Abstract P098: The Association Between Obesity Status and Long-Term Adherence to Mediterranean Diet in the PREDIMED Trial

Background: The aim of this study was to determine if long-term adherence to a prescribed diet, in the context of the PREDIMED trial, a multi-year, randomized, controlled trial, was different among obese and non-obese participants after an average follow-up of three years. Previous studies only examined short term compliance or were not sufficiently powered to compare obese with nonobese participants. Methods: This randomized clinical trial included 6,463 subjects. All subjects were asymptomatic; females aged 55-80 years and males 55-80 years and were at high-risk for cardiovascular disease at baseline. Participants’ characteristics were measured at baseline and every 12 months. Obesity was defined as having a BMI of 30kg/m2 or more. The main outcome measure was achieving an average score of 10 points or more on a validated 14-point Mediterranean diet adherence scale over follow-up. Results: In all three dietary intervention groups, obesity status was significantly inversely associated with adherence to the Mediterranean diet; In the olive oil group, the odds ratio of obtaining a score of 10 or more was 23.4% (95% CI: 6.3, 37.5%) lower for obese subjects than for non-obese subjects after an average follow-up of three years. A similar pattern was also seen in the nuts group; the odds of obtaining a score of 10 or more was 24.3% (95% CI: 5.1,39.6%) lower for obese subjects than for non-obese subjects. In the low fat group, subjects who were obese at baseline had 25.7% (95% CI:5.7, 40.8%) lower odds of obtaining a score of 10 or more on the adherence score. All models were adjusted for relevant covariates. Conclusion: In this long-term trial of the Mediterranean Diet, adherence was high across all intervention groups. However, adherence was appreciably lower among obese participants after three years. Additional intervention efforts may be necessary to achieve the same adherence among high-risk obese individuals.

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Adherence to the Mediterranean Diet and Physical Resilience in Older Adults: The Seniors-ENRICA Cohort

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa277 ◽

2020 ◽

Cited By ~ 1

Author(s):

Mercedes Sotos-Prieto ◽

Rosario Ortolá ◽

Esther López-García ◽

Fernando Rodríguez-Artalejo ◽

Esther García-Esquinas

Keyword(s):

Older Adults ◽

Mediterranean Diet ◽

Healthy Eating Index ◽

Deficit Accumulation ◽

Diet Adherence ◽

Age Related ◽

Mediterranean Diet Adherence ◽

Accumulation Index ◽

The Mediterranean

Abstract Background No prior studies have studied the association between diet and physical resilience, thus our aim was to assess the association between the adherence to the Mediterranean diet and other healthy dietary patterns and physical resilience, assessed empirically as a trajectory through exposure to chronic and acute stressors, in older adults participating in the Seniors-ENRICA (The Study on Nutrition and Cardiovascular Risk in Spain) cohort. Methods Data were assessed from 1301 individuals aged 60 and older, participating in the ENRICA prospective cohort study and recruited in 2008–2010 and followed up to 2012 (trial registration: NCT02804672). A Mediterranean Diet Adherence Screener score and the Alternate Healthy Eating Index 2010 were derived at baseline from a validated diet history. Health status was assessed at baseline and at the end of follow-up with a 52-item health Deficit Accumulation Index (DAI) including 4 domains (physical and cognitive function, mental health, self-rated health/vitality, and morbidity); higher DAI values indicate worse health. Physical resilience was defined as accumulating fewer health deficits than the expected age-related increase in DAI over follow-up, despite exposure to chronic and acute stressors. Results Over a 3.2-year follow-up, 610 individuals showed physical resilience. In multivariate analyses, the odds ratio (95% confidence interval) of physical resilience for the highest versus lowest tertile (lowest adherence) of the Mediterranean Diet Adherence Screener score was 1.47 (1.10–1.98). The association held for those maintaining or improving the DAI over follow-up (over-resilience): 1.58 (1.10–2.26). Results were consistent in those with unintentional weight loss (2.21 [1.10–4.88]) or hospitalization (2.32 [1.18, 4.57]) as acute stressors. Conclusion In older adults, a higher adherence to the Mediterranean diet is associated with a greater likelihood of physical resilience.

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Mediterranean Diet Adherence and Subjective Well-Being in a Sample of Portuguese Adults

Nutrients ◽

10.3390/nu12123837 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3837

Author(s):

Vanda Andrade ◽

Rui Jorge ◽

María-Teresa García-Conesa ◽

Elena Philippou ◽

Marika Massaro ◽

...

Keyword(s):

Mediterranean Diet ◽

Well Being ◽

Subjective Assessment ◽

P Value ◽

Subjective Well Being ◽

Online Questionnaire ◽

Diet Adherence ◽

Bonferroni Adjustment ◽

Mediterranean Diet Adherence ◽

The Mediterranean

The Mediterranean diet (MD) and other lifestyle characteristics have been associated with well-being, a broad multiparameter concept that includes individual’s subjective assessment of their own well-being (SWB). Some studies have suggested that diet influences SWB, thus, this work aimed to add novel information on the association of MD and SWB in a sample of Portuguese adults. Data on sociodemographic, economic, lifestyle, diet, and SWB were collected through a self-filled online questionnaire. MD adherence was assessed by the Mediterranean Diet Adherence Screener (MEDAS) score. Results showed a moderate adherence to the MD in 490 Portuguese adults (mean MEDAS of 7.4 ± 2.1). A higher MD adherence was found to be significantly positively associated with women, employed individuals, a higher number of meals per day, and those with frequent contact with nature (p-value < 0.0025, using Bonferroni adjustment). As a novelty, this study divided the participants into low SWB, medium SWB, and medium to high SWB profiles (3.9 ± 1.0; 6.2 ± 1.0; 8.2 ± 1.3, respectively; p-value < 0.05), which reported significantly increasing MEDAS scores (6.5 ± 2.1; 7.3 ± 2.1; 7.8 ± 1.9; respectively, p-value < 0.05).

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ADHERENCE TO THE MEDITERRANEAN DIET IS NOT RELATED TO BETA-AMYLOID DEPOSITION: DATA FROM THE WOMEN’S HEALTHY AGEING PROJECT

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2018.12 ◽

2018 ◽

pp. 1-5

Author(s):

E. Hill ◽

C. Szoeke ◽

L. Dennerstein ◽

S. Campbell ◽

P. Clifton

Keyword(s):

Positron Emission Tomography ◽

Mediterranean Diet ◽

Beta Amyloid ◽

Amyloid Deposition ◽

Healthy Ageing ◽

Emission Tomography ◽

Diet Adherence ◽

Positron Emission ◽

Mediterranean Diet Adherence ◽

The Mediterranean

Background: Research has indicated the neuroprotective potential of the Mediterranean diet. Adherence to the Mediterranean diet has shown preventative potential for Alzheimer’s disease incidence and prevalence, yet few studies have investigated the impact of Mediterranean diet adherence on the hallmark protein; beta-amyloid. Objectives: To investigate the association between Mediterranean diet adherence and beta-amyloid deposition in a cohort of healthy older Australian women. Design: This study was a cross-sectional investigation of participants from the longitudinal, epidemiologically sourced Women’s Healthy Ageing Project which is a follow-up of the Melbourne Women’s Midlife Health Project. Setting: Assessments were conducted at the Centre for Medical Research, Royal Melbourne Hospital in Melbourne, Australia. F-18 Florbetaben positron emission tomography scanning was conducted at the Austin Centre for PET in Victoria, Australia. Participants: One hundred and eleven Women’s Healthy Ageing Project participants were included in the study. Measurements: Mediterranean diet adherence scores for all participants were calculated from the administration of a validated food frequency questionnaire constructed by the Cancer Council of Victoria. Beta-amyloid deposition was measured using positron emission tomography standardised uptake value ratios. Results: Gamma regression analysis displayed no association between Mediterranean diet adherence and beta-amyloid deposition. This result was consistent across APOE-ε4 +/- cohorts and with the inclusion of covariates such as age, education, body mass index and cognition. Conclusions: This study found no association between adherence to the Mediterranean diet and beta-amyloid deposition in a cohort of healthy Australian women.

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Comparison of the Mediterranean diet and the Dietary Approach Stop Hypertension in reducing the risk of 10-year fatal and non-fatal CVD events in healthy adults: the ATTICA Study (2002–2012)

Public Health Nutrition ◽

10.1017/s136898002000230x ◽

2020 ◽

pp. 1-12

Author(s):

Elena Critselis ◽

Meropi D Kontogianni ◽

Ekavi Georgousopoulou ◽

Christina Chrysohoou ◽

Dimitrios Tousoulis ◽

...

Keyword(s):

Mediterranean Diet ◽

International Classification Of Diseases ◽

Cvd Risk ◽

Mediterranean Populations ◽

Dash Diet ◽

Classification Of Diseases ◽

Icd 10 ◽

The Mediterranean

Abstract Objective: To compare the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets in deterring 10-year CVD. Design: Prospective cohort (n 2020) with a 10-year follow-up period for the occurrence of combined (fatal or non-fatal) CVD incidence (International Classification of Diseases (ICD)-10). Baseline adherence to the Mediterranean and DASH diets was assessed via a semi-quantitative FFQ according to the MedDietScore and DASH scores, respectively. Setting: Attica, Greece. Participants: Two thousand twenty individuals (mean age at baseline 45·2 (sd 14·0) years). Results: One-third of individuals in the lowest quartile of Mediterranean diet consumption, as compared with 3·1 % of those in the highest quartile, developed 10-year CVD (P < 0·0001). In contrast, individuals in the lowest and highest DASH diet quartiles exhibited similar 10-year CVD rates (n (%) of 10-year CVD in DASH diet quartiles 1 v. 4: 79 (14·7 %) v. 75 (15·3 %); P = 0·842). Following adjustment for demographic, lifestyle and clinical confounding factors, those in the highest Mediterranean diet quartile had a 4-fold reduced 10-year CVD risk (adjusted hazard ratio (HR) 4·52, 95 % CI 1·76, 11·63). However, individuals with highest DASH diet quartile scores did not differ from their lowest quartile counterparts in developing such events (adjusted HR 1·05, 95 % CI 0·69, 1·60). Conclusions High adherence to the Mediterranean diet, and not to the DASH diet, was associated with a lower risk of 10-year fatal and non-fatal CVD. Therefore, public health interventions aimed at enhancing adherence to the Mediterranean diet, rather than the DASH diet, may most effectively deter long-term CVD outcomes particularly in Mediterranean populations.

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Validation of the Telephone-Administered Version of the Mediterranean Diet Adherence Screener (MEDAS) Questionnaire

Nutrients ◽

10.3390/nu12051511 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1511 ◽

Cited By ~ 4

Author(s):

Maria João Gregório ◽

Ana M. Rodrigues ◽

Clara Salvador ◽

Sara S. Dias ◽

Rute D. de Sousa ◽

...

Keyword(s):

Mediterranean Diet ◽

Large Population ◽

Population Based ◽

Validity And Reliability ◽

Face To Face ◽

Portuguese Version ◽

Diet Adherence ◽

Mediterranean Diet Adherence ◽

The Face ◽

The Mediterranean

A 14-Item Mediterranean Diet Adherence Screener (MEDAS) questionnaire was developed and validated in face-to-face interviews, but not via telephone. The aims of this study were to evaluate the validity and reliability of a telephone-administered version of the MEDAS as well as to validate the Portuguese version of the MEDAS questionnaire. A convenience community-based sample of adults (n = 224) participated in a three-stage survey. First, trained researchers administered MEDAS via a telephone. Second, the Portuguese version of Food Frequency Questionnaire (FFQ), and MEDAS were administered in a semi-structured face-to-face interview. Finally, MEDAS was again administered via telephone. The telephone-administered MEDAS questionnaire was compared with the face-to-face-version using several metrics. The telephone-administered MEDAS was significantly correlated with the face-to-face-administered MEDAS [r = 0.805, p < 0.001; interclass correlation coefficient (ICC) = 0.803, p < 0.001] and showed strong agreement (k = 0.60). The MEDAS scores that were obtained in the first and second telephone interviews were significantly correlated (r = 0.661, p < 0.001; ICC = 0.639, p < 0.001). The overall agreement between the Portuguese version of MEDAS and the FFQ-derived Mediterranean diet adherence score had a Cohen’s k = 0.39. The telephone-administered version of MEDAS is a valid tool for assessing the adherence to the Mediterranean diet and acquiring data for large population-based studies.

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Dietary Intake, Mediterranean Diet Adherence and Caloric Intake in Huntington’s Disease: A Review

Nutrients ◽

10.3390/nu12102946 ◽

2020 ◽

Vol 12 (10) ◽

pp. 2946

Author(s):

Christiana C. Christodoulou ◽

Christiana A. Demetriou ◽

Eleni Zamba-Papanicolaou

Keyword(s):

Huntington's Disease ◽

Huntington’S Disease ◽

Mediterranean Diet ◽

Rating Scale ◽

Age Of Onset ◽

Caloric Intake ◽

Diet Adherence ◽

Mediterranean Diet Adherence ◽

Disease Rating ◽

The Mediterranean

Decades of research and experimental studies have investigated Huntington’s disease (HD), a rare neurodegenerative disease. Similarly, several studies have investigated whether high/moderate adherence to the Mediterranean Diet and specific macro and micronutrients can decrease cognitive loss and provide a neuroprotective function to neurons. This review systematically identifies and examines studies that have investigated Mediterranean Diet adherence, micro- and macronutrients, supplementation and caloric intake in people with HD, in order to identify if dietary exposures resulted in improvement of disease symptoms, a delay in age of onset or if they contributed to an earlier age of onset in people with HD. A systematic search of PubMed, Directory of open access journal and HubMed was performed independently by two reviewers using specific search terms criteria for studies. The identified abstracts were screened and the studies were included in the review if they satisfied predetermined inclusion criteria. Reference screening of included studies was also performed. A total of 18 studies were included in the review. A few studies found that patients who had high/moderate adherence to Mediterranean Diet showed a slight improvement in their Unified Huntington’s Disease Rating Scale and Total Functional Capacity. In addition, people with HD who had high Mediterranean Diet adherence showed an improvement in both cognitive and motor scores and had a better quality of life compared to patients who had low Mediterranean Diet adherence. Furthermore, a few studies showed that supplementation with specific nutrients, such as triheaptanoin, L-acetyl-carnitine and creatine, had no beneficial effect on the patients’ Unified Huntington’s Disease Rating Scale score. A few studies suggest that the Mediterranean Diet may confer a motor and cognitive benefit to people with HD. Unfortunately, there was little consistency among study findings. It is important for more research to be conducted to have a better understanding of which dietary exposures are beneficial and may result delaying age of onset or disease progression in people with HD.

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The Mediterranean diet, plasma metabolome, and cardiovascular disease risk

European Heart Journal ◽

10.1093/eurheartj/ehaa209 ◽

2020 ◽

Vol 41 (28) ◽

pp. 2645-2656 ◽

Cited By ~ 7

Author(s):

Jun Li ◽

Marta Guasch-Ferré ◽

Wonil Chung ◽

Miguel Ruiz-Canela ◽

Estefanía Toledo ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Mediterranean Diet ◽

Metabolic Response ◽

Cvd Risk ◽

Diet Adherence ◽

Metabolic Signature ◽

Mediterranean Diet Adherence ◽

Plasma Metabolome ◽

The Mediterranean

Abstract Aims To investigate whether metabolic signature composed of multiple plasma metabolites can be used to characterize adherence and metabolic response to the Mediterranean diet and whether such a metabolic signature is associated with cardiovascular disease (CVD) risk. Methods and results Our primary study cohort included 1859 participants from the Spanish PREDIMED trial, and validation cohorts included 6868 participants from the US Nurses’ Health Studies I and II, and Health Professionals Follow-up Study (NHS/HPFS). Adherence to the Mediterranean diet was assessed using a validated Mediterranean Diet Adherence Screener (MEDAS), and plasma metabolome was profiled by liquid chromatography-tandem mass spectrometry. We observed substantial metabolomic variation with respect to Mediterranean diet adherence, with nearly one-third of the assayed metabolites significantly associated with MEDAS (false discovery rate < 0.05). Using elastic net regularized regressions, we identified a metabolic signature, comprised of 67 metabolites, robustly correlated with Mediterranean diet adherence in both PREDIMED and NHS/HPFS (r = 0.28–0.37 between the signature and MEDAS; P = 3 × 10−35 to 4 × 10−118). In multivariable Cox regressions, the metabolic signature showed a significant inverse association with CVD incidence after adjusting for known risk factors (PREDIMED: hazard ratio [HR] per standard deviation increment in the signature = 0.71, P < 0.001; NHS/HPFS: HR = 0.85, P = 0.001), and the association persisted after further adjustment for MEDAS scores (PREDIMED: HR = 0.73, P = 0.004; NHS/HPFS: HR = 0.85, P = 0.004). Further genome-wide association analysis revealed that the metabolic signature was significantly associated with genetic loci involved in fatty acids and amino acids metabolism. Mendelian randomization analyses showed that the genetically inferred metabolic signature was significantly associated with risk of coronary heart disease (CHD) and stroke (odds ratios per SD increment in the genetically inferred metabolic signature = 0.92 for CHD and 0.91 for stroke; P < 0.001). Conclusions We identified a metabolic signature that robustly reflects adherence and metabolic response to a Mediterranean diet, and predicts future CVD risk independent of traditional risk factors, in Spanish and US cohorts.

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The Mediterranean diet adherence by pregnant women delivering prematurely: association with size at birth and complications of prematurity

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2017.1399120 ◽

2017 ◽

Vol 32 (7) ◽

pp. 1084-1091 ◽

Cited By ~ 7

Author(s):

Elisavet Parlapani ◽

Charalampos Agakidis ◽

Thomais Karagiozoglou-Lampoudi ◽

Kosmas Sarafidis ◽

Eleni Agakidou ◽

...

Keyword(s):

Pregnant Women ◽

Mediterranean Diet ◽

Diet Adherence ◽

Mediterranean Diet Adherence ◽

The Mediterranean ◽

Size At Birth

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Study of Physical Fitness, Bone Quality, and Mediterranean Diet Adherence in Professional Female Beach Handball Players: Cross-Sectional Study

Nutrients ◽

10.3390/nu13061911 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1911

Author(s):

Alejandro Martínez-Rodríguez ◽

Javier Sánchez-Sánchez ◽

María Martínez-Olcina ◽

Manuel Vicente-Martínez ◽

Laura Miralles-Amorós ◽

...

Keyword(s):

Physical Fitness ◽

Mediterranean Diet ◽

Dietary Habits ◽

Broadband Ultrasound Attenuation ◽

Future Research ◽

Dominant Hand ◽

Cross Sectional ◽

Diet Adherence ◽

Mediterranean Diet Adherence ◽

The Mediterranean

(1) Background: Beach handball is a relatively new type of sport, derived from team handball. The purpose of the study was to evaluate the physical fitness of elite players of this sport by studying some variables of sports performance, including strength, endurance and power, and dietary habits, and to assess bone ultrasonographic variables. (2) Methods: 33 beach handball players have participated in this research; 18 juniors (age: 16.7 ± 0.50) and 15 seniors (age: 24.8 ± 4.71). The athletes’ strength was evaluated using the Handgrip Test on the dominant hand, the height of jump was evaluated by a counter-jump on a contact platform, and velocity, agility, and resistance by the Yo-Yo test. The broadband ultrasound attenuation (BUA) and the sound of speed (SOS) through the calcaneus were also measured. The Mediterranean diet adherence (KIDMED) was the questionnaire used to evaluate eating habits. In the statistical analysis, descriptions and correlations were made between the study variables. (3) Results: Both in the case of the dynamometric hand strength test (p < 0.05) and in the lower extremity power test (p < 0.01), senior players presented significantly higher values compared to junior players (35.1 ± 3.84 vs. 31.8 ± 3.37 and 35.1 ± 6.89 vs. 28.5 ± 5.69 with the dynamometry and Abalakov tests, respectively). However, no differences were observed in the variables by playing position. Significant correlations between different variables have been established, highlighting negative correlations between BMI and weight with the Abalakov Jump Test and positive correlations between Yo-Yo and BUA, and, between BMI and BUA. (4) Conclusions: Older and trained players are in better physical fitness; high weight and BMI have a negative influence on power, agility, speed, and endurance. In general, adherence to the Mediterranean diet is moderate and it seems evident that there is a beneficial influence of beach handball on bone condition, as measured by ultrasound. However future research should be carried on, including dual-energy x-ray absorptiometry assessments and food intake registers for a whole week.

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The Greek version of the Mediterranean diet adherence screener: development and validation

Nutrition & Food Science ◽

10.1108/nfs-03-2021-0084 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Athanasios Michalis ◽

Vassiliki Costarelli

Keyword(s):

Correlation Coefficient ◽

Mediterranean Diet ◽

Intraclass Correlation Coefficient ◽

Intraclass Correlation ◽

Greek Language ◽

Greek Version ◽

Content Type ◽

Diet Adherence ◽

Mediterranean Diet Adherence ◽

The Mediterranean

Purpose The purpose of this paper is to develop and validate the Greek version of the Mediterranean Diet Adherence Screener (MEDAS). Design/methodology/approach The MEDAS was translated to the Greek language forward and backward, twice and subsequently was administered to 50 healthy adult participants living in Attica, Greece. The participants had to complete the tool twice, within a period of 15 days. Participants also completed the well-recognized Mediterranean Diet Score (MedDietScore), for comparison purposes with the tested tool. Socioeconomic and anthropometric characteristics were also assessed. Findings There was a moderate association between the Greek MEDAS (MEDAS-Gr) and the MedDietScore [(Pearson r = 0.50, p < 0.001; Intraclass Correlation Coefficient (ICC)=0.46, p = 0.015)]. The concordance between these two questionnaires varied between the items (Intraclass correlation coefficient of 0.62 for fruit at the highest and −0.09 for alcohol consumption). The Cronbach’s a coefficient of reliability for the Greek MEDAS was good (a = 0.62). The two administrations of the MEDAS-Gr produced similar mean total scores (7.6 vs 7.9, p = 0.090), which were correlated (r = 0.71, p < 0.001; ICC = 0.85, p < 0.001) and agreed substantially [k statistic (k)=0.72, 95% CI 0.54–0.89, p < 0.001)]. Originality/value The MEDAS-Gr seems to be a valid tool for assessing adherence to the Mediterranean diet in the Greek population.

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