Similar prediction of decreased total mortality, diabetes incidence or cardiovascular events using relative- and absolute-component Mediterranean diet score: The SUN cohort.
ABSTRACT BACKGROUND AND AIM: Accumulated evidence supports the effectiveness of Mediterranean-type diets (MeDiet) in reducing mortality and preventing several chronic diseases. Widely used scores to assess adherence to MeDiet are based on specific sample characteristics; alternatively, they might be built according to absolute/normative cut-off points for the consumption of specific food groups (pre-defined servings/day or/week). The aim of this study was to compare sample-specific MeDiet adherence scores (MDS) versus absolute-normative scores (Mediterranean Diet Adherence Screener - MEDAS) on their association with macronutrient intake, total mortality and incidence of chronic diseases. Design: SUN (Seguimiento Universidad de Navarra) dynamic prospective cohort study (60.5% women; mean age 38.4 years). METHODS AND RESULTS: In cross-sectional analyses (n=20,155) we evaluated macronutrient distribution according to MDS (based on 136-item FFQ), MEDAS (based on 13 questions), and variants of both. In prospective analyses (n=9109; mean follow-up: 6.2 years), we evaluated disease incidence or mortality. Adherence to MeDiet increased with age and, as expected, was associated with higher fiber intake, lower total fat intake but higher monounsaturated/saturated fat ratio, using all scores. Among subjects initially free of cancer, diabetes, and cardiovascular disease (CVD), adherence to MeDiet appraised with an absolute-normative score (MEDAS) similarly predicted macronutrient distribution and disease incidence or mortality (diabetes incidence, CVD or all-cause mortality), when compared to a sample-specific score based on 136-item FFQ (MDS). CONCLUSIONS: Adherence to MeDiet was associated with a decreased incidence of a composite outcome including diabetes incidence, cardiovascular events incidence or all-cause mortality.
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ABSTRACT: There is a tendency in Mediterranean countries to abandon the characteristic Mediterranean diet. This is especially apparent within younger populations. This could have negative consequences for health such as, cardiovascular diseases, obesity or metabolic syndrome. The aim of this study was to describe adherence to the Mediterranean diet within a population of school children and examine the influence of different socio-demographic factors and lifestyle habits. The study was conducted on a representative sample of 321 school children aged 11-12 from 31 schools in the city of Logroño (La Rioja). Socio-demographic variables, anthropometric variables, blood pressure, level of development, aerobic fitness, lifestyle, physical activity habits and adherence to the Mediterranean diet were recorded. 46.7% reported high adherence to the Mediterranean diet, with low adherence being reported by 4.7% of the school children studied. Children attending state schools, immigrants and families from low-to-medium socioeconomic strata reported significantly lower adherence to the Mediterranean diet (p = 0.039), but the results did not reveal any significant differences in terms of body composition. Correlations were found between adherence to the Mediterranean diet and other lifestyle habits, especially level of physical activity (r = 0.38) and screen time (r = -0.18). Adherence to a Mediterranean diet differs according to the type of school attended by children, and the child´s nationality and socioeconomic status. Children who attended state schools, immigrants and those from families with a medium-to-low socio-economic status were less likely to follow healthy diets.Appetite 05/2014; · 2.54 Impact Factor
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ABSTRACT: To update previous meta-analyses of cohort studies that investigated the association between the Mediterranean diet and health status and to utilize data coming from all of the cohort studies for proposing a literature-based adherence score to the Mediterranean diet. We conducted a comprehensive literature search through all electronic databases up to June 2013. Cohort prospective studies investigating adherence to the Mediterranean diet and health outcomes. Cut-off values of food groups used to compute the adherence score were obtained. The updated search was performed in an overall population of 4 172 412 subjects, with eighteen recent studies that were not present in the previous meta-analyses. A 2-point increase in adherence score to the Mediterranean diet was reported to determine an 8 % reduction of overall mortality (relative risk = 0·92; 95 % CI 0·91, 0·93), a 10 % reduced risk of CVD (relative risk = 0·90; 95 % CI 0·87, 0·92) and a 4 % reduction of neoplastic disease (relative risk = 0·96; 95 % CI 0·95, 0·97). We utilized data coming from all cohort studies available in the literature for proposing a literature-based adherence score. Such a score ranges from 0 (minimal adherence) to 18 (maximal adherence) points and includes three different categories of consumption for each food group composing the Mediterranean diet. The Mediterranean diet was found to be a healthy dietary pattern in terms of morbidity and mortality. By using data from the cohort studies we proposed a literature-based adherence score that can represent an easy tool for the estimation of adherence to the Mediterranean diet also at the individual level.Public Health Nutrition 11/2013; · 2.25 Impact Factor
Article: Definition Mediterranean diet[Show abstract] [Hide abstract]
ABSTRACT: The Mediterranean diet has been linked to a number of health benefits, including reduced mortality risk and lower incidence of cardiovascular disease. Definitions of the Mediterranean diet vary across some settings, and scores are increasingly being employed to define Mediterranean diet adherence in epidemiological studies. Some components of the Mediterranean diet overlap with other healthy dietary patterns, whereas other aspects are unique to the Mediterranean diet. In this forum article, we asked clinicians and researchers with an interest in the effect of diet on health to describe what constitutes a Mediterranean diet in different geographical settings, and how we can study the health benefits of this dietary pattern. Mediterranean diet: what it is, what it does, how it works07/2014;