Adaptation and predictive utility of a Mediterranean diet screener score. Issue 6 (December 2019)

• Record Type: Journal Article
• Authors: Abu-Saad, Kathleen; Endevelt, Ronit; Goldsmith, Rebecca; Shimony, Tal; Nitsan, Lesley; Shahar, Danit R.; Keinan-Boker, Lital; Ziv, Arnona; Kalter-Leibovici, Ofra
• Is Part Of: Clinical nutrition. Volume 38:Issue 6(2019)
• Page Start: 2928
• Page End: 2935
• Publication Date: 2019-12
• Subjects: Mediterranean diet score -- Dietary screener -- Local adaptation -- Mortality -- Israel; 24HR 24-h recall -- CVD Cardiovascular disease -- FFQ Food frequency questionnaire -- HDS Hadera District Study -- I-MEDAS Israel-Mediterranean Diet Adherence Screener -- MEDAS Mediterranean Diet Adherence Screener -- MedDiet Mediterranean diet -- MOH Ministry of Health -- SES Socio-economic status; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2018.12.034
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: There is a substantial body of evidence supporting the health benefits of the Mediterranean diet, which has differing variations across the Mediterranean region. Abbreviated dietary screeners can be adapted and used to assess adherence to the local Mediterranean diet variant. We aimed to describe the process of adapting the Spanish Mediterranean Diet Adherence Screener (MEDAS) for use in Israel, and to test the predictive utility of the adapted score for mortality. Methods: A professional committee of nutritional policy makers, dieticians and researchers adapted MEDAS to create an Israeli Mediterranean diet screener (I-MEDAS) that reflected the local Mediterranean diet and national dietary recommendations. The Hadera District Study (HDS) was a population-based, prospective cohort study of adults in Israel. Food frequency questionnaire (FFQ) data from the HDS was used to calculate Mediterranean diet adherence according to the I-MEDAS score criteria and evaluate the score's predictive utility. Mortality status was obtained from the national population registry. Cox proportional hazards regression models were used to test the predictive utility of the I-MEDAS score for all-cause mortality. Results: The 14-item MEDAS was adapted to create a 17-item I-MEDAS. According to FFQ data from the HDS cohort (n = 1092 adults; median [IQR] follow-up time = 14 [12–15] years, 179 deaths), the median (IQR) I-MEDAS score was 8 (7–9). In multivariable analysis, every 1-point increase in the I-MEDAS score reduced the hazard of death by 12% (adjusted HR: 0.88; 95% CI: 0.80–0.97). The original MEDAS score was less strongly associated with mortality, and lost significance after adjustment for potential confounders. Conclusions: I-MEDAS reflects the local Mediterranean diet and national dietary recommendations in Israel. The I-MEDAS score, calculated from FFQ data, demonstrated predictive utility for mortality in a population-based cohort of adults.