Dataset Information

Agreement among Mediterranean Diet Pattern Adherence Indexes: MCC-Spain Study.

ABSTRACT: There are many different methods used to measure the degree of adherence to a Mediterranean diet (MD), limiting comparison and interpretation of their results. The concordance between different methodologies has been questioned and their evaluation recommended. The aim of this study was to evaluate the agreement among five indexes that measure adherence to a Mediterranean dietary pattern. The study population included healthy adults selected in the Multi-Case Control Spain (MCC-Spain) study recruited in 12 provinces. A total of 3640 controls were matched to cases by age and sex. To reach the aim, the following scores of adherence to a Mediterranean dietary pattern were calculated: Mediterranean diet score (MDS), alternative Mediterranean diet (aMED), relative Mediterranean diet (rMED), dietary score (DS) and literature-based adherence score (LBAS). The relative frequency of subjects with a high level of adherence to a MD varied from 22% (aMED index) to 37.2% (DS index). Similarly, a high variability was observed for the prevalence of a low level of MD: from 24% (rMED) to 38.4% (aMED). The correlation among MDS, aMED and rMED indexes was moderate, except for MDS and aMED with a high coefficient of correlation 0.75 (95% CI 0.74?0.77). The Cohen's Kappa coefficient among indexes showed a moderate?fair concordance, except for MDS and aMED with a 0.56 (95% CI 0.55?0.59) and 0.67 (95% CI 0.66?0.68) using linear and quadratic weighting, respectively. The existing MD adherence indexes measured the same, although they were based on different constructing algorithms and varied in the food groups included, leading to a different classification of subjects. Therefore, concordance between these indexes was moderate or low.

SUBMITTER: Olmedo-Requena R

PROVIDER: S-EPMC6471750 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Agreement among Mediterranean Diet Pattern Adherence Indexes: MCC-Spain Study.

Olmedo-Requena Rocío R González-Donquiles Carmen C Dávila-Batista Verónica V Romaguera Dora D Castelló Adela A Molina de la Torre Antonio José AJ Amiano Pilar P Dierssen-Sotos Trinidad T Guevara Marcela M Fernández-Tardón Guillermo G Lozano-Lorca Macarena M Alguacil Juan J Peiró Rosana R Huerta José María JM Gracia-Lavedan Esther E Aragonés Nuria N Fernández-Villa Tania T Solans Marta M Gómez-Acebo Inés I Castaño-Vinyals Gemma G Kogevinas Manolis M Pollán Marina M Martín Vicente V

Nutrients 20190226 3

There are many different methods used to measure the degree of adherence to a Mediterranean diet (MD), limiting comparison and interpretation of their results. The concordance between different methodologies has been questioned and their evaluation recommended. The aim of this study was to evaluate the agreement among five indexes that measure adherence to a Mediterranean dietary pattern. The study population included healthy adults selected in the Multi-Case Control Spain (MCC-Spain) study recr ...[more]

PMID: 30813581

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Project description:Background: Adherence to a Mediterranean diet (MD) has been quantified through various indexes that rely on full-length questionnaires, but their application in data collected with brief questionnaires has not been systematically investigated. Objective: We aimed to evaluate the ability of the commonly used MD score (MDS) to classify individuals according to their adherence to an MD when applied to data collected with brief questionnaires. Methods: We assessed the diet of 200 participants from a Greek national health survey with the use of 2 instruments: 1) a validated, detailed food-frequency questionnaire (FFQ) estimating grams per day of intake of individual foods and 2) a selection of 19 questions from the Baseline Nutrition Credits4Health (BNC4H) electronic platform questionnaire that assessed servings with subjective serving sizes. We calculated the MDS_FFQ (referent) and MDS_BNC4H indexes from each questionnaire and estimated their correlation and the percentage of study participants who were ranked in an identical tertile in both indexes. We repeated the analyses for 2 additional indexes defined with criteria different from the MDS [Mediterranean Diet Index (MDI)_BNC4H and Mediterranean Diet Assessment Score (MEDAS)_ BNC4H]. Results: Spearman correlation coefficients for the MDS_FFQ were 0.31 with the MDS_BNC4H, 0.24 with the MDI_BNC4H, and 0.23 with the MEDAS_BNC4H. The proportion of participants ranked into the same adherence level as the referent MDS_FFQ was 50% for the MDS_BNC4H (weighted κ = 0.27) and lower for the other indexes. The use of medians as cutoffs (as in the MDS_FFQ) had low discriminative ability when applied to servings per day (MDS_BNC4H) in some MDS components, leading to comparability problems in the range of values between the 2 indexes. Conclusions: Our findings highlight certain issues that need to be considered when applying pre-existing MD indexes in settings with different dietary assessments. Given the widespread use of electronic platforms for dietary assessment, our results may offer further insight into designing brief, simplified questionnaires that aim to estimate MD adherence with easily quantifiable scores.

Project description:BackgroundNon-steroidal anti-inflammatory drugs (NSAIDs) are widely used despite their risk of gastrointestinal bleeding or cardiovascular events. We report the profile of people taking NSAIDs in Spain, and we include demographic factors, health-related behaviours and cardiovascular disease history.MethodsFour thousand sixtyparticipants were selected using a pseudorandom number list from Family Practice lists in 12 Spanish provinces. They completed a face-to-face computerized interview on their NSAID consumption, demographic characteristics, body mass index, alcohol and tobacco consumption and medical history. In addition, participants completed a self-administered food-frequency and alcohol consumption questionnaire. Factors associated with ever and current NSAID consumption were identified by logistic regression.ResultsWomen consumed more non-aspirin NSAIDs (38.8% [36.7-41.0]) than men (22.3 [20.5-24.2]), but men consumed more aspirin (11.7% [10.3-13.2]) than women (5.2% [4.3-6.3]). Consumption of non-aspirin NSAIDs decrease with age from 44.2% (39.4-49.1) in younger than 45 to 21.1% (18.3-24.2) in older than 75, but the age-pattern for aspirin usage was the opposite. Aspirin was reported by about 11% patients, as being twice as used in men (11.7%) than in women (5.2%); its consumption increased with age from 1.7% (< 45 years old) to 12.4% (≥75 years old). Aspirin was strongly associated with the presence of cardiovascular risk factors or established cardiovascular disease, reaching odds ratios of 15.2 (7.4-31.2) in women with acute coronary syndrome, 13.3 (6.2-28.3) in women with strokes and 11.1 (7.8-15.9) in men with acute coronary syndrome. Participants with cardiovascular risk factors or diseases consumed as much non-aspirin NSAID as participants without such conditions.ConclusionsNon-aspirin NSAIDs were more consumed by women and aspirin by men. The age patterns of aspirin and non-aspirin NSAIDs were opposite: the higher the age, the lower the non-aspirin NSAIDs usage and the higher the aspirin consumption. People with cardiovascular risk factors or diseases consumed more aspirin, but they did not decrease their non-aspirin NSAIDs usage.

Project description:BackgroundThe Mediterranean diet pattern (MDP) is believed to improve health and promote balanced inflammation and metabolism. While unknown, compelling evidence suggests that MDP could benefit patients with inflammatory bowel disease (IBD). We aimed to evaluate the level of diet adherence, diet quality, and nutritional adequacy of the MDP in patients with Ulcerative Colitis (UC).MethodsAdult participants (n = 32) with quiescent UC were randomized to follow a MDP (n = 18) or Canadian Habitual Diet (CHD) (n = 14) for 12 weeks. The MDP participants received tailored nutrition education from a Registered Dietitian. Demographic, clinical data, medical history, and quality of life were assessed with the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), dietary adherence with the Mediterranean Diet Serving Score (MDSS), diet quality via the Healthy Eating Index-2015 (HEI-2015), and dietary intake (ASA-24) were completed at baseline and week 12.ResultsParticipants' diets were analyzed (MDP n = 15, CHD n = 13). The MDP (n = 10, 67%) achieved a high level of adherence (MDSS score between 16 and 24) vs. CHD (n = 3), (p = 0.030). HEI-2015 significantly increased from baseline to week 12 (p = 0.007) in the MDP and was significantly higher at week 12 compared to the CHD (p = 0.0001). The SIBDQ (bowel domain) showed reductions in the passage of large amounts of gas (p = 0.01) and improvements in tenesmus (p = 0.03) in the MDP. Despite enhanced diet quality and adherence in the MDP, females had inadequate intakes of calcium, iron, vitamin D, vitamin E, and choline and males had inadequate intakes of fiber, vitamin D, vitamin E, and choline. No adverse events were reported.ConclusionWith nutrition education, high adherence to the MDP was achieved without an increase in bowel symptoms. Following the MDP led to a higher diet quality; however, nutritional inadequacies were identified. Tailored dietary education focusing on nutrients of concern when following the MDP is recommended to ensure nutritional adequacy.Clinical trial registration[www.ClinicalTrials.gov], identifier [NCT03053713].

Dataset Information

Agreement among Mediterranean Diet Pattern Adherence Indexes: MCC-Spain Study.

Publications

Agreement among Mediterranean Diet Pattern Adherence Indexes: MCC-Spain Study.

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