Adherence to the Mediterranean diet and academic performance in youth: the UP&DOWN study.

PURPOSE:
To examine the association between adherence to the Mediterranean diet and academic performance in children and adolescents.

METHODS:
This is a cross-sectional study conducted with 1371 youth aged 12.04 ± 2.50 years (685 girls) in Spain during 2011-2012. Adherence to the Mediterranean diet was assessed using the KIDMED index (Mediterranean Diet Quality Index in children and adolescents), which includes 16 questions on specific dietary patterns. Levels of adherence were classified into three groups: poor adherence (0-3), average adherence (4-7), and good adherence (8-12). Academic performance was assessed through school records using four indicators: math, language, an average of math and language, and grade point average score.

RESULTS:
Adherence to the Mediterranean diet was related to academic performance (β ranging from 0.107 to 0.148; all P < 0.001) after adjusting for confounders. The group of good adherence to the Mediterranean diet had significantly higher scores in all of the academic indicators compared with the poor group (ranging from +0.429 to 0.464; all P ≤ 0.001); as well as the group of average adherence to the Mediterranean diet had significantly higher scores in all of the academic indicators compared with the poor group (ranging from +0.292 to 0.344; all P ≤ 0.06). There were no differences between the groups of good and average adherence to the Mediterranean diet.

CONCLUSIONS:
Adherence to the Mediterranean diet may have a beneficial influence on academic performance in youth. Importantly, the benefits of adherence to the Mediterranean diet on academic performance may be stronger as youth adhered to the optimal Mediterranean diet levels.