Validation of the English Version of the 14-Item Mediterranean Diet Adherence Screener of the PREDIMED Study, in People at High Cardiovascular Risk in the UK
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Procedures
2.3. Cardiometabolic, Anthropometric and Blood Pressure Measurements
2.4. Demographic Characteristics
2.5. MEDAS
2.6. Reference Instrument
2.7. Statistical Analyses
2.7.1. Concurrent Validity
2.7.2. Predictive Validity
2.7.3. Test-Retest Reliability
3. Results
3.1. Participant Characteristics
3.2. Concurrent Validity
3.3. Predictive Validity
3.4. Test-Retest Reliability
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Participant Characteristics | n | % |
---|---|---|
Sex | ||
Males | 34 | 34.3 |
Females | 65 | 65.7 |
Ethnic background | ||
Caucasian | 92 | 92.9 |
Other | 7 | 7.1 |
Marital status | ||
Single | 14 | 14.1 |
Married/cohabiting | 54 | 54.6 |
Divorced/separated/widowed | 31 | 31.3 |
Education | ||
No qualifications | 31 | 31.3 |
GCE ‘O’ levels, CSE, GCSE | 21 | 21.2 |
GCE ‘A’ level or equivalent | 11 | 11.1 |
Further education (e.g., HNC, HND) | 4 | 4.1 |
Degree or equivalent | 21 | 21.2 |
Postgraduate degree | 11 | 11.1 |
Occupation | ||
Retired | 75 | 75.8 |
Employed | 23 | 23.2 |
Unemployed | 1 | 1 |
Current smokers 1 | 15 | 15.1 |
Body weight status | ||
Underweight | 2 | 2 |
Normal weight | 21 | 21.4 |
Overweight | 42 | 42.9 |
Obese | 33 | 33.7 |
Age, years 2 | 68.3 ± 6.0 (56–80) | |
Body mass index, kg/m2 (n = 98) 3 | 28.3 ± 4.4 | |
Waist circumference, cm (n = 99) 3 | 99.3 ± 11.9 | |
Systolic blood pressure, mmHg (n = 95) 3 | 133.8 ±17.1 | |
Diastolic blood pressure, mmHg (n = 95) 3 | 79.5 ± 9.5 | |
Total cholesterol, mmol/L (n = 87) 3 | 5.5 ± 1.2 | |
LDL-cholesterol, mmol/L (n = 86) 3 | 3.2 ± 1.3 | |
HDL-cholesterol, mmol/L (n = 87) 3 | 1.6 ± 0.5 | |
Non-HDL-cholesterol, mmol/L (n = 87) 3 | 3.9 ± 1.1 | |
Triglycerides, mmol/L (n = 87) 3 | 1.7 ± 0.9 | |
Total:HDL-cholesterol ratio (n = 87) 3 | 3.7 ± 1.2 | |
Triglyceride:HDL-cholesterol ratio (n = 87) 3 | 1.2 ± 0.9 | |
Glycosylated haemoglobin (HbA1c), % (n = 54) 3 | 6.0± 3.1 |
MEDAS | 3-Day Food Record | κ (95% CIs) | p-Value | |
---|---|---|---|---|
Olive oil for cooking | 50 (52.1) | 38 (39.6) | 0.09 (−0.12, 0.28) | 0.356 |
Total olive oil consumed | 1 (1.0) | 1 (1.0) | −0.01 (−0.03, 0.00) | 0.918 |
Vegetables | 10 (10.4) | 5 (5.2) | 0.21 (−0.07, 0.52) | 0.026 |
Fruit | 35 (36.5) | 24 (25.0) | 0.49 (0.29, 0.66) | <0.001 |
Red and processed meat | 75 (78.1) | 69 (71.9) | 0.34 (0.11, 0.54) | 0.001 |
Butter, margarine, cream | 58 (60.4) | 51 (53.1) | 0.18 (−0.02, 0.37) | 0.080 |
Sugar sweetened beverages | 69 (71.9) | 76 (79.2) | 0.19 (−0.04, 0.40) | 0.059 |
Wine | 29 (30.2) | 26 (27.1) | 0.72 (0.55, 0.86) | <0.001 |
Pulses | 12 (12.5) | 12 (12.5) | −0.05 (−0.17, 0.15) | 0.641 |
Fish and seafood | 49 (51.0) | 39 (40.6) | 0.17 (−0.02, 0.35) | 0.089 |
Sweets and pastries | 22 (22.9) | 11 (11.5) | 0.03 (−0.15, 0.24) | 0.715 |
Nuts | 32 (33.3) | 21 (21.9) | 0.26 (0.05, 0.44) | 0.009 |
Preference for white over red meat | 73 (76.0) | 5 (5.2) | 0.03 (0.31, 0.33) | 0.197 |
Sofrito | 10 (10.4) | 6 (6.3) | 0.32 (0.01, 0.02) | 0.015 |
Dependent Variable | Unstandardised Regression Coefficient a | 95% CIs | p-Value |
---|---|---|---|
Body mass index, kg/m2 | −0.044 | −0.492, 0.404 | 0.847 |
Waist circumference, cm | −0.102 | −1.263, 1.060 | 0.862 |
Systolic blood pressure, mmHg | 0.229 | −1.742, 1.713 | 0.799 |
Diastolic blood pressure, mmHg | 0.232 | −0.781, 1.246 | 0.650 |
Total cholesterol, mmol/L | −0.024 | −0.151, 0.103 | 0.708 |
LDL-cholesterol b, mmol/L | −0.013 | −0.032, 0.006 | 0.181 |
HDL-cholesterol, mmol/L | −0.012 | −0.062, 0.038 | 0.632 |
Non-HDL-cholesterol, mmol/L | −0.012 | −0.129, 0.105 | 0.839 |
Triglycerides b, mmol/L | 0.010 | −0.013, 0.034 | 0.380 |
Total:HDL-cholesterol ratio b | 0.002 | −0.011, 0.016 | 0.731 |
Triglyceride:HDL-cholesterol ratio b | 0.015 | −0.016, 0.047 | 0.340 |
HbA1c b, % | 0.006 | −0.008, 0.020 | 0.400 |
1st Tertile (score = 0–4, n = 32) | 2nd Tertile (score = 5–6, n = 34) | 3rd Tertile (score = 7–14, n = 30) | p-Linear Trend b | |
---|---|---|---|---|
Foods | ||||
Olive oil (g/4.18 MJ) | 0.6 (0.1, 1.1) | 2.2 (1.1, 3.5) | 4.3 (2.5, 6.7) | 0.001 |
Vegetables (g/4.18 MJ) | 78.0 (57.6, 100.4) | 130.7 (103.6, 160.9) | 170.3 (132.3, 214.6) | 0.001 |
Fruits (g/4.18 MJ) | 87.5 (57.2, 128.9) | 103.6 (74.5, 145.0) | 154.1 (110.0, 206.2) | 0.085 |
Red and processed meat (g/4.18 MJ) | 70.1 (50.0, 90.1) | 39.8 (29.9, 50.5) | 32.7 (21.6, 44.3) | 0.001 |
Butter and animal fats (g/4.18 MJ) | 11.0 (7.5, 14.7) | 10.3 (7.1, 13.8) | 7.0 (4.7, 9.6) | 0.101 |
Sugar-sweetened beverages (g/4.18 MJ) | 77.8 (39.5, 119.4) | 18.3 (8.6, 30.7) | 9.1 (0.2, 23.1) | 0.001 |
Wine (g/4.18 MJ) | 43.0 (16.9, 78.6) | 52.6 (28.7, 80.0) | 49.5 (24.7, 77.2) | 0.967 |
Pulses (g/4.18 MJ) | 22.8 (14.8, 32.5) | 15.9 (8.6, 25.7) | 32.3 (9.5, 66.2) | 0.410 |
Nuts (g/4.18 MJ) | 2.4 (0.8, 4.4) | 3.6 (1.6, 6.3) | 4.9 (2.4, 7.6) | 0.103 |
Fish (g/4.18 MJ) | 34.0 (21.3, 49.1) | 28.8 (21.0, 37.0) | 49.8 (36.9, 64.0) | 0.094 |
Nutrients | ||||
Protein (% of energy intake) | 16.4 (15.2, 17.6) | 17.2 (15.6, 19.1) | 17.9 (16.6, 19.2) | 0.086 |
Carbohydrates (% of energy intake) | 47.8 (44.9, 50.7) | 42.3 (39.6, 44.8) | 41.8 (38.9, 44.7) | 0.007 |
Total fat (% of energy intake) | 33.7 (31.6, 35.8) | 38.1 (35.6, 40.8) | 37.9 (35.3, 40.9) | 0.021 |
Saturated fat (% of energy intake) | 12.8 (11.7, 13.9) | 13.5 (12.1, 15.2) | 11.6 (10.3, 13.2) | 0.364 |
Trans fat (% of energy intake) | 0.6 (0.5, 0.7) | 0.7 (0.5, 0.8) | 0.5 (0.4, 0.6) | 0.511 |
Monounsaturated fat (% of energy intake) | 12.1 (11.2, 13.0) | 14.2 (13.0, 15.6) | 15.0 (13.8, 16.3) | 0.002 |
Polyunsaturated fat (% of energy intake) | 4.6 (4.0, 5.3) | 4.5 (3.9, 5.2) | 5.7 (5.0, 6.5) | 0.022 |
Dietary fibre (g/4.18 MJ) | 11.0 (9.7, 12.6) | 11.7 (10.5, 13.1) | 13.5 (12.2, 15.3) | 0.099 |
Dietary cholesterol (mg/4.18 MJ) | 143.6 (123.4, 162.9) | 166.0 (138.6, 193.9) | 157.0 (128.1, 188.1) | 0.279 |
Carotenes (ug/4.18 MJ) | 1396.6 (985.7, 1854.9) | 2488.3 (1747.6, 3299.4) | 2275.5 (1544.1, 3165.6) | 0.179 |
Vitamin E (mg/4.18 MJ) | 4.8 (4.2, 5.4) | 5.1 (4.6, 5.6) | 6.3 (5.7, 6.8) | 0.001 |
Folate (ug/4.18 MJ) | 141.4 (126.1, 159.1) | 154.6 (138.4, 171.0) | 164.7 (151.0, 179.9) | 0.107 |
Vitamin C (mg/4.18 MJ) | 69.5 (49.9, 90.3) | 71.6 (56.7, 89.0) | 81.8 (67.1, 98.4) | 0.711 |
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Papadaki, A.; Johnson, L.; Toumpakari, Z.; England, C.; Rai, M.; Toms, S.; Penfold, C.; Zazpe, I.; Martínez-González, M.A.; Feder, G. Validation of the English Version of the 14-Item Mediterranean Diet Adherence Screener of the PREDIMED Study, in People at High Cardiovascular Risk in the UK. Nutrients 2018, 10, 138. https://doi.org/10.3390/nu10020138
Papadaki A, Johnson L, Toumpakari Z, England C, Rai M, Toms S, Penfold C, Zazpe I, Martínez-González MA, Feder G. Validation of the English Version of the 14-Item Mediterranean Diet Adherence Screener of the PREDIMED Study, in People at High Cardiovascular Risk in the UK. Nutrients. 2018; 10(2):138. https://doi.org/10.3390/nu10020138
Chicago/Turabian StylePapadaki, Angeliki, Laura Johnson, Zoi Toumpakari, Clare England, Manmita Rai, Stu Toms, Chris Penfold, Itziar Zazpe, Miguel A. Martínez-González, and Gene Feder. 2018. "Validation of the English Version of the 14-Item Mediterranean Diet Adherence Screener of the PREDIMED Study, in People at High Cardiovascular Risk in the UK" Nutrients 10, no. 2: 138. https://doi.org/10.3390/nu10020138