Weight Status, Adherence to the Mediterranean Diet, and Physical Fitness in Spanish Children and Adolescents: The Active Health Study

The aim of this study was to analyze the differences in body composition and physical fitness according to the weight status (normoweight, overweight and obese) and the level of adherence to the Mediterranean diet (MD; low, medium or high), in physically active children and adolescents. Furthermore, this study also analyzed the relationship between body composition and physical fitness with Body Mass Index (BMI), fat mass and the level of adherence to the MD. In total, 1676 participants aged 6-17 from different municipal sports schools participated in this cross-sectional study. Data on adherence to the MD (a KIDMED questionnaire), anthropometric measurements, body composition and physical fitness parameters (the 20-m shuttle run test and muscular strength) were collected. A total of 43.5% of the sample were presented as overweight and obese, and only 35.7% had high or optimal adherence to the MD. The results revealed that a normoweight status was associated with greater cardiorespiratory fitness (p< 0.05; ES: 0.50 to 0.67) and lower-body muscular strength (p< 0.05; ES: 0.58 to 1.10). The overweight group showed more significant results than the other groups in handgrip strength (p< 0.01). Greater adherence to the MD in this population indicated better physical fitness, but only in boys. It is concluded that normoweight status and optimal adherence to the MD in children and adolescents are associated with health benefits, which are significant in the body composition and the effect on physical fitness.