The Mediterranean dietary pattern has been linked with lower incidence of cardiovascular disease and the Mediterranean diet scale (MDS) has been created to incorporate and test the inherent characteristics of this dietary pattern. This study aimed to psychometrically validate a self-administered version of the MDS in cardiac rehabilitation (CR) patients in Canada. To establish content validity, the scale was reviewed by an expert interdisciplinary panel. A final version of the tool was tested in 150 CR patients. Cronbach's alpha was 0.69. All ICC coefficients met the minimum recommended standard. Factor analysis revealed four factors, all internally consistent. Criterion validity was supported by significant differences in total scores by duration in CR. Construct validity was supported by agreements between the self-administered MDS and original MDS in all items and with the 3-day food record in 8 of 13 items. In conclusion, the self-administered version of the MDS demonstrated good reliability and validity.

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Dietary patterns begin in early childhood and can continue into adulthood. Thus, the early years are crucial for nutrition interventions and habit formation. 1 Infants have a natural affinity to sweet foods overall, and preand postnatal exposures of added sugar are important. 2,3 Genetic, environmental and cultural influences can increase preferences for sugary foods in children. 2 However, there is a lack of high-quality research data on the dietary intake of sugars among young children, especially among infants and toddlers. 4 Given that cardiometabolic risk markers may begin to emerge in children as young as 3 years of age, 5 it is important to understand patterns of sugar intake and explore associations between intake of sugar and cardiometabolic risk markers (including anthropometric measures) in early life. This information can help inform policy development and programs for behaviour change intervention focused on early prevention.Adverse effects of excessive sugar intake are a cause for global public health concern in all age groups. 6 Overconsumption of sugar has been associated with increased risk of excessive weight gain, dental decay, poor diet quality and nutritional inadequacy in children and adolescents younger than 19 years. 4,7,8 Excessive sugar intake has also been implicated in the development of