title: 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.
authors.affiliation: Cardiovascular Risk and Nutrition Research Group, IMIM-Institut de Recerca del Hospital del Mar, Barcelona 08003, Spain. hschroeder@imim.es
authors.forename: Helmut
authors.initials: H
authors.lastname: Schröder
authors.forename: Montserrat
authors.initials: M
authors.lastname: Fitó
authors.forename: Ramón
authors.initials: R
authors.lastname: Estruch
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martínez-González
authors.forename: Dolores
authors.initials: D
authors.lastname: Corella
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.forename: Rosa
authors.initials: R
authors.lastname: Lamuela-Raventós
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
authors.forename: Itziar
authors.initials: I
authors.lastname: Salaverría
authors.forename: Miquel
authors.initials: M
authors.lastname: Fiol
authors.forename: José
authors.initials: J
authors.lastname: Lapetra
authors.forename: Ernest
authors.initials: E
authors.lastname: Vinyoles
authors.forename: Enrique
authors.initials: E
authors.lastname: Gómez-Gracia
authors.forename: Carlos
authors.initials: C
authors.lastname: Lahoz
authors.forename: Lluis
authors.initials: L
authors.lastname: Serra-Majem
authors.forename: Xavier
authors.initials: X
authors.lastname: Pintó
authors.forename: Valentina
authors.initials: V
authors.lastname: Ruiz-Gutierrez
authors.forename: María-Isabel
authors.initials: MI
authors.lastname: Covas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D003324:Coronary Artery Disease / Q000517:prevention & control; D004034:Diet Surveys; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011315:Preventive Medicine; D012307:Risk Factors; D013030:Spain; D011795:Surveys and Questionnaires; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008055:Lipids