title: Adherence to the "Mediterranean Diet" in Spain and Its Relationship with Cardiovascular Risk (DIMERICA Study).
abstract: BACKGROUND
  Nutritional studies focus on traditional cultural models and lifestyles in different countries. The aim of this study was to examine the adherence to the Mediterranean diet, life habits, and risk factors associated with cardiovascular diseases among people living in different geographical regions in Spain.
  
  
  METHODS
  A descriptive cross-sectional study was conducted in each region. The sampling scheme consisted of a random three-stage stratified sampling program according to geographic region, age, and gender. A total of 1732 subjects were asked to complete a questionnaire designed to assess their nutrient intake, dietary habits, and exercise. A diet score that assesses the adherence of participants to the Mediterranean diet (range 0-10) was also applied.
  
  
  RESULTS
  Southeastern Spain had the lowest score for adherence to the Mediterranean diet because of the low consumption of fish and plant products. A lower adherence score to the Mediterranean diet was strongly associated with the prevalence of hypertension (p= 0.018).
  
  
  CONCLUSIONS
  A low level of adherence to the Mediterranean diet is accompanied by a high prevalence of hypertension and, therefore, a raised cardiovascular risk in the country. The adherence score could help identify individuals at greater cardiovascular risk.
authors: Departamento de Nutrición y Cátedra de Riesgo Cardiovascular, Facultad de Ciencias de la Salud, UCAM Universidad Católica San Antonio de Murcia, Campus de los Jerónimos, s/n, Guadalupe 30107, Murcia, Spain. jabellan@ucam.edu.
authors: José
authors: J
authors: Abellán Alemán
authors: Departamento de Nutrición y Cátedra de Riesgo Cardiovascular, Facultad de Ciencias de la Salud, UCAM Universidad Católica San Antonio de Murcia, Campus de los Jerónimos, s/n, Guadalupe 30107, Murcia, Spain. mpzafrilla@ucam.edu.
authors: María Pilar
authors: MP
authors: Zafrilla Rentero
authors: Departamento de Nutrición y Cátedra de Riesgo Cardiovascular, Facultad de Ciencias de la Salud, UCAM Universidad Católica San Antonio de Murcia, Campus de los Jerónimos, s/n, Guadalupe 30107, Murcia, Spain. smontoro@ucam.edu.
authors: Silvia
authors: S
authors: Montoro-García
authors: Departamento de Nutrición y Cátedra de Riesgo Cardiovascular, Facultad de Ciencias de la Salud, UCAM Universidad Católica San Antonio de Murcia, Campus de los Jerónimos, s/n, Guadalupe 30107, Murcia, Spain. jmulero@ucam.edu.
authors: Juana
authors: J
authors: Mulero
authors: Departamento de Nutrición y Cátedra de Riesgo Cardiovascular, Facultad de Ciencias de la Salud, UCAM Universidad Católica San Antonio de Murcia, Campus de los Jerónimos, s/n, Guadalupe 30107, Murcia, Spain. aperez@ucam.edu.
authors: Alfonso
authors: A
authors: Pérez Garrido
authors: Departamento de Nutrición y Cátedra de Riesgo Cardiovascular, Facultad de Ciencias de la Salud, UCAM Universidad Católica San Antonio de Murcia, Campus de los Jerónimos, s/n, Guadalupe 30107, Murcia, Spain. arboleja@yahoo.es.
authors: Mariano
authors: M
authors: Leal
authors: Grupo EHRICA (Enfermería de Hipertensión y Riesgo Cardiovascular) Hospital 12 de Octubre, Madrid 28041, Spain. lucia.guerrero@ehrica.org.
authors: Lucía
authors: L
authors: Guerrero
authors: Grupo EHRICA (Enfermería de Hipertensión y Riesgo Cardiovascular) Hospital 12 de Octubre, Madrid 28041, Spain. elena-rq@telefonica.net.
authors: Elena
authors: E
authors: Ramos
authors: Instituto de Investigación y Unidad de Hipertensión, Hospital 12 de Octubre, Madrid 28041, Spain. ruilope@ad-hocbox.com.
authors: Luis Miguel
authors: LM
authors: Ruilope
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects / Q000208:ethnology; D038441:Diet, Mediterranean / Q000208:ethnology; D015444:Exercise; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D000070497:Healthy Lifestyle; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D010349:Patient Compliance / Q000208:ethnology; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
keywords: Mediterranean diet; Spain; adherence; cardiovascular risk factors; score