Association of the Modified Mediterranean Diet Score (mMDS) with Anthropometric and Biochemical Indices in US Career Firefighters

Abstract

The Mediterranean diet is associated with multiple health benefits, and the modified Mediterranean Diet Score (mMDS) has been previously validated as a measure of Mediterranean diet adherence. The aim of this study was to examine associations between the mMDS and anthropometric indices, blood pressure, and biochemical parameters in a sample of career firefighters. The participants were from Indiana Fire Departments, taking part in the “Feeding America’s Bravest” study, a cluster-randomized controlled trial that aimed to assess the efficacy of a Mediterranean diet intervention. We measured Mediterranean diet adherence using the mMDS. Anthropometric, blood pressure, and biochemical measurements were also collected. Univariate and multivariate linear regression models were used. In unadjusted analyses, many expected favorable associations between the mMDS and cardiovascular disease risk factors were found among the 460 firefighters. After adjustment for age, gender, ethnicity, physical activity, and smoking, a unitary increase in the mMDS remained associated with a decrease of the total cholesterol/HDL ratio (β-coefficient −0.028, p = 0.002) and an increase of HDL-cholesterol (β-coefficient 0.254, p = 0.004). In conclusion, greater adherence to the Mediterranean diet was associated with markers of decreased cardiometabolic risk. The mMDS score is a valid instrument for measuring adherence to the Mediterranean diet and may have additional utility in research and clinical practice.

Special Issue “Mediterranean Diet and Metabolic Diseases”

“…The authors reported the beneficial effects of a higher MD adherence on both HDL-c and TG levels, the latter coinciding with more frequent olive oil intake, the main denominator of the MD. Results on HDL-c were in agreement with a cross-sectional study [ 7 ] and an intervention study [ 6 ] on healthy volunteers also included in the issue [ 6 ], and results on HDL-c and TG are in agreement with the systematic review published on metabolic syndrome specific risk factors [ 1 ]. The authors found that nutritional counselling improved adherence, as was also suggested by Grabia and colleagues in their study on T1DM women [ 2 ].…”

“…This SI contains multifaceted research articles and a systematic review, which have addressed these issues both in healthy individuals and in those with specifically defined disease states or risk factors. Specifically, this SI contains research that has been carried out in not only the general population, but also among patients with Type 1 diabetes mellitus (T1DM) [ 2 ] or dyslipidemia [ 3 , 4 , 5 ], as well as among firefighters who are proxy to healthy and physically fit individuals [ 6 , 7 ], adding valuable information to the pre-stated gap in knowledge.…”

“…Four of the studies included in this issue have been carried out in healthy volunteers [ 4 , 5 , 6 , 7 ]. Romanidou and colleagues reported that for a unitary increase in MD adherence, the ratio of total cholesterol to HDL-c decreased by 0.03 and HDL-c increased by 0.25 mg/dL in 460 firefighters, after adjusting for multiple confounders [ 7 ].…”

“…Four of the studies included in this issue have been carried out in healthy volunteers [ 4 , 5 , 6 , 7 ]. Romanidou and colleagues reported that for a unitary increase in MD adherence, the ratio of total cholesterol to HDL-c decreased by 0.03 and HDL-c increased by 0.25 mg/dL in 460 firefighters, after adjusting for multiple confounders [ 7 ]. Two of the studies examined adults residing in the United Arab Emirates (UAE), one of the countries that makes up the Gulf Cooperation Council that has seen a rapid improvement in socio-economic status and a simultaneous dietary transition.…”

The use of functional food products for the prevention of vitamin deficiency in people with increased physical and neuropsychic stress on the example of firefighters-rescuers

“…The choice of the recipe composition of the instant granular drink was carried out taking into account the content of ingredients that enhance the positive effect on each other and on the body as a whole from the point of view of the prevention of vitamin deficiency in firefighters-rescuers. So, having carried out a number of studies and guided by literature data, the best composition of the drink is as follows: modified potato starch, powdered sugar, concentrated chokeberry juice, black chokeberry cake, thickened curd whey, native curd whey, citric acid [8][9].…”