Abstract
BACKGROUND: Healthy eating habits during childhood and adolescence are essential to support optimal nutritional status and may influence health in adulthood. This study assessed nutritional status and adherence to the Mediterranean diet (MD) among Albanian students. METHODS: A cross-sectional study was conducted on a convenience sample of 388 students aged 9-17 years living in Vlora and Tirana. Data collected included sociodemographic information, anthropometric measurements, and KIDMED index. Factors associated with poor MD adherence were investigated using univariate analysis and multivariable logistic regression (AORs: 95% CIs). RESULTS: Data from 388 students were included in the analysis (mean age: 13.0 ± 1.9 years; 54.1% females). Pre-adolescents (≤13 years) accounted for 53.4% of the sample, while adolescents (>13 years) accounted for 46.6%. Overall, 35% of students were overweight or obese. The mean KIDMED score indicated suboptimal MD adherence (5.5 ± 2.6), with significant differences by sex (females 5.2 ± 2.7 vs. males 5.8 ± 2.5; p = 0.03), place of residence (Vlora 5.8 ± 2.5 vs. Tirana 5.2 ± 2.6; p = 0.05), and age (≤13 years 6.1 ± 2.3 vs. >13 years 4.8 ± 2.7; p < 0.001). Adolescence was the strongest predictor of poor MD adherence (AOR 3.25; 1.96-5.38; p < 0.001). CONCLUSIONS: The MD is a key dietary pattern for supporting health across the life course. Girls and adolescents showed poorer MD profiles. Further research is needed to clarify the determinants that drive suboptimal dietary behaviors in Albanian youth, in line with growing concerns about the "hidden crisis" of adolescent nutrition.