TY - JOUR
T1 - Exploring the validity of the 14-item mediterranean diet adherence screener (Medas)
T2 - A cross-national study in seven european countries around the mediterranean region
AU - García-Conesa, María Teresa
AU - Philippou, Elena
AU - Pafilas, Christos
AU - Massaro, Marika
AU - Quarta, Stefano
AU - Andrade, Vanda
AU - Jorge, Rui
AU - Chervenkov, Mihail
AU - Ivanova, Teodora
AU - Dimitrova, Dessislava
AU - Maksimova, Viktorija
AU - Smilkov, Katarina
AU - Ackova, Darinka Gjorgieva
AU - Miloseva, Lence
AU - Ruskovska, Tatjana
AU - Deligiannidou, Georgia Eirini
AU - Kontogiorgis, Christos A.
AU - Pinto, Paula
PY - 2020/10
Y1 - 2020/10
N2 - This study provides comprehensive validation of the 14-item Mediterranean Diet Adherence Screener (14-MEDAS) in an adult population from Greece (GR), Portugal (PT), Italy (IT), Spain (SP), Cyprus (CY), Republic of North Macedonia (NMK), and Bulgaria (BG). A moderate association between the 14-MEDAS and the reference food diary was estimated for the entire population (Pearson r = 0.573, p-value < 0.001; Intraclass Correlation Coefficient (ICC) = 0.692, pvalue < 0.001) with the strongest correlation found in GR, followed by PT, IT, SP, and CY. These results were supported by kappa statistics in GR, PT, IT, and SP with ≥50% of food items exhibiting a fair or better agreement. Bland–Altman analyses showed an overestimation of the 14-MEDAS score in the whole population (0.79 ± 1.81, 95%Confidence Interval (CI) 0.61, 0.96), but this value was variable across countries, with GR, NMK, and BG exhibiting the lowest bias. Taking all analyses together, the validation achieved slightly better results in the Mediterranean countries but a definitive validation ranking order was not evident. Considering growing evidence of the shift from Mediterranean Diet (MD) adherence and of the importance of culture in making food choices it is crucial that we further improve validation protocols with specific applications to compare MD adherence across countries.
AB - This study provides comprehensive validation of the 14-item Mediterranean Diet Adherence Screener (14-MEDAS) in an adult population from Greece (GR), Portugal (PT), Italy (IT), Spain (SP), Cyprus (CY), Republic of North Macedonia (NMK), and Bulgaria (BG). A moderate association between the 14-MEDAS and the reference food diary was estimated for the entire population (Pearson r = 0.573, p-value < 0.001; Intraclass Correlation Coefficient (ICC) = 0.692, pvalue < 0.001) with the strongest correlation found in GR, followed by PT, IT, SP, and CY. These results were supported by kappa statistics in GR, PT, IT, and SP with ≥50% of food items exhibiting a fair or better agreement. Bland–Altman analyses showed an overestimation of the 14-MEDAS score in the whole population (0.79 ± 1.81, 95%Confidence Interval (CI) 0.61, 0.96), but this value was variable across countries, with GR, NMK, and BG exhibiting the lowest bias. Taking all analyses together, the validation achieved slightly better results in the Mediterranean countries but a definitive validation ranking order was not evident. Considering growing evidence of the shift from Mediterranean Diet (MD) adherence and of the importance of culture in making food choices it is crucial that we further improve validation protocols with specific applications to compare MD adherence across countries.
KW - Body mass index
KW - Diet adherence
KW - Diet quality
KW - Dietary assessment
KW - Dietary health benefits
KW - Food frequency questionnaire
KW - Mediterranean Diet
KW - Southern Europe
KW - Survey instruments
KW - Validation
UR - http://www.scopus.com/inward/record.url?scp=85091632000&partnerID=8YFLogxK
U2 - 10.3390/nu12102960
DO - 10.3390/nu12102960
M3 - Article
AN - SCOPUS:85091632000
SN - 2072-6643
VL - 12
SP - 1
EP - 18
JO - Nutrients
JF - Nutrients
IS - 10
M1 - 2960
ER -