Context: Given the high prevalence of metabolic syndrome (MetS) among children and adolescents, the role of dietary habits on MetS development, and formation of food preferences from childhood, it is highly important to determine the association of dietary habits with pediatric MetS.
Objective: This study aimed at systematically reviewing the association of different dietary patterns with MetS in a pediatric age group.
Data Sources and Study Selection: An electronic search was conducted in international electronic databases including PubMed, Cochrane, Scopus, Google Scholar, and domestic data sources.  The following keywords were used ;((“Child”(Mesh) OR “Adoles- cent”(Mesh) AND (“Metabolic Syndrome”(Mesh) AND “Diet”(Mesh) OR “Dietary Pattern” (Mesh)).We included all published data on the association of MetS (presence of a cluster of 3 or more metabolic abnormalities) with dietary pattern in the pediatric age group aged 3 to 18 years.
Data Extraction: At first, 4194 articles were identified (PubMed: 566; Scopus: 60; Google scholar: 3550; domestic data source: 18). Results: After quality assessment, 17 studies were selected for text appraisal, of which 15 qualified articles were evaluated at the final step. The number of total population and points of data were 19 298. From reported studies, 10 had a cross- sectional design, 3 were interventional studies, 1 was cohort study, and 1 was a systematic review on Korean adolescents.
Conclusion:  Our results indicated that the Mediterranean diet or diets with a higher score of healthy eating index, i.e., with higher content of grains, vegetables, fruits, milk, and meat/meat alternatives, have inverse associations with the prevalence of MetS, whereas Western type diets are associated with higher frequency of MetS in children and adolescents.