Increased fruit consumption was favorably associated with dietary habits, obesity, sedentary time, and physical fitness among Greek children and adolescents

Background: Fruit intake is important for school-age children's health since it is linked to a lower risk of obesity, cancer, heart disease, stroke, and hypertension and it also improves gastrointestinal health. The purpose of this study was to look at the prevalence of increased fruit consumption as well as any relationships between it and sedentary behavior, obesity, diet, and physical fitness (PF) in children and adolescents. Methods: Data from a national health survey, which was performed in 2015 on a representative sample of 177,091 Greek schoolchildren aged 8 to 17 years old, were used in this cross-sectional observational analysis. The study employed the Mediterranean Diet Quality Index in children and adolescents (KIDMED) index to evaluate fruit consumption and nutritional patterns, and self-completed questionnaires were utilized to assess physical activity, sedentary time, and sleeping habits. Teachers of physical education measured anthropometric and PF parameters. The Student's t-test examined differences in mean values, while the chi-square test evaluated differences between categorical variables. The impact of lifestyle factors on increased fruit consumption, adjusted for confounders (e.g., age, anthropometric variables, etc.), was found through binary logistic regression analysis. Results: A marginally higher percentage of boys as compared to girls ate two or more fruits, daily (51.2% vs. 48.8%, P=0.74). Fruit consumers (>= 2 fruits or juices), in both genders, had reduced sedentary time, healthier eating habits, better anthropometric and aerobic fitness assessments, and more sleep than nonconsumers (all P values <0.01). Consuming fruit was positively correlated with maintaining a healthy diet [odds ratio (OR) =6.60; 95% confidence interval (CI): 6.02-6.98], which includes eating fish, vegetables, legumes, dairy products, and olive oil regularly. For both boys and girls, the likelihood of eating fruit fell by 8% (OR =0.92; 95% CI: 0.91-0.92) and 10% (OR =0.90; 95% CI: 0.89-0.91) with every year of age growth, respectively. Compared to normal weight, those who were overweight or obese had a 20% decreased chance of eating more fruit (OR =0.80; 95% CI: 0.73-0.87). Increased sedentary time and inadequate sleeping hours decreased the odds of being an increased fruit consumer by 25% (OR =0.75; 95% CI: 0.72-0.78) and 22% (OR =0.78; 95% CI: 0.68-0.79) respectively. Conclusions: Among schoolchildren of both genders, increased fruit consumption was positively correlated with healthy eating practices, lower rates of obesity and sedentary behavior, and improved PF. Adolescents and children should be encouraged to eat fresh fruits as part of public health initiatives.