title: A novel Mediterranean diet index from Lebanon: comparison with Europe.
abstract: OBJECTIVE
  To propose an index for assessing adherence to a Middle Eastern version of the Mediterranean diet as represented by the Traditional Lebanese Mediterranean diet (LMD), to evaluate the association between the LMD and selected European Mediterranean diets (EMD), and to examine socio-demographic and lifestyle correlates of adherence to Mediterranean diet (MD) among Lebanese adults.
  
  
  METHODS
  Using nationally representative dietary intake data of Lebanese adults, an index to measure Adherence to the LMD was derived. The choice of foods/food groups used for calculating the LMD score was based on results of previous factor analyses conducted on the same dataset. These foods/food groups included fruits, vegetables, legumes, olive oil, burghol, dairy products, starchy vegetables, dried fruits and eggs. Using Pearson's correlation and scores tertiles distributions agreement, the derived LMD index was compared to previously published EMD indexes from Greece, Spain, Italy, France and EPIC/Europe.
  
  
  RESULTS
  Fruits, vegetables and olive oil were common denominators to most MD scores. Food groups, specific to the LMD, included burghol, dried fruits, and eggs. The LMD score significantly correlated with the EMD scores, while being closest to the Italian (r = 0.56) and farthest from the French (r = 0.21). Percent agreement between scores' tertile distributions and Kappa statistics confirmed these findings. Multivariate linear regressions showed that older age and higher educational levels were associated with increased adherence to all MDs studied.
  
  
  CONCLUSIONS
  A novel LMD index was proposed to assess adherence to a Middle Eastern version of MD, complementing international efforts to characterize the MD and its association with disease risk.
authors.affiliation: Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon. fn14@aub.edu.lb.
authors.forename: Farah
authors.initials: F
authors.lastname: Naja
authors.affiliation: Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon. nahla@aub.edu.lb.
authors.forename: Nahla
authors.initials: N
authors.lastname: Hwalla
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El-Solh, Beirut, 1107 2809, Lebanon. itani.leila@gmail.com.
authors.forename: Leila
authors.initials: L
authors.lastname: Itani
authors.affiliation: Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon. shirine_baalbaki@hotmail.com.
authors.forename: Shirine
authors.initials: S
authors.lastname: Baalbaki
authors.affiliation: Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Riad El-Solh, Beirut, 1107 2020, Lebanon. am00@aub.edu.lb.
authors.forename: Abla
authors.initials: A
authors.lastname: Sibai
authors.affiliation: Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon. ln10@aub.edu.lb.
authors.forename: Lara
authors.initials: L
authors.lastname: Nasreddine
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D038441:Diet, Mediterranean; D005260:Female; D005602:France; D005638:Fruit; D006115:Greece; D006801:Humans; D007558:Italy; D007861:Lebanon; D008019:Life Style; D016014:Linear Models; D008297:Male; D009043:Motor Activity; D015999:Multivariate Analysis; D000069463:Olive Oil; D010349:Patient Compliance; D012959:Socioeconomic Factors; D013030:Spain; D014675:Vegetables; D055815:Young Adult
chemical_list: D000069463:Olive Oil
keywords: Adherence; Europe; Lebanon; Mediterranean diet; Middle East