Original article
Adherence to the Mediterranean diet in children: Is it associated with economic cost?
G. Albuquerquea, P. Moreiraa,b,c, R. Rosáriod,e, A. Araújoa, V.H. Teixeiraa,b, O. Lopesf, A. Moreirag,h, P. Padrãoa,c,,
a Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
b Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
c EPI Unit – Institute of Public Health, University of Porto, Porto, Portugal
d Education School, Child Study Centre, University of Minho, Braga, Portugal
e Nursing School, University of Minho Braga, Portugal
f Erdal Association, Guimarães, Portugal
g Department of Immunology, Faculty of Medicine, University of Porto, Porto, Portugal
h Department of Immunoallergology, Hospital of São João, Porto, Portugal
Received 17 October 2016, Accepted 23 January 2017

To assess how the diet cost is associated with socio-demographic factors and adherence to Mediterranean diet in children.


Data were obtained from a community-based survey of children selected from public elementary schools in Portugal. Of a total of 586 children attending these schools, 464 (6–12 years), were studied. Dietary intake was assessed by a 24hour recall and the adherence to Mediterranean diet was evaluated through the KIDMED index. The cost of the diet was calculated based on the collection of food prices of a national leader supermarket, and expressed as Total Daily Cost (TDC) and Total Daily Cost-Adjusted for Energy (TDEC). Anthropometric measures were taken and socio-demographic data were gathered from a questionnaire filled by parents. Logistic regression was used to quantify the association between diet cost, socio-demographics and adherence to Mediterranean diet.


The average TDC was 4.58€ (SD=1.24). Most children (69.1%) reported medium adherence to Mediterranean diet, and 4.6% rated the higher score. TDC was higher for children with highest adherence to Mediterranean diet, compared to those with lowest adherence [TDC: OR=5.70 (95% CI 1.53, 21.33), p for trend=0.001; TDEC: OR=2.83 (95% CI 0.89, 8.96, p for trend 0.018)]. No meaningful variation in the diet cost with age and parental education was observed.


Higher adherence to Mediterranean diet was associated with higher diet cost in children.


  • The average diet cost was 4.58€ (SD=1.24) in 6–12 years-old children.

  • Diet cost calculations were based on food prices information from 2011.

  • Most children reported medium (69.1%) or high (4.6%) adherence to Mediterranean diet.

  • Higher adherence to Mediterranean diet was associated with higher diet cost.

Diet cost, Mediterranean diet, Children

Open Access

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Porto Biomedical Journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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