarket chains. Descriptive statistics and inferential tests were run to evaluate the sample's characteristics and correlations between diet cost, socio-demographics, and adherence to MD.Results. Data highlighted that 31.5% of the children achieved high compliance with the MD, whereas 22.2% showed low adherence. The average diet cost increased significantly with the increasing level of adherence to the MD (Spearman's Rho = 0.322, p = 0.018). Moreover, results showed that a high parent educational level was positively associated with the KIDMED score (Spearman's Rho = 0.323, p = 0.017). No significant correlations were found between dietary cost and other characteristics such as economic status and house type.Conclusions for Practice. Despite the small sample size, our results suggest that nutrition education interventions targeted at children and their parents/caregivers might favour more conscious dietary choices, which in turn will help reduce the differences in diet quality caused by the educational level gaps existing in families.Mediterranean Diet (MD) adherence may be affected by many factors, among which demographic, social, and economic ones are of great relevance. Family characteristics may, in turn, have an impact on the dietary model and nutritional status of children, who represent a vulnerable and underinvestigated population in this specific context.This study explored the cost of MD in Italian families with at least one child and highlighted that parents' educational level correlates with children's compliance to MD more decisively than demographic and economic factors. This suggests that targeted nutrition education interventions might lead families towards healthier food choices, mitigating existing educational differences.