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A Short Screener Is Valid for Assessing Mediterranean Diet Adherence among Older Spanish Men and Women

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Schröder, Helmut, Fitó, Montserrat, Estruch, Ramón, Martínez-González, Miguel A., 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·2011·The Journal of Nutrition

DOI 10.3945/jn.110.135566

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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.

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Authors: Schröder, H., Fitó, M., Estruch, R., Martínez-González, M. A., Corella, D., Salas-Salvadó, J., Lamuela-Raventós, R., Ros, E., Salaverría, I., Fiol, M., Lapetra, J., Vinyoles, E., Gómez-Gracia, E., Lahoz, C., Serra-Majem, L., Pintó, X., Ruiz-Gutierrez, V., & Covas, M.-I.
Affiliations: Instituto de Salud Carlos III (ES)
Universitat de València (ES)
Carlos III Hospital (ES)
Bellvitge University Hospital (ES)
Corresponding author: Schröder, Helmut
ORCID: Schröder, Helmut
Fitó, Montserrat
Estruch, Ramón
Corella, Dolores
Lamuela-Raventós, Rosa
Ros, Emilio
Fiol, Miquel
Lapetra, José
Vinyoles, Ernest
Lahoz, Carlos
Pintó, Xavier
Venue: The Journal of Nutrition
Publisher: Elsevier BV
Published: 2011-06
Volume: 141
Issue: 6
Pages: 1140-1145
ISSN: 0022-3166 (ISSN-L)
DOI: 10.3945/jn.110.135566
OpenAlex: W2106641403
Cited by: 1,624
References: 34
Citations by year: 2026: 164 · 2025: 174 · 2024: 212 · 2023: 161 · 2022: 149 · 2021: 154 · 2020: 133 · 2019: 120 · 2018: 102 · 2017: 67 · 2016: 57 · 2015: 40 · 2014: 41 · 2013: 23 · 2012: 21
FWCI: 28.00
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 4271 d)
Locations: Journal of Nutrition (publishedVersion)
PubMed (publishedVersion)
Rovira & Virgili repository (submittedVersion, cc-by)
Acceda (Universidad de Las Palmas de Gran Canaria) (submittedVersion)
DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion)
Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion)
RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion)
Repositori institucional URV (Universitat Rovira i Virgili) (submittedVersion)
Funders: Eli Lilly and Company
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
Keywords: Mediterranean Diet Adherence Screener, Mediterranean diet adherence, dietary assessment validity, PREDIMED study, food frequency questionnaire, older adults, coronary artery disease risk, HDL cholesterol, triglycerides, body mass index, waist circumference, fasting blood glucose
MeSH terms: Aged, Aged, 80 and over, Blood Glucose, Coronary Artery Disease, Diet Surveys, Female, Humans, Lipids, Male, Middle Aged, Patient Compliance, Preventive Medicine, Surveys and Questionnaires, Risk Factors, Spain, Linear Models, Diet, Mediterranean, Waist Circumference

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A Short Screener Is Valid for Assessing Mediterranean Diet Adherence among Older Spanish Men and Women

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