Cardiorespiratory Fitness as Mediator of the Relationship of Recreational Screen Time on Mediterranean Diet Score in Schoolchildren

Background: Studies have reported the association between cardiorespiratory fitness and higher adherence to the Mediterranean diet as well as lower recreational screen time. Similarly, higher screen time has been negatively linked to a lower adherence to the Mediterranean diet. However, the mediator effect of cardiorespiratory fitness on the influence of screen time on adherence to the Mediterranean diet is still unknown. The aim of this study was two-fold: first, to assess the combined association of recreational screen time and cardiorespiratory fitness with adherence to Mediterranean diet among Spanish schoolchildren, and second, to elucidate whether the association between recreational screen time and adherence to the Mediterranean diet is mediated by cardiorespiratory fitness. Methods: A descriptive and cross-sectional study was conducted. A total of 370 schoolchildren aged 6-13 years from six schools in the Region of Murcia (Spain) were included. Results: The mediation analysis showed that once screen time and cardiorespiratory fitness were included together in the model, cardiorespiratory fitness was positively linked to adherence to the Mediterranean diet (p = 0.020) and although screen time remained negatively related to adherence to the Mediterranean diet, this association was slightly attenuated (indirect effect = -0.027; 95% CI = (-0.080, -0.002)). Conclusions: This research supports that cardiorespiratory fitness may reduce the negative association between screen time and Mediterranean dietary patterns.