Background and AimsNumerous studies have demonstrated a relationship between Mediterranean Diet (MD) adherence and the prevention of cardiovascular diseases, cancer, and diabetes, etc. The study aim was to validate a novel instrument to measure MD adherence based on the consumption of food servings and food groups, and apply it in a female population from southern Spain and determining influential factors.Methods and ResultsThe study included 1,155 women aged 12-83 yrs, classified as adolescents, adults, and over-60-yr-olds. All completed a validated semi-quantitative food frequency questionnaire (FFQ). The Mediterranean Dietary Serving Score (MDSS) is based on the latest update of the Mediterranean Diet Pyramid, using the recommended consumption frequency of foods and food groups; the MDSS ranges from 0 to 24. The discriminative power or correct subject classification capacity of the MDSS was analyzed with the Receiver Operating Characteristic (ROC) curve, using the MDS as reference method. Predictive factors for higher MDSS adherence were determined with a logistic regression model, adjusting for age. According to ROC curve analysis, MDSS evidenced a significant discriminative capacity between adherents and non-adherents to the MD pattern (optimal cutoff point=13.50; sensitivity=74%; specificity=48%). The mean MDSS was 12.45 (2.69) and was significantly higher with older age (p<0.001). Logistic regression analysis showed highest MD adherence by over 60-year-olds with low BMI and no habit of eating between meals.ConclusionsThe MDSS is an updated, easy, valid, and accurate instrument to assess MD adherence based on the consumption of foods and food groups per meal, day, and week. It may be useful in future nutritional education programs to prevent the early onset of chronic non-transmittable diseases in younger populations.

Objective: The Mediterranean diet is considered one of the healthiest dietary models. Recent changes in the actual Mediterranean diet include a reduction in energy intake and a higher consumption of foods with low nutrient density (e.g. soft drinks, candy, sweets, etc.). In Spain, in association with cultural and lifestyle changes, there has been a reduction in the intake of antioxidants and vitamins, an increase in the proportion of SFA and a decrease in the consumption of fibre, among other changes. Children and adolescents may be the age groups with the most deteriorated Mediterranean diet. The current paper presents the results of applying the Mediterranean Diet Quality Index for children and adolescents (KIDMED) to a large sample of Spanish schoolchildren. Design: Data from questionnaires were used to calculate the KIDMED index. Setting: Granada, Southern Spain. Subjects: Schoolchildren (n 3190) aged 8-16 years. Results: Among the 8-10-year-olds, the KIDMED index classification was 'good' in 48?6 % of the population, 'average' in 49?5 % and 'poor' in 1?6 %. Among the 10-16-year-olds, the KIDMED index classification was good in 46?9 % of the population, average in 51?1 % and poor in 2?0 %. Conclusions: The nutritional behaviour of the present population of schoolchildren is similar to that found in the earlier KIDMED study.

We hypothesized that adherence to the Mediterranean diet measured as a Mediterranean diet score (MDS) has a beneficial effect on bone mineral density (BMD). For the purposes of this study, a sample of healthy women from Southern Spain was chosen. Subjects were grouped into two major groups: a first group consisted of women of reproductive age (premenopausal, pre-M) and a second group consisted of postmenopausal women (pos-M). The consumption of vegetables and fruit was found to be significantly related to BMD in both groups of subjects studied. In the pre-M group, the lipid ratio was positively associated with BMD and in pos-M women nuts intake was also associated with BMD. After implementing the analysis of covariance analysis, significant linear trends between the MDS and BMD were observed in all subjects studied. Our results indicate that a varied diet based on Mediterranean diet patterns may be beneficial in the prevention of osteoporosis.

Objective: To propose and apply an instrument to assess the breakfast quality of children and adolescents in the Mediterranean area. Design: Randomized, cross-sectional survey of breakfast consumption using a validated semi-quantitative FFQ administered at school by trained dietitians between Tuesday and Friday. A Breakfast Quality Index (BQI) score was developed, assigning a positive value to the consumption of cereals, fruit, vegetables, dairy products, MUFA, Ca and compliance with energy recommendations, and to the absence of SFA and trans-rich fats. Data were analysed by Student's t test and ANOVA. Setting: Schools in Granada and Balearic Islands (Spain). Subjects: All schoolchildren (n 4332) aged 8-17 years at randomly selected and representative schools between 2006 and 2008, stratified by age and sex. Results: Breakfast was not consumed by 6?5 % of participants. BQI score was highest for children aged 7-9 years and decreased with age (P 5 0?001). Females scored higher in all age groups. The lowest score was in males aged 14-17 years and the highest in females aged 7-9 years (P 5 0?006). Conclusions:The proposed BQI appears useful to estimate the breakfast quality of schoolchildren and to form a basis for nutrition education.

Numerous studies have addressed the nutritional needs of pregnant women. The nutritional status of the woman before and during gestation affects the growth of the fetus and the course of the pregnancy and influences the risk of obesity for mother and infant. The aim of this study was to propose a diet quality index for pregnancy based on a Mediterranean-type diet (MDS-P), evaluating the diet of a group of pregnant women by applying the Mediterranean Diet Score (MDS) and evaluating their intake of micronutrients required in optimal amounts during pregnancy, such as Fe, folic acid and Ca. The data used to construct this index (MDS-P) were gathered by means of a FFQ specifically designed for pregnant women. The mean MDS of this group, was 4·31 (SD 1·32), considered to represent satisfactory compliance with the Mediterranean diet (range 0 -8).The mean MDS-P (range 0 -11), which also takes account of dietary intake or supplements of folic acid, Fe and Ca was 7·53 (SD 1·44), indicating a compliance of around 70 %. The present study findings suggest that the MDS-P, which evaluates the adequacy of folic acid, Fe and Ca as well as compliance with the Mediterranean diet, may represent a valid tool for the specific assessment of the diet of pregnant women living in countries in the Mediterranean area. Further studies are required to complete the validation process.