Critical evaluation of the questionnaires assessing adherence to the Mediterranean diet that are based on servings

Chiriacò, Martina; Tubili, Claudio; Bo, Simona; Parillo, M.; Vetrani, Claudia; Mazzotti, Arianna; Pistis, Danila; Marelli, Giuseppe; Grandone, Ilenia; Natali, Andrea

doi:10.1016/j.numecd.2023.01.024

Cited by 8 publications

(12 citation statements)

References 66 publications

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“…Further, the question regarding wine consumption (seven glasses/week) may be inappropriate for the age group investigated since young adults usually do not drink wine to the same extent as older adults. Additionally, the binary scoring system for different food items does not allow for the assessment of the degree of proximity to the optimal consumption of a particular item [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Mediterranean Diet Adherence and Its Relationship to Metabolic Markers and Body Composition in Portuguese University Students

et al. 2023

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Background: Transitioning to university involves several changes, which might affect dietary habits. The present study aimed to assess the potential relationships involving adherence to the MedDiet, body composition, and metabolic markers within a Portuguese university sample. Methods: A cross-sectional study involved 70 participants, 52 women, and 18 men (23.00 ± 7.00 years old and a BMI of 21.99 ± 2.79 kg/m2). The average MedDiet adherence of participants was 9.23 points, as evaluated by the 14 point validated questionnaire, with classifications of low and high (under or over 9 points, respectively). Body composition was assessed using X-ray dual densitometry (DXA), and metabolic markers were collected from capillary blood. Results: Statistically significant differences in HDL cholesterol and the total/HDL cholesterol ratio were found between groups. Lower levels (p < 0.05) of visceral (VAT) and subcutaneous adipose tissue (SAT), BMI, and waist circumference were found in the higher MedDiet adherence group. Those measures were negatively correlated (p < 0.05) with the adherence scores to the MedDiet. Conclusion: Higher adherence to MedDiet seemed to have a favorable and important impact on lipid profiles, primarily HDL-c. A positive relationship between MedDiet adherence and body composition distribution was also described, mostly due to the influence of higher adherence to MedDiet at lower levels of VAT and SAT in Portuguese university students.

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Section: Discussionmentioning

confidence: 99%

Mediterranean Diet Adherence and Its Relationship to Metabolic Markers and Body Composition in Portuguese University Students

et al. 2023

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“…d Servings were as listed on the food-frequency questionnaire. e Servings were adjusted based on the food guide pyramid recommendations ( 5 ). f 1 serving of alcoholic beverage consists of 12 % ethanol.…”

Section: Methodsmentioning

confidence: 99%

“…Various a priori criterion-based dietary indices have been developed over the years to assess a population's conformity to the Mediterranean diet (5,6) and examine the cancerprotective effects of this dietary pattern. Evidence from some observational studies suggests that higher adherence to the Mediterranean diet is protective against breast cancer (7), especially in postmenopausal women (8)(9)(10), although evidence on molecular subtypes (defined by hormone receptor status) is very limited and inconsistent (11)(12)(13)(14).…”

Section: Methodsmentioning

confidence: 99%

“…Mediterranean diet indices are designed to assess conformity to a single dietary pattern, but they often have different dietary components, use different methodologies for assigning points and scoring the diet, and apply different weighting strategies ( 5 , 6 , 15 ). These differences may influence the ability of a given index to assess conformity to the diet and predict disease risk.…”

Section: Introductionmentioning

confidence: 99%

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Indices of Mediterranean diet adherence and breast cancer risk in a community-based cohort

2023

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IntroductionA Mediterranean-style dietary pattern is believed to have cancer-protective effects. We compared the prospective associations between adherence to four established Mediterranean diet indices and breast cancer risk (including total, postmenopausal, and hormone receptor positive cases) in women in the Framingham Offspring Study.MethodsThe four indices used two different approaches to measuring adherence to a Mediterranean diet: (a) scores based on the population-specific median intakes of Mediterranean diet-related foods in a given population (i.e., alternate Mediterranean Diet (aMED) index and Mediterranean Diet Score (MDS) index), and (b) scores based on compliance with recommended intakes of relevant foods from the Mediterranean diet pyramid [i.e., Mediterranean Diet (MeDiet) index and Mediterranean Style Dietary Pattern (MSDP) index]. Dietary data were derived from semiquantitative food frequency questionnaires collected in 1991-95. Participants included 1579 women aged ≤ 30 years who were free of prevalent cancer. Women were followed through 2014, and Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for various confounders.ResultsDuring a median follow-up of approximately 18 years, 87 breast cancer cases were documented. Women in the highest (vs. lowest) score category of the pyramid-based scores (i.e., MeDiet or MSDP) had approximately 45% statistically significantly lower breast cancer risks. These effects were even stronger for any hormone receptor positive cases using the MeDiet index (highest vs. lowest score categories: HR = 0.45, 95% CI: 0.22–0.90). Neither of the median intake-based scores (i.e., aMED, MDS) was associated with breast cancer risk.DiscussionOur results suggest that the methodology and the composition of Mediterranean diet indices influence their ability to assess conformity to this specific diet pattern and predict breast cancer risk.

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“…In this study, we investigated the adherence to the MD, calculated using the Mediterranean Diet Adherence Screener (MEDAS) [ 14 ], Pyramid-based Mediterranean Diet Score (PyrMDS) [ 12 ], and Italian Mediterranean Index (IMI) [ 15 ] in pwMS from a cohort of northwestern Italy. Furthermore, dietary intakes were collected and analyzed using a 3-day food intake diary that pwMS filled in every 3 months for 1 year.…”

Section: Introductionmentioning

confidence: 99%

Lower Multiple Sclerosis Severity Score Is Associated with Higher Adherence to Mediterranean Diet in Subjects with Multiple Sclerosis from Northwestern Italy

Bronzini,

Maglione,

Rosso

et al. 2024

Nutrients

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The Mediterranean Diet (MD) is described in the literature as a beneficial dietary pattern for neurodegenerative diseases such as Multiple Sclerosis (MS). The objective of this study was to evaluate the dietary habits in people with MS (pwMS) and to test whether adherence to the MD could have an impact on the severity of the disease measured as the MS severity score (MSSS). Adherence to the MD was assessed in 31 PwMS using the Mediterranean Diet Adherence Screener (MEDAS), the Pyramid-based Mediterranean Diet Score (PyrMDS) index, and the Italian Mediterranean Index (IMI), and their eating habits were recorded in a food diary for a one-year follow-up. When data obtained from dietary analysis were compared to the MSSS, results showed that pwMS with lower MSSS adhere more to the MD than the other pwMS groups according to the MEDAS index. Furthermore, a high consumption of fiber in the MS mild severity class was observed. Further studies are needed to clarify which of the nutritional components of the MD may impact the course of MS and if the sensitization of pwMS to MD adherence can be a strategy for mitigating the disease.

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Critical evaluation of the questionnaires assessing adherence to the Mediterranean diet that are based on servings

Cited by 8 publications

References 66 publications

Mediterranean Diet Adherence and Its Relationship to Metabolic Markers and Body Composition in Portuguese University Students

Mediterranean Diet Adherence and Its Relationship to Metabolic Markers and Body Composition in Portuguese University Students

Indices of Mediterranean diet adherence and breast cancer risk in a community-based cohort

Lower Multiple Sclerosis Severity Score Is Associated with Higher Adherence to Mediterranean Diet in Subjects with Multiple Sclerosis from Northwestern Italy

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