Increased knowledge predicts greater adherence to the Mediterranean diet in Greek adolescents

Objectives: To examine knowledge of and adherence to the Mediterranean dietary pattern (MDP) among Greek adolescents, assess associations between MDP knowledge and adherence with BMI, and determine socio-cultural factors predicting MDP compliance. Design: Cross-sectional. Setting: Greek adolescents aged 15-17 years. Subjects: Two hundred adolescents (103 females, ninety-seven males) from six schools on the Greek island of Chios. The sampling procedure was similar for all schools; schools were randomly selected from different geographic areas and all Municipalities. BMI was calculated from measured height and weight; participants completed four questionnaires assessing parents' socio-economic status and education, adolescents' perceived and actual MDP knowledge, past-week dietary habits, and MDP adherence. Results: Participants' BMI indicated 64-5% were normal weight and 35-5% were overweight/obese (mean BMI 23.7 (si) 3.8 kg/m(2)). Over half had very poor MDP knowledge (58.50/6) and adherence (59.5%); both perceived (F=3.35, P=0.037) and actual MDP knowledge (F=3.45, P=0.034) were significantly different across MDP adherence. Perceived MDP knowledge was positively correlated with vegetable consumption (r = 0.185, P = 0.009); actual knowledge was negatively correlated with meat consumption (r = -0.191, P = 0.007). BMI was negatively correlated with family income (r = -0.202, P = 0.004), indicating higher BMI in less affluent households. Actual MDP knowledge was the only significant predictor of MDP adherence (standardized G = 0.162, P = 0.030) in a model accounting for 7.3% of overall variance. Conclusions: Greek adolescents reported consuming a more Westernized diet detached from the traditional MDP. Actual MDP knowledge and family income were important factors affecting MDP adherence and BMI, respectively. Promoting the traditional MDP among Greek adolescents and their families appears warranted.