Adherence to the Mediterranean diet and academic performance in adolescents: Does BMI status moderate this association?

Background: Adolescence is a critical period for neurodevelopment, it is characterised by the establishment of behavioural patterns that can affect children's physical, mental and cognitive health, both immediately and later in life. Objective: The aim of the present research was to examine the association between adherence to the Mediterranean diet (MeD) and academic performance, as well as to analyze the moderating role of body mass index (BMI) status in this relationship. Methods: This cross-sectional study had a total 1290 adolescents (13.07 +/- 0.82 years old, 714 boys and 576 girls) aged 12-14 years were included in this study. Adherence to the MeD was assessed using the Mediterranean Diet Quality Index. Academic performance was assessed through school records using four subjects: language, mathematics, English and grade point average (GPA). Results: Results showed a positive association between adherence to the MeD and all academic indicators after adjusting for potential confounders (b ranging from 0.165 to 0.213, all p < 0.001). The group of good adherence to the MeD had significantly higher scores in all the academic indicators compared with the poor/average group (p < 0.01). No interaction was found between BMI status and adherence to MeD in relation to academic indicators (all p > 0.340). These differences remained significant for both normal weight and overweight/obesity groups (p < 0.01). Conclusions: Our results suggest that adherence to the MeD may be positively associated academic performance on adolescents regardless, of BMI status. (c) 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.