Evaluating the usefulness of the Mediterranean Diet Quality Index (KIDMED) in assessing eating habits and nutritional status among preschool children.

BACKGROUND: Establishing healthy eating habits during early childhood is essential for long-term health and prevention of non-communicable diseases. The Mediterranean Diet (MD) is recognized as one of the healthiest dietary patterns worldwide. This study aimed to evaluate dietary habits and adherence to the MD among preschool children using the Mediterranean Diet Quality Index (KIDMED) and to explore the influence of parental sociodemographic and anthropometric factors on children's dietary adherence. METHODS: This cross-sectional study included 114 preschool children (24-60 months) from Sarajevo and Orašje, Bosnia and Herzegovina. Data were collected using a modified KIDMED questionnaire, assessing dietary habits and general sociodemographic information. Children's anthropometric parameters were obtained from medical records, and Body Mass Index (BMI) z-scores were calculated using WHO AnthroPlus. Descriptive statistics, group comparisons, and multiple linear regression were performed in RStudio (version 2024.12.0+467), with statistical significance set at p<0.05. RESULTS: The mean KIDMED score was 5.17±2.98 (median 6, interquartile range IQR 3-8), indicating moderate adherence to the MD. Thirty-four percent of children had a poor-quality diet, 36.8% required improvement, and 28.9% showed optimal adherence. Fruit and vegetable consumption was high, but intake of fish, whole grains, nuts, and olive oil was low. Parental education, employment, economic status, and BMI were not significantly associated with children's KIDMED scores (Regression correlation coefficient=0.249, p=0.433). CONCLUSIONS: Preschool children demonstrated moderate adherence to the MD, with clear signs of dietary westernization. Early, family-centered nutritional education is essential to promote and maintain healthy eating habits from early childhood.