A Short Screener Is Valid for Assessing Mediterranean Diet Adherence among Older Spanish Men and Women
2011
Schröder, Helmut | Fitó, Montserrat | Estruch, Ramón | Martínez G., Miguel A (Martínez González) | Corella, Dolores | Salas-Salvadó, Jordi | Lamuela-Raventós, Rosa | Ros, Emilio | Salaverría, Itziar | Fiol, Miquel | Lapetra, José | Vinyoles, Ernest | Gómez-Gracia, Enrique | Lahoz, Carlos | Serra-Majem, Lluis | Pintó, Xavier | Ruiz-Gutierrez, Valentina | Covas, María-Isabel
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.
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