Enhancing nutritional knowledge and self-regulation among adolescents: efficacy of a multifaceted food literacy intervention.

This health literacy intervention study, conducted on adolescent students, aimed to evaluate the impact of a comprehensive educational program on promoting healthy eating habits. The intervention sought to enhance adolescents' knowledge about nutrition, foster self-regulation skills, and ultimately improve their overall health, including their body mass index (BMI). Through a multi-component approach that combined theoretical learning with practical activities and the integration of digital tools such as the MyFitnessPal app, the study targeted improvements in food literacy, which encompasses nutrition knowledge, food label interpretation skills, and cooking abilities. These elements are critical in influencing adolescents' food choices and eating behaviors, with a focus on increasing the consumption of fruits and vegetables while reducing the intake of fast food and processed snacks. The intervention was structured around a series of educational workshops and interactive sessions, facilitated by professionals experienced in nutrition. These sessions covered topics such as food composition, the importance of a balanced diet, and strategies for avoiding excessive consumption of processed and high-energy-density foods. A distinctive feature of the program was its use of digital tools to enhance engagement and allow for the practical application of learned concepts through food tracking and activity monitoring. Preliminary results indicate positive outcomes in terms of increased food knowledge and improved dietary habits among participants. Notably, there was a significant improvement in adolescents' BMI, highlighting the potential of food literacy interventions to contribute to better physical health outcomes. The study underscores the importance of adopting multidisciplinary and technology-enhanced approaches in educational programs aimed at promoting healthy eating among adolescents. The study's findings suggest that well-structured food education programs, tailored to address the specific needs of adolescents, can facilitate positive changes in eating behavior. This highlights the critical role of food literacy in adolescents' health and wellbeing and points to the need for continued investment in research and development to optimize intervention strategies. The integration of digital technologies and a focus on self-regulation strategies are identified as promising avenues for future research and educational practice, reinforcing the call for innovative investments in food education and health promotion among the youth.

A cross-sectional study of the association between food literacy and dietary intake among Danish adolescents.

Food literacy is theorized to be associated with healthy dietary intake. However, empirical knowledge on the association between adolescents' food literacy and dietary intake is limited. The aim of this study was to investigate the association between food literacy and dietary intake among Danish schoolchildren aged 11-13 years. The study applied a cross-sectional design using baseline data from a cluster-based quasi-experimental controlled study in a sample (n = 377) of Danish school children. Mixed model analyses were performed to investigate the associations between overall food literacy as well as its five competencies ("to know", "to do", "to sense", "to care", and "to want") and dietary intake of vegetables, fruit, fish, meat, discretionary foods, and sugar-sweetened beverages. Positive associations were found between overall food literacy (E = 1.493, p = 0.002) as well as the competencies "to know" (E = 1.249, p = 0.027), "to do" (E = 1.236, p = 0.028), "to sense" (E = 1.183, p = 0.029), and "to care" (E = 1.249, p = 0.018) and intake of vegetables. The study also found a positive association between the competency "to want" and intake of fruit (E = 13.50, p = 0.037), "to care" and intake of fish (E = 2.050, p < 0.001), and a negative association between the competency "to want" and intake of meat (E = 0.748, p = 0.003) and sugar-sweetened beverages (E = 0.576, p = 0.0021). No associations were found between overall food literacy or any of its five competencies and intake of discretionary foods. These findings suggest that improving specific aspects of food literacy may have a potential to promote healthier dietary intake, though additional research is needed.

Psychological differences and similarities between vegans, prospective vegans, and vegetarians. Motivation, knowledge, vegan literacy - and cheese.

Introduction: Although vegan and vegetarian diets and lifestyles differ significantly from each other, among other things, notably in their respective consequences regarding animal welfare and their ecological impact, vegans and vegetarians are often grouped together and usually compared to omnivores in psychological research. Considering that vegans and vegetarians often share similar motives for their lifestyle choices, namely animal and environmental issues, the question arises why similar motives lead to different conclusions and correspondingly different behaviors, most notably, of course, that vegetarians consume animal-derived foods such as cheese or milk while vegans do not consume animal-derived products (e.g., food, cosmetic products). This is why this study explored the psychological differences between vegans, vegetarians, and prospective vegans - the latter group being located in an intermediate, transitionary position. Focusing on the motivational, affective and cognitive components of dietary transition and participants' adherence to eating patterns, reasons for said patterns, possible hinderances to becoming vegan, the role of participants' social environments, and the impact of various misconceptions regarding the feasibility of a vegan diet in everyday life were all explored. Methods: An observational study was conducted via online questionnaire (1420 participants). Results: Significant differences were found between vegans, prospective vegans, and vegetarians, especially concerning their knowledge of issues pertaining to their respective lifestyles. Discussion: The critical role of knowledge is invoked as an explanation as to why vegans and vegetarians display different behaviors although they share a similar motivation. Thus, in this study the concept of vegan literacy is introduced. Additionally, the distinctive role of cheese is explored, discussing possible indications of its potentially addictive nature and, consequently, the importance of cheese as a hindering factor for pursuing a vegan diet.

Promoting Nutrition and Food Sustainability Knowledge in Apprentice Chefs: An Intervention Study at The School of Italian Culinary Arts-ALMA.

Chefs' decisions can greatly improve the quality of food provided and positively guide diners' choices. Culinary students' knowledge of healthy and sustainable nutrition is still scarcely investigated and is limited to the nutritional aspect of the diet, without considering food sustainability or the environmental impact of foods. This study aims to determine the effectiveness of an educational program designed for apprentice chefs. Two questionnaires were administered twice to each student who followed dedicated lectures about nutrition and food sustainability and to other students enrolled as the control group. A total of 264 and 252 apprentice chefs of The School of Italian Culinary Arts-ALMA were enrolled in the control and intervention groups, respectively. At baseline, both groups showed a good level of nutrition knowledge, whereas food sustainability knowledge was lower in all students, regardless of the group. This educational intervention proved to be effective in improving knowledge about nutrition and the environmental impact of food production and consumption. However, a small but significant improvement in nutritional knowledge was also found over time in the control group. Finally, a food sustainability knowledge questionnaire was developed and validated for this study, providing interesting results to be treated as a guide for future developments.

A Specific Carbohydrate Diet Virtual Teaching Kitchen Curriculum Promotes Knowledge and Confidence in Caregivers of Pediatric Patients with Inflammatory Bowel Disease.

Diet-based approaches such as the Specific Carbohydrate Diet (SCD) have proposed health benefits for patients with Inflammatory Bowel Disease (IBD). Despite its potential effectiveness, patients and caregivers identified barriers towards implementing the SCD, and a majority expressed interest in formal education surrounding the SCD. This study aimed to determine the impact of a virtual teaching kitchen curriculum on caregivers' knowledge and perspectives on implementing the SCD. Inclusion criteria included pediatric patients with IBD aged 3-21 years and their caregivers. Participants should have fewer than 12 months of experience with the SCD or have no experience with the SCD but with an interest in learning it. Twenty-three caregivers took part in a 90-min virtual teaching kitchen curriculum and completed pre- and post-session surveys. Caregivers had statistically significant increases in total curriculum scores (p < 0.0001) as well as increases in all curricular elements post-curriculum teaching. Caregivers indicated that they plan to apply the newly acquired recipes and cooking concepts and appreciated the encouragement and support they received during the course. Curricular strengths identified included the innovative multimodal curriculum structure and professional and community support. IBD centers can use this pilot study to create or expand SCD and other nutritional curricula for the IBD community.

A new methodology to structure a nutrition educational course: the results of a short-term educational-intervention pilot study.

The incidence of malnutrition in developing countries, such as Kenya, is still high. The most recent international reports outline an increase in the prevalence of overnutrition in Sub-Saharan Africa, where undernutrition and hidden hunger conditions still represent an emergency. Among the factors influencing malnutrition conditions connected to dietary intake and eating habits, evidence shows the importance of food knowledge. Traditionally, in developing countries, women represent the pillar of the food system and impact their children's nutrition: food-based, women-centred strategies are recommended to address nutrient gaps, educate and empower women, and counteract malnutrition. The short communication presents the results of the ACTION project: an educational-intervention pilot study targeting childbearing-age women living in rural areas of Southern Kenya. To evaluate the feasibility of the educational course built, the authors administered to the women a food knowledge questionnaire, before and after the intervention. Study results describe an increase in women's food knowledge after attending the food education course. This encourages to increase education courses which can represent a starting point in improving food habits with a positive effect on the health condition in developing counties too.

Food knowledge level among Tanzanian women of childbearing age: developing a score for the food knowledge questionnaire.

Food knowledge (FK) is one of the factors that contribute to malnutrition conditions in developing countries, together with food safety, food security and food access. FK is defined as 'the competence to understand healthy nutrition concepts'; it impacts individuals' life due to its relationship with food behaviour and eating habits. Therefore, acting on FK can represent a starting point for improving the health status of vulnerable populations. The authors present a total score of an FK questionnaire (FKQ) and its relation to the socio-demographic characteristics of a specific target population: Tanzanian women of childbearing age. The results of the manuscript complement evidence of construct validity of the FKQ by providing an algorithm to compute a total score as a measure of FK. The strength of this tool, and its score, lies in the fact that the questionnaire has been validated and is easy to administer.

Traditional food knowledge of local people and its sustainability in mountains of Uttarakhand State of India.

With homogenisation of various cultural groups due to outside forces and the effect of globalisation, many traditional foods, as developed by various cultural groups, have been lost or on the verge of elimination. In this context, the present study aims to examine and document the traditional food knowledge of local people in Uttarakhand State of India. Interviews and interactions with the local people resulted in documentation of 38 cuisines traditionally prepared by the local people of selected study regions in Uttarakhand. Apart from boiled rice and chapattis (flatbread) of wheat flour, chapattis and porridge of finger millet flour and boiled barnyard and foxtail millets were frequently consumed dishes in combination with dishes made with locally grown pulses such as horse gram and black gram and vegetables such as potato, radish and other leafy vegetables. The supplementary dishes were locally called as fanu, chaisu, gathoni, thechwani, kafli and kadhi. Plants formed the major ingredients in making traditional cuisines. The present study documented 41 plant species comprising of cereals, millets, pulses and spices. With a view to enhance the taste of the dishes, different spices and condiments such as Allium humile, Allium wallichii, Cleome viscosa, Cannabis sativa, Perilla frutescens and Cinnamomum tamala were used by the local people. These dishes possessed some unique characteristics and ethno-medicinal values; hence, when required, they were used to cure a number of ailments as well. Since most of the mountain region in the study area was once inaccessible and health facilities were not much developed till recent times, the traditional health-care system was supported by the traditional food systems. The findings of the present study are further discussed in the context of sustainability of socio-ecological systems of Uttarakhand.

Fruit and Vegetable Intake Is Associated with Food Knowledge among Children Aged 9-14 Years in Southwestern Ontario, Canada.

Interventions to improve dietary quality and intake of fruits and vegetables (FV) among Canadian children have had modest success, and it has been suggested that food knowledge could be key to improvement. Programs have been criticized for insufficiently connecting food knowledge with food skills and decision making about dietary intake. The objective of this study was to investigate factors associated with FV consumption by elementary school children, aged 9-14 years, in Ontario, Canada, including food knowledge, socioeconomic status, sociodemographic characteristics, and the food environment. In 2017-2019, a cross-sectional survey was administered to 2443 students at 60 elementary schools across Southwestern Ontario (SWO), Canada. A parent survey was used to validate self-reported sociodemographic variables. The mean intake of FV reported by these participants was 2.6 (SD 1.1) and 2.4 (SD 1.2) servings/day, respectively. A FV intake below WHO guidelines was reported by 40.7% of respondents. Knowledge score, child age, and parent employment status significantly predicted higher reported intake of FV. This study shows that FV intake among this population group is low, and increased intake is associated with higher food knowledge. To encourage healthy eating, school-based food and nutrition programs that incorporate multiple components and emphasize food literacy are needed.

Cameras in the Hands of Indigenous Youth: Participation, Films, and Nutrition in India.

Background: Indigenous communities in India have diets that do not fulfill all of their minimum nutritional requirements. Given the unaffordability of healthy diets, these communities rely on common-pool resources to make up for shortfalls in food. Yet, such foods are devalued as "backward," and accessing them is regulated by unequal gendered roles. Objectives: To explore the central role of community participation in documenting and transmitting indigenous knowledge about the role of locally available foods in improving dietary diversity. Methods: Through a participatory action research approach, 10 Santhal youth were trained to make films about a range of locally available foods and other issues of concern to them (Santhal/Santal is a native ethnic group in India). These films were broadcast on a YouTube channel and screened locally. A thematic content analysis of 49 films was undertaken, alongside interviews with the filmmakers and focus group discussions with viewers who attended 4 film screenings. Results: A majority of the films produced drew on intergenerational and indigenous knowledge about edible plants, insects, and rodents; skills in foraging and preparing food; awareness of the benefits of the food; and sustainability issues across the traditional food systems. The filmmakers initially focused on responding to community needs and showcasing Santhal cultural practices. Their later films began to reflect on aspects of their culture that needed to be preserved, revived, or modified. Audiences noted the relatability and relevance of the provided information, generated ideas and priority themes for further documentation, and expressed the need for revival and modification of certain cultural food practices. Conclusion: A participatory filmmaking process in the context of community nutrition can enable participants to question unequal power relations by enabling the most marginalized to voice their own perspectives with the support of cameras and filmmaking skills.

Nutrition and food literacy among young Canadian adults living with type 1 diabetes.

AIM: Nutrition and food literacy encompasses knowledge, skills and confidence to prepare healthy meals. This project aimed to assess and compare the proportion of young Canadian adults (18-29 years old) living with type 1 diabetes and without diabetes (controls) who demonstrated adequate nutritional health literacy. METHODS: This cross-sectional study involved participants completing an online survey that included questions on socio-economic status, nutrition knowledge, confidence and skills in meal preparation and the Short Food Literacy Questionnaire (SFLQ). Proportion of participants with adequate SFLQ score (i.e. ≥34/52) was compared between the groups (two-sample t-test). RESULTS: Among the 236 people living with type 1 diabetes and 191 controls (81.5% women), mean age was 24 ± 3 years for people living with type 1 diabetes and 22 ± 3 years for controls (p < 0.001). More people living with type 1 diabetes reported adequate SFLQ score (people living with type 1 diabetes 88.0% vs. Controls 68.0%; p < 0.001). Similarly, majority of people living with type 1 diabetes prepared their own meals compared to the controls (74.5% vs. 47.6%; p < 0.001). Enhanced SFLQ score was associated with higher cooking skills (p = 0.02) and confidence (p < 0.01) in preparing healthy meals. CONCLUSIONS: Living with type 1 diabetes was associated with greater SFLQ scores among young Canadian adults. Having the independence, the confidence and skills in meal preparation were contributing factors.

Sports Nutrition and Food Knowledge among Malaysian University Athletes.

Sports nutrition and food knowledge can influence athletes' dietary intake, potentially affecting athletic performance. Limited studies have been conducted to identify sports nutrition and food knowledge among Malaysian university athletes. This study aimed to determine Malaysian university athletes' knowledge of sports nutrition and food, and their reference sources and preferred sports nutrition education programme. Seventy athletes (52.9% females, mean weight = 61.8 kg; height = 1.66 m) aged 18.5-22.4 years responded to an online survey administered using a Google Form. A score of ≥60% was considered as adequate knowledge. The average overall knowledge score was 58.6%. The highest knowledge score was for sports nutrition, specifically food intake periodicity (84.8%), while the lowest was for general food knowledge on fat (44.6%). An analysis of specific questions revealed a lack of understanding about the recommended daily intake of fruits and vegetables (only 14.3% answered correctly), the roles of vitamins and minerals in energy production (21.4%), and good sources of unsaturated fat (37.2%). The academician was the primary reference source (81%), while magazines were the least referred to sources (36%). The university athletes preferred sports camps (33%) over the other nutrition education programme options. More initiatives are needed to improve Malaysian university athletes' understanding and knowledge of sports nutrition and general food.

Validation of a Food Knowledge Questionnaire on Tanzanian Women of Childbearing Age.

The present manuscript describes the validation of a food knowledge questionnaire (FKQ) for Tanzanian childbearing age women. The FKQ was derived from the Ugandan version and was adapted according to Tanzanian culture and food habits, including 114 closed-ended questions, divided into five different sections. The FKQ was administered to 671 Tanzanian childbearing-age women who were eligible if they: (i) were aged between 14 and 49 years old, (ii) had not been diagnosed with any disease and (iii) lived in the urban or peri-urban area of the Arusha and Morogoro region. The validation process of the FKQ was conducted in Tanzania and the recruitment occurred between August and October 2020. The final version of the validated questionnaire was characterized by a total of 88 questions, divided into ten different sections; each section aimed to investigate a different aspect of food knowledge, except for section A, which collected information related to the social and demographic characteristics of the respondent. The food knowledge questionnaire showed good construct validity and content validity to assess knowledge and food practices in Tanzanian women of childbearing age and could be used in future studies to identify women at higher risk of unhealthy eating habits and food choices.

Food Literacy Scale: Validation through Exploratory and Confirmatory Factor Analysis in a Sample of Portuguese University Students.

Eating behaviors and healthy food choices are associated with food literacy, and they have a huge impact on one's health status. For that reason, to increase food literacy is a way to effectively help individuals make appropriate choices that help maintain health and diminish the incidence of non-communicable diseases. The objective of this work was to test and validate a scale to assess food literacy. The validation was conducted on a sample of 924 Portuguese university students. The scale was composed of 50 items, which were submitted to exploratory and confirmatory factors analysis. The final validated scale corresponded to a second-order model with a global factor called "Food literacy", which retained 26 items distributed by three factors: F1-literacy about the nutritional composition of foods (10 items), F2-literacy about labelling and food choices (7 items), and F3-literacy about healthy eating practices (9 items). The internal consistency of the scale is very high, with an alpha higher than 0.9, and the Pierson correlations between the three factors and the global are also higher than 0.9. In conclusion, the present scale has been validated and can therefore be utilized to measure food literacy.

Determinants and Prevention Strategies for Household Food Waste: An Exploratory Study in Taiwan.

Given the large amount of food waste coming from households, reducing household food waste is essential to the mitigation of overall food waste and the provision of multi-faceted benefits for both people and the planet. This study identifies factors and management strategies for the reduction of household food waste in the Taiwanese household setting. Using snowball sampling, semi-structured interviews are conducted to collect data from 27 household food providers in Taipei. The research findings identify four critical motivators and four barriers to minimizing household food waste in Taiwan. The most frequently mentioned motivator for the reduction of food waste is a convenient shopping environment, and the most important barrier is lack of knowledge for assessing the edibility of food. Additionally, four major prevention strategies are identified to help reduce household food waste: (1) planned purchase schedule; (2) skills to keep food fresh and longer; (3) understanding family preferences and leftover management, and (4) sharing additional food and co-procurement and cooking. The results of this study not only help improve the understanding and application of Chinese household food waste reduction, but also demonstrate the significance of its socio-cultural impacts in future studies.

The development of a food knowledge questionnaire for tanzanian women of childbearing age.

BACKGROUND: The incidence of malnutrition in developing countries, such as many of those located in Sub-Saharan Africa, is still high, especially in vulnerable categories such as women of childbearing age. Among the several factors influencing dietary intake and eating habits, evidence shows the importance of food knowledge (FK), essential in establishing and maintaining strategies aimed at reducing the burden of disease and promoting wellbeing. The present research was aimed at describing the methodology for designing a questionnaire to investigate Food Knowledge in Tanzania women of childbearing age. METHODS: The Food Knowledge Questionnaire (FKQ) was developed by adapting items from the Ugandan questionnaire to cultural background and food habits of Tanzanian women of childbearing age. A pilot version of the FKQ was tested on a small sample of respondents, 83 women of childbearing age living in the region of Arusha. After describing the sample and the scorings, the pilot version of the questionnaire was analysed through Multiple Correspondence Analysis, aimed at exploring the relationships between items and the properties of the scoring system. RESULTS: The exploratory analyses of the questionnaire allowed to identify those items not related to the others and whose scores were not related to food knowledge, therefore constituting the basis for the questionnaire to be refined and validated. DISCUSSION: The final version of the Tanzanian FKQ "to be validated" ended up consisting of five sections: Section A, about social and economic information (17 questions); Section B, related to health experts advice (5 questions); Section C1 and C2 about food groups (7+7 questions); Section D about diseases and nutrition (6 questions). The questionnaire includes 114 close-ended questions in total. The exploratory analyses performed have led to define the relationships between items and latent constructs, allowing to identify of "correct food knowledge" and "incorrect food knowledge" archetypals.

Exploring Food Literacy Domains in an Adult Samoan Population.

Samoan food systems have undergone a dramatic nutrition transition, with dietary patterns changing concurrently with increased rates of obesity and non-communicable disease. Whilst policy action and environmental interventions play an important role in improving access to and consumption of healthy food, the success of these relies on a greater understanding of individuals' food knowledge and behaviours. This study aimed to explore these behaviours using the construct of food literacy in an adult Samoan population. A cross-sectional interviewer-administered questionnaire of a convenience sample of 150 adult Samoans (≥20 years) assessed the four domains of food literacy: plan/manage, select, prepare, and eat. Participants generally plan to include healthy food (87%) and budget money for food (87%). The majority know where to find nutrition labels (68%), of which 43% always use them to inform their food choices. Participants were mostly confident with cooking skills, although food storage practices require further investigation. Over 90% agreed or strongly agreed that food impacts health, although understanding of the Pacific Guidelines for Healthy Living was lacking. Understanding the ability of Samoans to plan/manage, select, prepare, and eat food is an important consideration for future interventions aiming to assist this population in navigating the modern-day food system.

Food Sustainability Knowledge and Attitudes in the Spanish Adult Population: A Cross-Sectional Study.

Moving towards sustainable food systems and food consumption are proposed as strategies to reduce environmental impact. However, these strategies require joint action between different stakeholders, including the general population's knowledge and perception, as final consumers. To assess the knowledge and awareness on food sustainability and environmental impact concepts in a representative sample of Spanish adult population, we conducted a cross-sectional, nationally representative telephone survey. After random selection, 2052 respondents aged ≥18 years (57% woman and 43% men) participated. A questionnaire was specifically designed for the research. Participants showed a good attitude towards sustainable diets, which were described as healthy by 40% of the population. Most of the responders (>70%), did not well understand ecological and carbon footprints, and green and blue water concepts. Men declared a higher understanding of sustainability concepts, as compared to women. More than 50% of the population misunderstood the impact of meat and derivatives production on sustainability, and 70% perceived the same for fish and dairy products. Women were more prone to pay more money to afford a sustainable diet than men were. In conclusion, although consumers show a positive attitude towards sustainability, important misconceptions remain, and thus require intervention through education, information, and motivation.

Shared but Threatened: The Heritage of Wild Food Plant Gathering among Different Linguistic and Religious Groups in the Ishkoman and Yasin Valleys, North Pakistan.

A wild food ethnobotanical field study was conducted in the Ishkoman and Yasin valleys, located in the Hindukush Mountain Range of Gilgit-Baltistan, northern Pakistan. These valleys are inhabited by diverse, often marginalized, linguistic and religious groups. The field survey was conducted via one hundred and eighty semistructured interviews to record data in nine villages. Forty gathered wild food botanical and mycological taxa were recorded and identified. Comparative analysis among the different linguistic and religious groups revealed that the gathered wild food plants were homogenously used. This may be attributed to the sociocultural context of the study area, where most of the population professes the Ismaili Shia Islamic faith, and to the historical stratifications of different populations along the centuries, which may have determined complex adaptation processes and exchange of possibly distinct pre-existing food customs. A few wild plants had very rarely or never been previously reported as food resources in Pakistan, including Artemisia annua, Hedysarum falconeri, Iris hookeriana, Lepidium didymium and Saussurea lappa. Additionally, the recorded local knowledge is under threat and we analyzed possible factors that have caused this change. The recorded biocultural heritage could, however, represent a crucial driver, if properly revitalized, for assuring the food security of the local communities and also for further developing ecotourism and associated sustainable gastronomic initiatives in the area.

Waist Circumference and Healthy Lifestyle Preferences/Knowledge Monitoring in a Preschool Obesity Prevention Program.

Weight and body mass index (BMI) changes appear to be poor measures for assessing the success of most pediatric obesity prevention programs (POPP). The aim of this study is to evaluate the effectiveness of the preschool-age prevention program (3P) in improving and maintaining overtime preschoolers' knowledge/preferences about healthy nutrition and physical activity (PA), and the relationship between acquired healthy behaviors and anthropometrics including waist circumference (WC). Twenty-five preschoolers underwent a 24-month healthy lifestyle multi-component pilot intervention followed by a one-year wash-out period; 25 age-matched served as controls. Anthropometric/behavioral data were monitored. After the 2-year study and wash-out, the rates of children overweight and with obesity decreased only in the intervention group, where, also, normal-weight children with visceral obesity attained WC normal values (p = 0.048). While mean values of BMI Z-scores remained unchanged in both the intervention and control groups, WC (values and percentiles) showed a significant reduction only in the intervention group. Children's adherence to the Mediterranean diet remained acceptable among the entire sample. Although daily sweet beverage consumption remained unchanged in both groups, knowledge/preferences improved significantly more in the intervention group. In conclusion, WC may be more sensitive than BMI for monitoring preschoolers in POPP and reflects healthy behavioral changes acquired during the intervention.