Cross-Sectional Associations Between Mediterranean Diet Adherence, Physical Activity, Satisfaction with Physical Education, and Bicycle Use Among Primary School Children

Abstract

Background/Objectives: This descriptive cross-sectional study examined adherence to the Mediterranean diet (MD) among primary school students and its associations with out-of-school physical activity, bicycle availability and use, and satisfaction with physical education (PE). The MD is regarded as an ideal dietary pattern for promoting health during childhood and adolescence. Its well-established benefits support its integration into nutrition and health education within the PE curriculum. However, the connection between adherence to the MD and factors such as satisfaction with PE, bicycle availability and use, and out-of-school physical activity during primary education remains insufficiently explored. Methods: The study included 347 primary school students (53.6% girls; Mage = 10.55, SD = 0.97). Data were collected using an ad hoc questionnaire including sociodemographic information, out-of-school physical activity, and bicycle availability and use. MD adherence was evaluated using the KIDMED index, while satisfaction with PE was measured with the Spanish version of the Physical Activity Class Satisfaction Questionnaire (PACSQ). Results: No significant associations were found between MD adherence and out-of-school physical activity (χ2 = 0.882; p = 0.663) or bicycle use (χ2 = 4.767; p = 0.092). In contrast, a significant association was observed between MD adherence and satisfaction with PE (p < 0.002), including most of its dimensions. Conclusions: Overall, the findings indicate an association between satisfaction with PE and MD adherence, which should be interpreted as exploratory and non-causal in nature.