title: Factors associated with a low adherence to a Mediterranean diet pattern in healthy Spanish women before pregnancy.
abstract: OBJECTIVE
  To analyse the factors associated with the level of adherence to a Mediterranean dietary pattern in healthy Spanish women before pregnancy.
  
  
  METHODS
  A prospective series of 1175 women. An FFQ validated in Spanish populations served to collect dietary data. The Mediterranean Diet Adherence Index was used to assess the level of adherence to a Mediterranean diet pattern. Polytomic regression was performed to identify the associated factors.
  
  
  METHODS
  Catchment area of Virgen de las Nieves University Hospital, Andalusia, Spain.
  
  
  METHODS
  The women were invited to participate in the study at the 20th-22nd gestational week. The selection criteria were: Spanish nationality, 18 years of age or older, singleton pregnancy and absence of health problems that required modifying the diet or physical activity.
  
  
  RESULTS
  An inverse relationship was found between women's age and level of adherence to a Mediterranean diet pattern, with a clear dose-response association: a younger age entailed worse adherence (P < 0·001). The habit of smoking and sedentary lifestyle had a positive relationship with low adherence, giving OR = 5·36 (95 % 1·91, 15·07) for women who smoked >20 cigarettes/d and OR = 2·07 (95 % CI 1·34, 3·17) for sedentary women. Higher age, higher educational level, and higher social class of the women were associated with a higher level of adherence to the Mediterranean diet (P < 0·001).
  
  
  CONCLUSIONS
  In our sample population, younger age, lower social class, primary educational level and elements of an unhealthy lifestyle such as smoking and lack of exercise were associated with low adherence to a Mediterranean diet.
authors.affiliation: 1 Department of Preventive Medicine and Public Health, University of Granada, Avenida de Madrid 11, 18071 Granada, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: Olmedo-Requena
authors.affiliation: 3 Gynecology and Obstetrics Service, Jaen Hospital Complex, Jaén, Spain.
authors.forename: Julia Gómez
authors.initials: JG
authors.lastname: Fernández
authors.affiliation: 1 Department of Preventive Medicine and Public Health, University of Granada, Avenida de Madrid 11, 18071 Granada, Spain.
authors.forename: Carmen Amezcua
authors.initials: CA
authors.lastname: Prieto
authors.affiliation: 4 Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: Juan Mozas
authors.initials: JM
authors.lastname: Moreno
authors.affiliation: 1 Department of Preventive Medicine and Public Health, University of Granada, Avenida de Madrid 11, 18071 Granada, Spain.
authors.forename: Aurora
authors.initials: A
authors.lastname: Bueno-Cavanillas
authors.affiliation: 1 Department of Preventive Medicine and Public Health, University of Granada, Avenida de Madrid 11, 18071 Granada, Spain.
authors.forename: José J
authors.initials: JJ
authors.lastname: Jiménez-Moleón
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002391:Catchment Area, Health; D038441:Diet, Mediterranean / Q000523:psychology* / Q000706:statistics & numerical data; D002149:Energy Intake; D015444:Exercise / Q000502:physiology; D005260:Female; D005502:Food / Q000145:classification; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D011446:Prospective Studies; D057185:Sedentary Behavior; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult