Is adherence to the 24-Hour Movement Guidelines associated with Mediterranean dietary patterns in adolescents?

Multiple health-risk behaviours such as physical inactivity, excessive recreational screen time, and insufficient sleep have been independently and positively associated with poor adherence to the Mediterranean diet in adolescents. However, little is known about the combined association between 24-Hour Movement Guidelines (i.e., physical activity, screen time, and sleep duration) and adherence to the Mediterranean diet. The aim of the present study was to examine whether adolescents who meet all three 24-Hour Movement Guidelines report greater adherence to the Mediterranean diet, and the different foods that comprise it, compared to those who do not meet the three recommendations. In this cross-sectional study, 1391 Spanish adolescents (13.08 ± 0.85, 44.82% girls), aged 11–16 years, completed self-reported questionnaires on physical activity, recreational screen time, sleep duration and adherence to the Mediterranean diet. A binary logistic regression analysis was used to predict the likelihood of having an optimal adherence to the Mediterranean diet, as well as different food items, according to the meeting of the three 24-Hour Movement Guidelines. Covariates included were age, sex, socioeconomic status, and body mass index (z-score). Adolescents who met all three 24-Hour Movement Guidelines obtained higher adherence to the Mediterranean diet than those who did not meet with the three recommendations (β = 1.33, 95% confidence interval [CI]: 0.81, 1.85, p