A Short Screener Is Valid for Assessing Mediterranean Diet Adherence among Older Spanish Men and Women

Abstract

Ensuring the accuracy of dietary assessment instruments is paramount for interpreting diet-disease relationships. The present study assessed the relative and construct validity of the 14-point Mediterranean Diet Adherence Screener (MEDAS) used in the Prevención con Dieta Mediterránea (PREDIMED) study, a primary prevention nutrition-intervention trial. A validated FFQ and the MEDAS were administered to 7146 participants of the PREDIMED study. The MEDAS-derived PREDIMED score correlated significantly with the corresponding FFQ PREDIMED score (r = 0.52; intraclass correlation coefficient = 0.51) and in the anticipated directions with the dietary intakes reported on the FFQ. Using Bland Altman's analysis, the average MEDAS Mediterranean diet score estimate was 105% of the FFQ PREDIMED score estimate. Limits of agreement ranged between 57 and 153%. Multiple linear regression analyses revealed that a higher PREDIMED score related directly (P < 0.001) to HDL-cholesterol (HDL-C) and inversely (P < 0.038) to BMI, waist circumference, TG, the TG:HDL-C ratio, fasting glucose, and the cholesterol:HDL-C ratio. The 10-y estimated coronary artery disease risk decreased as the PREDIMED score increased (P < 0.001). The MEDAS is a valid instrument for rapid estimation of adherence to the Mediterranean diet and may be useful in clinical practice.

Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial

“…Peanuts, almonds, hazelnuts, walnuts, pine nuts, pistachios, Brazil nuts, macadamia and cashews were all considered nuts. In addition, dietitians administered a validated 14-item MedDiet screener designed to assess the degree of adherence to the traditional MedDiet [20]. We used the score of this brief screener to control for the overall dietary pattern, because a higher adherence to the MedDiet among frequent consumers of nuts could introduce confounding.…”

Diabetes and Risk of Frailty and Its Potential Mechanisms: A Prospective Cohort Study of Older Adults

“…Adherence to the Mediterranean diet was summarized using the Mediterranean Diet Adherence Screener (MEDAS) index (18).…”

Extra virgin olive oil consumption reduces the risk of osteoporotic fractures in the PREDIMED trial

“…[22] A validated 14-item MedDiet screener was also administered to assess the degree of adherence to the MedDiet. [25] Two of the 14 items were related to olive oil intake. To control for the overall dietary pattern, the 2 items related to olive oil were removed from the total score; thus, a 12-point score was used as covariate in the models.…”