{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:15:53Z","timestamp":1788236153498,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Several studies have reported a high prevalence of overweight and obesity among children and adults, with relevant implications for long-term health. Digital platforms and social media may support nutrition education when their content is developed and supervised by health professionals. This study evaluated whether dietary habits, lifestyle indicators, body mass index-related measures, and Mediterranean diet adherence differed between baseline and 210-day assessments among participants in a family- and school-mediated multimedia educational program aimed at promoting healthier lifestyles and greater adherence to the Mediterranean diet. Methods: This was an uncontrolled repeated cross-sectional before-and-after evaluation based on online surveys administered at baseline and after 210 days to respondent samples from the same project population. The multimedia educational program was delivered through a dedicated website and social media channels. The analysis included 329 children\/adolescents at both assessment waves and 119 and 122 adult female respondents at baseline and 210 days, respectively. Since only 11 adult males responded, analyses of adults were restricted to women. Additionally, Mediterranean diet adherence was assessed using a modified KIDMED-derived score in children\/adolescents and the PREDIMED score in adults. Data from the two assessment waves were compared at the group level, rather than as paired longitudinal observations. Results: Among children\/adolescents, higher physical activity, lower screen time, and more favorable dietary indicators were observed at 210 days than at baseline. Moreover, daily fruit intake, daily vegetable intake, regular fish consumption, and the modified KIDMED score were higher at 210 days. Good adherence to the Mediterranean diet increased from 46.8% at baseline to 61.4% at 210 days. Among adult female respondents, the median body mass index was lower at 210 days than at baseline, and favorable differences were observed for vegetable, fish\/seafood, legume, and nut intake. The median PREDIMED score increased from 7.0 [6.0\u20138.0] at baseline to 9.0 [7.0\u201310.0] at 210 days, and good Mediterranean diet adherence increased from 10.9% to 35.2%. Conclusions: Among children\/adolescents, physical activity, screen time, and dietary indicators showed more favorable distributions in the 210-day respondent group than in the baseline respondent group. Daily fruit intake, daily vegetable intake, regular fish consumption, and the modified KIDMED-derived score were higher at 210 days, and good Mediterranean diet adherence was more frequent at 210 days than at baseline (61.4% vs. 46.8%). Among adult female respondents, the median body mass index was lower in the 210-day respondent group than in the baseline respondent group, and more favorable distributions were observed for vegetable, fish\/seafood, legume, and nut intake. The median PREDIMED score was higher at 210 days than at baseline: 9.0 [7.0\u201310.0] versus 7.0 [6.0\u20138.0], respectively. Good Mediterranean diet adherence was also more frequent at 210 days (35.2% vs. 10.9%).<\/jats:p>","DOI":"10.3390\/nu18172851","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:19:26Z","timestamp":1788232766000},"page":"2851","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Innovative, Multimedia-Based Intervention for Promoting Changes in Lifestyle in Italian Families"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8030-9689","authenticated-orcid":false,"given":"Iolanda","family":"Chinellato","sequence":"first","affiliation":[{"name":"Presidio Ospedaliero San Pio da Pietrelcina, 74011 Castellaneta, TA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Acquaviva","sequence":"additional","affiliation":[{"name":"Istituto Oncologico Romagnolo (IOR), 47122 Forl\u00ec, FC, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Lista","sequence":"additional","affiliation":[{"name":"Presidio Ospedaliero San Pio da Pietrelcina, 74011 Castellaneta, TA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loreto","family":"Nemi","sequence":"additional","affiliation":[{"name":"Independent Researcher, 00152 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Da","family":"Ros","sequence":"additional","affiliation":[{"name":"Independent Researcher, 31029 Vittorio Veneto, TV, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Morlupi","sequence":"additional","affiliation":[{"name":"Independent Researcher, 06073 Corciano, PG, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Maione","sequence":"additional","affiliation":[{"name":"Ospedale del Mare, ASL Napoli 1 Centro, 80147 Napoli, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5548-0950","authenticated-orcid":false,"given":"Renata","family":"Carraro","sequence":"additional","affiliation":[{"name":"Independent Researcher, 25122 Brescia, BS, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lodi","sequence":"additional","affiliation":[{"name":"Independent Researcher, 41012 Carpi, MO, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8721-7912","authenticated-orcid":false,"given":"Alessandra","family":"Micozzi","sequence":"additional","affiliation":[{"name":"Faculty of Social and Communication Sciences, Universitas Mercatorum, 00186 Rome, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Cipriano","sequence":"additional","affiliation":[{"name":"Independent Researcher, 80045 Pompei, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4959-579X","authenticated-orcid":false,"given":"Patrizia","family":"Serra","sequence":"additional","affiliation":[{"name":"Biostatistics and Clinical Trial Unit, Istituto Romagnolo per lo Studio dei Tumori \u201cDino Amadori\u201d IRST IRCCS, 47014 Meldola, FC, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6299-2239","authenticated-orcid":false,"given":"Monica","family":"Turchetto","sequence":"additional","affiliation":[{"name":"Independent Researcher, 20157 Milano, MI, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1422-5695","authenticated-orcid":false,"given":"Marco","family":"Sandri","sequence":"additional","affiliation":[{"name":"Big and Open Data Innovation Laboratory (BODaI-Lab), University of Brescia, 25122 Brescia, BS, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Poggiante","sequence":"additional","affiliation":[{"name":"Independent Researcher, 80131 Napoli, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Spinelli, A., Censi, L., Mandolini, D., Ciardullo, S., Salvatore, M.A., Mazzarella, G., Nardone, P., and 2019 OKkio alla SALUTE Group (2023). Inequalities in Childhood Nutrition, Physical Activity, Sedentary Behaviour and Obesity in Italy. Nutrients, 15.","DOI":"10.3390\/nu15183893"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s13668-024-00544-w","article-title":"Eating Behaviours and Dietary Intake in Children and Adolescents: A Systematic Review","volume":"13","author":"Maneschy","year":"2024","journal-title":"Curr. Nutr. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"113053","DOI":"10.1016\/j.nut.2025.113053","article-title":"Efficacy of Mediterranean diet for the prevention of cardiovascular disease in patients: A systematic review and meta-analysis featured in the Italian National Guidelines \u201cLa Dieta Mediterranea\u201d","volume":"144","author":"Volpe","year":"2026","journal-title":"Nutrition"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Barros, A.K.C., de Jesus, G.M., Vieira, G.O., and Dias, L.A. (2023). Use of screens and intake of unhealthy food among children and adolescents: Association with physical activity in a cross-sectional study. BMC Nutr., 9.","DOI":"10.1186\/s40795-023-00763-4"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Qiu, C., Hatton, R., Li, Q., Xv, J., Li, J., Tian, J., Yuan, S., and Hou, M. (2023). Associations of parental feeding practices with children\u2019s eating behaviors and food preferences: A Chinese cross-sectional study. BMC Pediatr., 23.","DOI":"10.1186\/s12887-023-03848-y"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1186\/s12966-020-01037-z","article-title":"2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5\u201317 years: Summary of the evidence","volume":"17","author":"Chaput","year":"2020","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1017\/S0007114522003701","article-title":"Diet quality indices and their associations with all-cause mortality, CVD and type 2 diabetes mellitus: An umbrella review","volume":"130","author":"Brlek","year":"2023","journal-title":"Br. J. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"106771","DOI":"10.1016\/j.cct.2022.106771","article-title":"HomeStyles-2 for SNAP-Ed families with children in middle childhood: Cluster randomized trial protocol","volume":"117","author":"Carman","year":"2022","journal-title":"Contemp. Clin. Trials"},{"key":"ref_9","first-page":"CD001871","article-title":"Interventions for Preventing Obesity in Children","volume":"7","author":"Brown","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_10","unstructured":"World Health Organization (2026, July 07). Obesity and Overweight. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"150","DOI":"10.12701\/jyms.2024.00360","article-title":"What is the disease burden from childhood and adolescent obesity?: A narrative review","volume":"41","author":"Lee","year":"2024","journal-title":"J. Yeungnam Med. Sci."},{"key":"ref_12","unstructured":"World Health Organization Regional Office for Europe (2025). WHO European Childhood Obesity Surveillance Initiative (COSI): Report on the Sixth Round of Data Collection, 2022\u20132024, WHO Regional Office for Europe."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"ckaf161.242","DOI":"10.1093\/eurpub\/ckaf161.242","article-title":"Continuous survey-based monitoring: Lessons from PASSI","volume":"35","author":"Capelli","year":"2025","journal-title":"Eur. J. Public Health"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Lauria, L., Spinelli, A., Buoncristiano, M., and Nardone, P. (2019). Decline of childhood overweight and obesity in Italy from 2008 to 2016: Results from 5 rounds of the population-based surveillance system. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-6946-3"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Stival, C., Lugo, A., Barone, L., Fattore, G., Odone, A., Salvatore, S., Santoro, E., Scaglioni, S., van den Brandt, P.A., and Gallus, S. (2022). Prevalence and Correlates of Overweight, Obesity and Physical Activity in Italian Children and Adolescents from Lombardy, Italy. Nutrients, 14.","DOI":"10.3390\/nu14112258"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Masini, A., Dallolio, L., Sanmarchi, F., Lovecchio, F., Falato, M., Longobucco, Y., Lanari, M., and Sacchetti, R. (2024). Adherence to the Mediterranean Diet in Children and Adolescents and Association with Multiple Outcomes: An Umbrella Review. Healthcare, 12.","DOI":"10.3390\/healthcare12040449"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/ejcn.2017.58","article-title":"Mediterranean diet and multiple health outcomes: An umbrella review of meta-analyses of observational studies and randomised trials","volume":"72","author":"Dinu","year":"2018","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1080\/09637486.2024.2353065","article-title":"Understanding consumer food choices & promotion of healthy and sustainable Mediterranean diet and lifestyle in children and adolescents through behavioural change actions: The DELICIOUS project","volume":"75","author":"Grosso","year":"2024","journal-title":"Int. J. Food Sci. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"106320","DOI":"10.1016\/j.appet.2022.106320","article-title":"The correlation between different operationalisations of parental restrictive feeding practices and children\u2019s eating behaviours: Systematic review and meta-analyses","volume":"180","author":"Say","year":"2023","journal-title":"Appetite"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e80821","DOI":"10.2196\/80821","article-title":"Digital Interventions Targeting Healthy and Sustainable Eating Behavior: Systematic Review and Meta-Analysis","volume":"28","author":"Vanwinkelen","year":"2026","journal-title":"J. Med. Internet Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lawton, K., Hess, L., McCarthy, H., Marini, M., McNitt, K., and Savage, J.S. (2022). Feasibility of Using Facebook to Engage SNAP-Ed Eligible Parents and Provide Education on Eating Well on a Budget. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031457"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"St Pierre, C., Guan, W., Barry, L., Dease, G., Gottlieb, S., Morris, A., Merrill, J., and Sacheck, J.M. (2021). Themes in Train-the-Trainer Nutrition Education Interventions Targeting Middle School Students: A Systematic Review. Nutrients, 13.","DOI":"10.3390\/nu13082749"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e58434","DOI":"10.2196\/58434","article-title":"Assessing the Uses, Benefits, and Limitations of Digital Technologies Used by Health Professionals in Supporting Obesity and Mental Health Communication: Scoping Review","volume":"27","author":"Kearns","year":"2025","journal-title":"J. Med. Internet Res."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Dess\u00ec, A., Petza, S., Di Carlo, A., Infantino, F., Zanco, F., Galimberti, L., Fanos, V., and Bosco, A. (2025). Parenting Style and Social Media: Impact on Children\u2019s Dietary Patterns. Nutrients, 17.","DOI":"10.3390\/nu17203254"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e60602","DOI":"10.2196\/60602","article-title":"Mobile- and Web-Based Interventions for Promoting Healthy Diets, Preventing Obesity, and Improving Health Behaviors in Children and Adolescents: Systematic Review of Randomized Controlled Trials","volume":"27","author":"Talens","year":"2025","journal-title":"J. Med. Internet Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e36132","DOI":"10.2196\/36132","article-title":"Social Media Interventions for Nutrition Education Among Adolescents: Scoping Review","volume":"6","author":"Kulandaivelu","year":"2023","journal-title":"JMIR Pediatr. Parent"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Buja, A., Miatton, A., Zanovello, A., Brocadello, F., Baldovin, T., Muhiddin, M.N., and Spreghini, I. (2024). Media Usage and Adherence to the Mediterranean Diet in Children. Nutrients, 16.","DOI":"10.3390\/nu16203481"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e30160","DOI":"10.2196\/30160","article-title":"Digital Interventions to Promote Healthy Eating in Children: Umbrella Review","volume":"4","author":"Prowse","year":"2021","journal-title":"JMIR Pediatr. Parent"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Mart\u00ednez-Gonz\u00e1lez, M.A., Garc\u00eda-Arellano, A., Toledo, E., Salas-Salvad\u00f3, J., Buil-Cosiales, P., Corella, D., Covas, M.I., Schr\u00f6der, H., Ar\u00f3s, F., and G\u00f3mez-Gracia, E. (2012). A 14-Item Mediterranean Diet Assessment Tool and Obesity Indexes among High-Risk Subjects: The PREDIMED Trial. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0043134"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1017\/S1368980019001058","article-title":"An update of the KIDMED questionnaire, a Mediterranean Diet Quality Index in children and adolescents","volume":"22","author":"Altavilla","year":"2019","journal-title":"Public Health Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1038\/sj.ejcn.1601473","article-title":"A chart to link child centiles of body mass index, weight and height","volume":"56","author":"Cole","year":"2002","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Duarte, A., Martins, J., Silva, M.J., Augusto, C., Martins, S.P., and Ros\u00e1rio, R. (2024). The Role of Parental Adherence to the Mediterranean Diet and Family Time in Children\u2019s Weight Status. Nutrients, 16.","DOI":"10.20944\/preprints202402.1511.v1"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.numecd.2017.01.002","article-title":"Adherence to the Mediterranean Diet in Children and Adolescents: A Systematic Review","volume":"27","author":"Idelson","year":"2017","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Haghjoo, P., Siri, G., Soleimani, E., Farhangi, M.A., and Alesaeidi, S. (2022). Screen time increases overweight and obesity risk among adolescents: A systematic review and dose-response meta-analysis. BMC Prim. Care, 23.","DOI":"10.1186\/s12875-022-01761-4"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1186\/s12966-021-01189-6","article-title":"Identifying effective intervention strategies to reduce children\u2019s screen time: A systematic review and meta-analysis","volume":"18","author":"Jones","year":"2021","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ijmedinf.2018.10.001","article-title":"The Use of Social Media in Nutrition Interventions for Adolescents and Young Adults\u2014A Systematic Review","volume":"120","author":"Chau","year":"2018","journal-title":"Int. J. Med. Inform."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"107526","DOI":"10.1016\/j.appet.2024.107526","article-title":"A Cross-Sectional Study of the Association between Food Literacy and Dietary Intake among Danish Adolescents","volume":"200","author":"Stjernqvist","year":"2024","journal-title":"Appetite"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/17\/2851\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:33:23Z","timestamp":1788233603000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/17\/2851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":37,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["nu18172851"],"URL":"https:\/\/doi.org\/10.3390\/nu18172851","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}