The association between nutrition knowledge and adherence to a Mediterranean dietary pattern in Iranian female adolescents.

Background: Adherence to a Mediterranean dietary pattern (MDP) has been reported to decrease chronic diseases.

Objective: The aim of the present study was to determine the association between nutrition knowledge (NK) and adherence to MDP in Iranian female adolescents.

Subjects: This cross-sectional study was conducted on 297 female adolescents aged 15-18 years.

Methods: The participants were interviewed using a valid and structured questionnaire to collect information on socio-demographic, lifestyle and anthropometric variables. Dietary intakes were assessed using a validated 168-item Food Frequency Questionnaire (FFQ). Adherence to MDP was measured by the Mediterranean-Style Dietary Pattern Score (MSDPS). Each participant's NK was determined using a 20-item NK questionnaire.

Results: The mean ± standard deviation (SD) age and body mass index (BMI) of participants were 16.1 ± 0.9 years and 22.3 ± 4.6 kg/m, respectively. The median [interquartile range (IQR)] of the NK score and the MSDPS were 80.0 (68.0-87.0) and 15.2 (11.9-19.5), respectively. The odds ratio (OR) of higher adherence to MDP in the highest tertile of the NK score was 2.19 [95% confidence interval (CI): 1.22-3.95; p for trend = 0.009], compared to the lowest tertile after adjusting for age and energy intake. In a multivariable-adjusted model, after further adjustment for BMI, mother's/father's education level, mother's/father's employment status, parent's marital status and physical activity, the subjects in the highest tertile of the NK score had higher adherence to MDP compared with those in the lowest tertile (OR = 2.05; 95% CI, 1.09-3.83; p for trend = 0.013).

Conclusion: Our findings support the hypothesis that a higher NK score is significantly associated with a higher MDP adherence score in Iranian female adolescents.