Adherence to the Mediterranean diet pattern among university staff: a cross-sectional web-based epidemiological study in Southern Italy

Caparello, Giovanna; Galluccio, Angelo; Giordano, Cinzia; Lofaro, Danilo; Barone, Ines; Morelli, Catia; Sisci, Diego; Catalano, Stefania; Andò, Sebastiano; Bonofiglio, Daniela

doi:10.1080/09637486.2019.1686753

Cited by 32 publications

(45 citation statements)

References 41 publications

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“…Furthermore, no significant differences were found in adherence to the MD according to gender, in agreement with the data reported by other authors among adolescents living in the Mediterranean region [42]. We have also recently found an average adherence to the MD in the adult population from the same Mediterranean area, which was independent of sex, but directly associated with age [46]. Importantly, in all samples, the percentage of adherers to recommendations for fruits, nuts, and fish, estimated by a validated 14-point Mediterranean adherence screener (MEDAS) result was outside the dietary guidelines [46].…”

Section: Discussionsupporting

confidence: 92%

“…We have also recently found an average adherence to the MD in the adult population from the same Mediterranean area, which was independent of sex, but directly associated with age [46]. Importantly, in all samples, the percentage of adherers to recommendations for fruits, nuts, and fish, estimated by a validated 14-point Mediterranean adherence screener (MEDAS) result was outside the dietary guidelines [46]. Referring to the evaluation using the KIDMED to assess the adherence to the MD in our adolescent sample, the compliance rates for consuming yogurts or cheese every day, more vegetables a day, nuts every day, and a second fruit each day resulted in being definitively outside the recommendations.…”

Section: Discussionmentioning

confidence: 54%

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Impact of Vigorous-Intensity Physical Activity on Body Composition Parameters, Lipid Profile Markers, and Irisin Levels in Adolescents: A Cross-Sectional Study

et al. 2020

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In adolescence, health status is influenced by several factors, including dietary pattern and physical activity (PA) which are crucial elements of lifestyle in terms of prevention and treatment of metabolic and chronic diseases. The current study aimed to explore the impact of the different intensity levels of PA along with the adherence to a Mediterranean diet (MD), on body composition indices and metabolic parameters in a cohort of adolescents, thereby investigating potential predictors of health behavior in youth. This cross-sectional study was carried out among 92 participants (44 girls and 48 boys, aged 14 to 17 years), which were divided into the following three groups according to intensity levels of PA: Group A (physical inactivity), Group B (moderate PA), and Group C (vigorous-intensity PA). The Questionnaire of Adherence to the Mediterranean Diet (KIDMED test) was used to assess both diet composition and adherence to a MD. All subjects underwent anthropometric measurements, bio-impedentiometric analysis for body composition parameters, and biochemical and hormonal measurements. The majority of adolescents (60.87%) had a medium adherence to the MD, and even a better distribution of food rates was found in adolescents performing vigorous-intensity PA. A comparison of anthropometric measurements and body composition parameters among groups showed that body mass index and fat mass (FM) were significantly lower while body cell mass (BCM), free fat mass (FFM), phase angle (PhA), and total body water (TBW) were higher in Group C adolescents as compared with those of Group A. In Group C, insulin resistance (HOMA-IR) was reduced and insulin levels were inversely associated with FFM (r = −0.454 and p = 0.004) and directly correlated with FM (r = 0.331 and p = 0.003). In the same Group C, we observed elevated serum irisin levels and lower lipid profile markers as compared with Group A. Interestingly, irisin negatively correlated with both total cholesterol (r = −0.428 and p = 0.04) and LDL (r = −0.468 and p = 0.02) in Group C. Finally, a receiver operator characteristic curve (ROC) analysis revealed irisin, LDL, HDL, and body composition variables (FFM, BMC, PhA, and TBW) as the most predictive measures for vigorous-intensity PA. Our results highlight the importance of developing healthy lifestyle programs that include improving the intensity of PA among a young population as a superior strategy for ensuring a better quality of life.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 54%

Impact of Vigorous-Intensity Physical Activity on Body Composition Parameters, Lipid Profile Markers, and Irisin Levels in Adolescents: A Cross-Sectional Study

et al. 2020

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“…The average score and the percentage of adherents to the Mediterranean diet were higher in women, in line with other published data [1,19].…”

Section: Discussionsupporting

confidence: 92%

Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study

et al. 2020

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The objective of this study is to analyze the influence of adherence to the Mediterranean diet (MDA) and its components on early vascular aging (EVA) in a Spanish population sample free of cardiovascular disease and to analyze the differences by sex. Methods: We recruited 501 individuals aged 35–75 without cardiovascular disease by random sampling (55.90 ± 14.24 years, 49.70% men). EVA was defined in two steps: Step 1: subjects with vascular damage in carotid arteries or peripheral artery disease were classified as EVA. Step 2: subjects at the percentile of the combined Vascular Aging Index (VAI) were classified; ≥ p90 was considered EVA and < p90 was considered normal vascular aging (NVA), estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76 by age and sex. Carotid-femoral pulse wave velocity (cfPWV) was measured by SphigmoCor System® and carotid intima-media thickness by Sonosite Micromax® ultrasound and classified thus: values ≥ Percentile 90 were considered EVA and those < Percentile 90 as NVA, with population percentiles analyzed. The principal result variable was assessed using the 14-item MEDAS questionnaire, developed and validated by the PREDIMED group, comprising 12 questions about the frequency of food consumption and two questions regarding the Spanish population’s typical eating habits. Results: MDA was observed by 25% (17% men and 34% women). EVA was present in 17% (29% men and 4% women). The adjusted logistic regression models showed that an increase in MDA decreases the probability of EVA in the global analysis (OR = 0.36; 95% CI: 0.16–0.82). In the analysis by sex, this association was only seen in men (OR = 0.33; 95% CI: 0.12–0.86), but not in women (OR = 0.31; 95% CI: 0.04–2.50). Conclusion: The results of this study suggest that a greater adherence to the Mediterranean diet decreases the probability of presenting EVA. In the analysis by sex, this association applies only to men.

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“…Further, the sample population from SP, which exhibited the highest adherence to the MD, reached an average MEDAS of 8.35 ± 1.65 and was very close to the value attained in the PREDIMED validation study (8.68 ± 1.90) [ 6 ]. Moreover, our estimated IT, PT, and GR 14-MEDAS scores (6.86 ± 1.63, 6.55 ± 1.98 and 6.32 ± 1.68, respectively) were not too dissimilar from the previously published scores of 7.34 ± 1.9 in Southern Italy [ 35 ], 7.29 ± 2.15 in a population of Portuguese adults from Lisbon [ 14 ], and 6.40 ± 1.90 in a sample population of Greek students [ 36 ] and were all classified in the fair-to-moderate adherence range [ 22 ]. Conversely, in non-Mediterranean European countries, the 14-item MEDAS scores were lower such as in the UK study with a value of 5.47 ± 2.09 [ 9 ].…”

Section: Discussioncontrasting

confidence: 48%

“…Misreporting is a common reason for the differences found between dietary assessment instruments and can be influenced by factors such as sex [ 38 ] or BMI, with the probability of underreporting increasing with a higher BMI [ 39 ]. In the same way, the 14-MEDAS score has also been reported to be influenced by sex [ 36 ] or age [ 35 ] as well as having a negative association with BMI, i.e., higher 14-MEDAS score is correlated with lower BMI [ 22 ]. Our analyses further corroborate this negative relationship between BMI and the 14-MEDAS score as well as between BMI and the validation of the 14-MEDAS score against the 3d-FD score, which may partially contribute to explain the results attained in NMK and BG both countries with a significant higher percentage of participants with overweight and obesity than in the other countries.…”

Section: Discussionmentioning

confidence: 99%

Exploring the Validity of the 14-Item Mediterranean Diet Adherence Screener (MEDAS): A Cross-National Study in Seven European Countries around the Mediterranean Region

et al. 2020

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This study provides comprehensive validation of the 14-item Mediterranean Diet Adherence Screener (14-MEDAS) in an adult population from Greece (GR), Portugal (PT), Italy (IT), Spain (SP), Cyprus (CY), Republic of North Macedonia (NMK), and Bulgaria (BG). A moderate association between the 14-MEDAS and the reference food diary was estimated for the entire population (Pearson r = 0.573, p-value < 0.001; Intraclass Correlation Coefficient (ICC) = 0.692, p-value < 0.001) with the strongest correlation found in GR, followed by PT, IT, SP, and CY. These results were supported by kappa statistics in GR, PT, IT, and SP with ≥50% of food items exhibiting a fair or better agreement. Bland–Altman analyses showed an overestimation of the 14-MEDAS score in the whole population (0.79 ± 1.81, 95%Confidence Interval (CI) 0.61, 0.96), but this value was variable across countries, with GR, NMK, and BG exhibiting the lowest bias. Taking all analyses together, the validation achieved slightly better results in the Mediterranean countries but a definitive validation ranking order was not evident. Considering growing evidence of the shift from Mediterranean Diet (MD) adherence and of the importance of culture in making food choices it is crucial that we further improve validation protocols with specific applications to compare MD adherence across countries.

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Adherence to the Mediterranean diet pattern among university staff: a cross-sectional web-based epidemiological study in Southern Italy

Cited by 32 publications

References 41 publications

Impact of Vigorous-Intensity Physical Activity on Body Composition Parameters, Lipid Profile Markers, and Irisin Levels in Adolescents: A Cross-Sectional Study

Impact of Vigorous-Intensity Physical Activity on Body Composition Parameters, Lipid Profile Markers, and Irisin Levels in Adolescents: A Cross-Sectional Study

Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study

Exploring the Validity of the 14-Item Mediterranean Diet Adherence Screener (MEDAS): A Cross-National Study in Seven European Countries around the Mediterranean Region

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