Validity of the energy-restricted Mediterranean Diet Adherence Screener

Schröder, Helmut; Zomeño, María Dolores; Martínez‐González, Miguel Ángel; Salas‐Salvadó, Jordi; Corella, Dolores; Vioque, Jesús; Romaguera, Dora; Martínéz, J. Alfredo; Tinahones, Francisco J.; López‐Miranda, José; Estruch, Ramón; Bueno‐Cavanillas, Aurora; Gómez, Ángela; Tur, Josep A.; Wärnberǵ, Julia; Serra‐Majem, Lluís; Martín, Vicente; Vázquez, Clotilde; Lapetra, José; Pintó, Xavier; Vidal, Josep; Daimiel, Lidia; Gaforio, José J.; Matía‐Martín, Pilar; Ros, Emilio; Lassale, Camille; Ruíz-Canela, Miguel; Babió, Nancy; Sorlí, José V.; García‐Arellano, Ana; Díaz‐López, Andrés; Fitó, Montserrat; Castañer, Olga; investigators, PREDIMED-Plus

doi:10.1016/j.clnu.2021.06.030

Cited by 72 publications

(66 citation statements)

References 27 publications

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“…With growing evidence to support the imbedding of the Mediterranean diet into cardiac group education programs, clinicians and researchers alike require appropriate tools to evaluate the effectiveness of interventions [21,22]. The Med-NKQ complements dietary adherence screeners, recently endorsed by the American Heart Association, through diversifying the tools available to provide a more comprehensive assessment of dietary intervention educational effects [11,12,64].…”

Section: Discussionmentioning

confidence: 99%

“…This is often achieved through group education programs such as those delivered within cardiac rehabilitation. Short item dietary screeners including the 14-point Mediterranean Diet Adherence Screener (MEDAS) used within the PREDIMED trial and more recently the 17-point energy-restricted Mediterranean Diet Adherence Screener (er-MEDAS) are validated measures of dietary adherence, which, due to their short form, are ideal for use in a clinical setting [11,12]. Unfortunately, nutrition knowledge is rarely evaluated, and this may in part be due to the lack of appropriate tools for use in clinical practice [13].…”

Section: Introductionmentioning

confidence: 99%

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The Med-NKQ: A Reliable Mediterranean Diet Nutrition Knowledge Questionnaire for Cardiovascular Disease

2021

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The Mediterranean diet (MD) has significant benefits for cardiovascular disease (CVD), yet clinicians lack reliable tools to measure patient knowledge. This study aimed to develop a short tool to test knowledge of MD related to cardiac health. Themes included foods to reduce CVD risk factors, quantification of servings, and common MD dietary patterns; a maximum score of 42 was determined for correct responses. Content validity was assessed through expert consensus in a Delphi survey. A 70% level of agreement was set for each domain tested. Repeatability was assessed via a test-retest protocol in a sample with self-reported CVD, advertised through social media and administered online. Ten and six of twenty-five invited experts responded to round one and two of the Delphi survey respectively. All items achieved greater than 70% consensus. Twenty people completed the repeatability study. A paired t-test found no significant difference in mean scores between the two test periods (Test one, 28 (standard deviation (SD) 5.4). Test two 29.5, (SD 5.5), p = 0.174) and a Bland-Altman Plot indicated no bias between the two surveys. The Med-NKQ demonstrated good content validity and reliability in people with CVD, and is short and easy to administer, making it practical in clinical and research settings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Med-NKQ: A Reliable Mediterranean Diet Nutrition Knowledge Questionnaire for Cardiovascular Disease

2021

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“…Adherence to the energy-reduced Mediterranean Diet (er-MedDiet) was assessed by trained dieticians using a recently validated questionnaire of 17 items [ 31 ]. This questionnaire has been used in the ongoing PREDIMED-Plus study aiming to assess the effect of an er-MedDiet on cardiovascular events in people with overweight and obesity at increased risk of CVD.…”

Section: Methodsmentioning

confidence: 99%

Deprivation Index and Lifestyle: Baseline Cross-Sectional Analysis of the PREDIMED-Plus Catalonia Study

et al. 2021

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This baseline cross-sectional analysis from data acquired in a sub-sample of the PREDIMED-Plus study participants aimed to evaluate the relation between the Composite Socioeconomic Index (CSI) and lifestyle (diet and physical activity). This study involved 1512 participants (759 (52.2%) women) between 55 and 80 years with overweight/obesity and metabolic syndrome assigned to 137 primary healthcare centers in Catalonia, Spain. CSI and lifestyle (diet and physical activity) were assessed. Multiple linear regression or multinomial regression were applied to the data. Cluster analysis was performed to identify dietary patterns. The multiple linear regression model showed that a high deprivation index was related to a higher consumption of refined cereals (11.98 g/d, p-value = 0.001) and potatoes (6.68 g/d, p-value = 0.001), and to a lower consumption of fruits (−17.52 g/d, p-value = 0.036), and coffee and tea (−8.03 g/d, p-value = 0.013). Two a posteriori dietary patterns were identified by cluster analysis and labeled as “healthy” and “unhealthy”. In addition, the multinomial regression model showed that a high deprivation index was related to an unhealthy dietary pattern and low physical activity (OR 1.42 [95% CI 1.06–1.89]; p-value < 0.05). In conclusion, a high deprivation index was related to an unhealthy lifestyle (diet and physical activity) in PREDIMED-Plus study participants.

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“…Except for blood pressure determined in triplicate, the remaining anthropometric variables were determined in duplicate, and the mean of these measurements was used. Dietitians used a validated food frequency questionnaire to estimate dietary consumption [22] and a 17-point validated tool [23] to calculate the energy-restricted MedDiet adherence score (erMedDiet score). Leisure-time physical activity was assessed using the validated REGICOR questionnaire [24] (including questions to collect information on the type of activity, frequency (number of days), and duration (min/day)).…”

Section: Assessment Of Covariatesmentioning

confidence: 99%

Modulation of Telomere Length by Mediterranean Diet, Caloric Restriction, and Exercise: Results from PREDIMED-Plus Study

et al. 2021

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Telomere length (TL) has been associated with aging and is determined by lifestyle. However, the mechanisms by which a dietary pattern such as the Mediterranean diet (MedDiet) affects TL homeostasis are still unknown. Our aim was to analyse the effect of an energy-restricted MedDiet with physical activity promotion (intervention group) versus an unrestricted-caloric MedDiet with no weight-loss advice (control group) on TL and 8-hydroxydeoxyguanosine (8-OHdG) plasma levels. In total, 80 non-diabetic participants with metabolic syndrome were randomly selected from the PREDIMED (PREvención con DIeta MEDiterránea)-Plus-Reus study. TL was measured by a hybridisation method and 8-OHdG levels by ELISA at baseline and after one year of intervention. Linear mixed models (LMM)—raw and after adjusting for potential confounders—were used to examine the associations between TL or 8-OHdG plasma levels by intervention group and/or time. A total of 69 subjects with available DNA samples were included in the analyses. A significant β-coefficient was found for time towards increasing values through the year of follow-up for TL (unadjusted β of 0.740 (95% CI: 0.529 to 0.951), and multivariable model β of 0.700 (95% CI: 0.477 to 0.922)). No significant βs were found, neither for the intervention group nor for the interaction between the intervention group and time. Regarding 8-OHdG plasma levels, no significant βs were found for the intervention group, time, and its interaction. Our results suggest that MedDiet could have an important role in preventing telomere shortening, but calorie restriction and exercise promotion did not provide an additional advantage concerning telomere length after one year of MedDiet intervention.

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Validity of the energy-restricted Mediterranean Diet Adherence Screener

Cited by 72 publications

References 27 publications

The Med-NKQ: A Reliable Mediterranean Diet Nutrition Knowledge Questionnaire for Cardiovascular Disease

The Med-NKQ: A Reliable Mediterranean Diet Nutrition Knowledge Questionnaire for Cardiovascular Disease

Deprivation Index and Lifestyle: Baseline Cross-Sectional Analysis of the PREDIMED-Plus Catalonia Study

Modulation of Telomere Length by Mediterranean Diet, Caloric Restriction, and Exercise: Results from PREDIMED-Plus Study

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