Adherence To The Mediterranean Diet And Risk Of Functional Constipation In Children In Turkey: Case-Control Study

Background: Functional constipation is often seen in children, affecting quality of life and imposing a considerable burden on health care services. The Mediterranean diet is associated with a lower risk of functional gastrointestinal disorders. Aims: This study aimed to evaluate the relationship between functional constipation and adherence to the Mediterranean diet in Turkish children aged 6-18 years. Methods: In this case-control study, 221 children with functional constipation (cases) were selected from a paediatric gastroenterology clinic between May 2018 and September 2019, and 230 children without constipation (controls) were randomly selected from those attending a well-child check-up. Cases and controls were matched on sex, age and socioeconomic characteristics. Compliance with the Mediterranean diet was assessed using the KIDMED index score. Multivariable logistic regression analysis was used to analyses the data. Results: KIDMED index scores in cases and controls were 4.0 (SD = 2.5) and 6.3 (SD = 2.4), respectively (P < 0.001). Odds ratios for functional constipation were 0.23 (95% confidence interval (CI): 0.13-0.38) for KIDMED index score 4-7 and 0.05 (95% CI: 0.03-0.11) for score >= 8 compared with the lowest category (score <= 3; P < 0.001). A negative correlation was observed between age and adherence to the Mediterranean diet. Conclusion: Good adherence to the Mediterranean diet was associated with a lower risk of functional constipation, and adherence to the Mediterranean diet decreased with age. Education on nutrition and health is warranted to help maintain and improve the health of young people in Turkey.