Table 1 - available via license: Creative Commons Attribution 4.0 International
Content may be subject to copyright.
Source publication
Objective:
Independently of total caloric intake, a better quality of the diet (for example, conformity to the Mediterranean diet) is associated with lower obesity risk. It is unclear whether a brief dietary assessment tool, instead of full-length comprehensive methods, can also capture this association. In addition to reduced costs, a brief tool...
Similar publications
Background:
Strong evidence supports that dietary modifications may decrease incident type 2 diabetes mellitus (T2DM). Numerous diabetes risk models/scores have been developed, but most do not rely specifically on dietary variables or do not fully capture the overall dietary pattern. We prospectively assessed the association of a dietary-based dia...
Background
Dietary factors seem to influence telomere length. Moreover, associations between changes in adiposity indices and telomere length (TL) have been found in intervention studies.
Objective
We evaluated changes in two diet quality indices and their association with TL in children with abdominal obesity in a 12‐month lifestyle intervention....
Metabolic syndrome (MetS) is characterized by an association of cardiovascular and diabetes mellitus type 2 risk factors. Although the definition of MetS slightly differs depending on the society that described it, its central diagnostic criteria include impaired fasting glucose, low HDL-cholesterol, elevated triglycerides levels and high blood pre...
Background/objectives:
Dietary habits are important determinants of individual cardiovascular and metabolic risk. This study investigated the association between dietary patterns and asymptomatic carotid atherosclerosis, defined as the presence of plaques and/or increased intima-media thickness, and metabolic biomarkers of insulin resistance, incl...
Several epidemiological studies have shown that consumption of tree nuts is associated with lower cardiovascular risk, specific cause of mortality and total mortality. Clinical feeding trials have demonstrated that tree nuts protect from cardiovascular disease risk through different mechanisms: regulating inflammatory processes, oxidative stress an...
Citations
... [133]) have adapted the 14-point validated Mediterranean Diet Adherence Score used in the PREDIMED trial [51,134] for screening and tracking adherence in patients. Oldways, a notfor-profit dedicated to public health through the support of healthy eating, provides food pyramids of several traditional dietary patterns including the Mediterranean [135] and vegetarian dietary patterns [76]. ...
Guidelines for nutrition therapy of cardiometabolic-based chronic disease (CMBCD) have moved away from nutrient-based recommendations to food/dietary pattern-based recommendations. Dietary patterns that combine the advantages of different foods can result in meaningful improvements in glycemic control, blood lipids, blood pressure, and inflammation. By allowing for flexibility in the proportion of macronutrients in the diet, these dietary patterns provide an opportunity to individualize therapy based on values, preferences, and treatment goals. To assist in the implementation of these dietary patterns into clinical practice, patient and physician engagement tools have been developed including food pyramids, infographics, and apps. Several research gaps remain related to the reliance on small RCTs of intermediate outcomes and observational prospective cohort studies, the lack of large RCTs of clinical outcomes, pragmatic trial designs leveraging primary care networks, and administrative and multi-omics approaches.
... The validated 14-item Mediterranean diet assessment tool by Martínez-González et al. was translated into German and applied for adult study participants to evaluate their adherence to Mediterranean diet [12]. For participants < 18 years, the KIDMED index by Serra-Majem et al. was translated into German and used [13]. ...
... For participants < 18 years, the KIDMED index by Serra-Majem et al. was translated into German and used [13]. A score ≥ 8 was considered a high adherence to the Mediterranean diet [12,13]. The German version of the Global Physical Activity Questionnaire developed by the WHO was selected to assess the level of physical activity in adult study participants [14]. ...
Background: One in fifty infants is conceived through assisted reproductive technologies (ART). To date, data on the cardiovascular morbidity of ART individuals is ambiguous. This study investigated the vascular function of young ART subjects using 24 hour ambulatory blood pressure monitoring (24 h ABPM). Methods: ART subjects and spontaneously conceived controls matched in age as well as sex were enrolled. A 24 h blood pressure profile including pulse wave analysis was executed in all study participants. Blood pressure readings were assessed every 15 min during daytime and every 30 min during nighttime. The 24 h systolic/diastolic blood pressure (SBP/DBP) as well as central blood pressure, nocturnal blood pressure decrease, and 24 h pulse wave velocity (PWV) were analyzed. Results: A total of 41 ART individuals and 46 spontaneously conceived peers were included in the final analysis (mean age: 15.37 ± 5.46 years vs. 16.48 ± 5.23 years, p = 0.338). The 24 h SBP (112.74 ± 9.24 mmHg vs. 112.73 ± 6.70 mmHg, p = 0.997), 24 h DBP (65.61 ± 7.98 mmHg vs. 66.57 ± 7.03 mmHg, p = 0.550), 24 h central blood pressure, nocturnal blood pressure decrease, and 24 h PWV did not demonstrate significant differences between the ART and control group. Conclusions: In contrast to previous studies, no significant differences in 24 h blood pressure were demonstrated between ART subjects and spontaneously conceived peers. Hence, the results of this study do not indicate an unfavorable blood pressure profile in ART offspring. Larger multi-centric studies are needed to validate these results in the future.
... Lifestyle measures, apart from the abovementioned VREM, included adherence to the Mediterranean diet, assessed with the Mediterranean Diet Adherence Screener (MedAS) [98], and sleep quality, evaluated using the Pittsburgh Sleep Quality Index (PSQI) [99]. All self-reported questionnaires, except for the VREM, were completed online via Microsoft Forms under a license from the University of Barcelona. ...
Background/Objectives: Stroke often leads to persistent cognitive and emotional impairments, which rehabilitation may mitigate. However, the biological mechanisms underlying such improvements remain unclear. This study investigated whether supplementing computerized cognitive training (CCT) with mindfulness-based stress reduction (MBSR) or physical exercise (PE) modulated biomarkers of neuroplasticity, inflammation, and stress in patients with chronic stroke compared to CCT alone. We also explored whether biomarker changes mediated or correlated with behavioral improvements. Methods: In a three-arm, single-blind, randomized controlled trial (NCT04759950), 141 patients with chronic stroke were randomized (1:1:1) to MBSR+CCT, PE+CCT, or CCT-only for 12 weeks. Plasma levels of brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), C-reactive protein (CRP), interleukin-6 (IL-6), and cortisol were measured at baseline and post-intervention. Cognitive, mental health, mindfulness, and fitness outcomes were also assessed. Between- and within-group changes were analyzed using ANCOVA and paired t-tests. Per-protocol and complete-case analyses were conducted. Results: Among the 109 participants with ≥80% adherence, the only significant between-group difference was for VEGF: it remained stable in the MBSR+CCT group but declined in PE+CCT and CCT-only. Within-group analyses showed significant decreases in cortisol in MBSR+CCT and PE+CCT, while IGF-1 levels declined across all groups. In contrast, BDNF, IL-6, and CRP did not show significant changes, and biomarker changes were not significantly associated with behavioral improvements. Complete-case analysis (n = 126) yielded similar findings. Conclusions: Our findings suggest that combining MBSR or PE with CCT may modulate certain biological processes relevant to stroke recovery. MBSR may help maintain VEGF levels, which could support vascular health, while MBSR and PE may contribute to lowering cortisol levels. However, since no clear association with behavioral improvements was found, further research is needed to determine the clinical relevance of these biomarker changes in stroke recovery.
... A quantitative assessment with portion size quantification is included to provide a more comprehensive and detailed report. Adherence to the MedDiet is assessed with the Portuguese version [28] of the 14-Item Mediterranean Diet Assessment Tool developed by PREDIMED study authors [29,30], in which a maximum score of 14 points can be achieved, being a strong adherence defined by a score ≥ 10 points. Anthropometric measurements (height, weight, and waist circumference) are performed by registered dietitians. ...
Background
The gut microbiota has been implicated in the onset and progression of Rheumatoid Arthritis (RA). It has been proposed that gut dysbiosis impairs gut barrier function, leading to alterations in mucosal integrity and immunity. This disruption allows bacterial translocation, contributing to the perpetuation of the inflammatory process. Since diet is recognised as a key environmental factor influencing the gut microbiota, nutritional interventions targeting RA activity are currently being explored. This study aims to investigate whether a dietary intervention based on a typical Mediterranean Diet enriched with fermented foods (MedDiet +) can impact the gut microbiota, intestinal permeability, and RA-related outcomes.
Methods
One hundred RA patients are being recruited at Unidade Local de Saúde (ULS) Santa Maria in Lisbon, Portugal, and randomly assigned to either the intervention (MedDiet +) or the control group. The 12-week nutritional intervention includes a personalised dietary plan following the MedDiet + pattern, along with educational resources, food basket deliveries, and clinical culinary workshops, all developed and monitored weekly by registered dietitians. The control group receives standardised general healthy diet recommendations at baseline. The intervention's effects will be assessed by evaluating disease activity, functional status, quality of life, intestinal permeability, endotoxemia, inflammatory biomarkers, intestinal and oral microbiota, serum proteomics, and serum glycome profile characterisation.
Discussion
We anticipate obtaining integrative insights into the interplay between diet, the gut, and RA, while also exploring the underlying mechanisms driving these changes. This study, conducted by a multidisciplinary research team of registered dietitians, rheumatologists, biologists, and immunologists, aims to bridge the current gap between nutrition-related knowledge and RA.
Trial registration
Registered in ClinicalTrials.gov (NCT06758817; date of registry: January 6th 2025).
... Frequency of moderate and vigorous activity were measured on a 6-point scale, and reverse scored to range from 1 (every day) to 6 (never). Fruit and vegetable consumption (portions per day) were assessed using items from the Prevention with Mediterranean Diet assessment tool [22], which were summed and reverse scored. Binge drinking was consuming six or more alcoholic beverages on the same occasion at least once per month (question from The Alcohol Use Disorders Identification Test-Concise). ...
Background
Overweight and obesity are associated with poor mental health, and the association is bidirectional. Few studies have examined the association between weight change and mental health over time. We aimed to provide further insight into the association between weight gain and mental health, with a focus on emotional eating and body dissatisfaction as mediating factors.
Methods
Height and weight were self-reported upon registration, and in Spring 2022, 2023, and 2024 in the Specchio cohort (Geneva, Switzerland). BMI trajectories were estimated by (1) mixed-effects models to calculate participants’ personal slopes (increase in BMI score per year), and (2) testing the odds of an upward BMI category transition from baseline to last follow-up. The associations of behavioural and psychosocial factors with BMI trajectories (slopes and transitions), and BMI trajectories with mental health outcomes were estimated using regressions adjusted for age, sex, education, and physical health condition. Structural equation modelling was used to test mediating pathways.
Results
Among 7388 participants (59% women, mean age 51 years), factors associated with increasing BMI over 4 years included financial hardship, short sleep duration, less physical activity, more leisure screen time, depressive and anxiety symptoms, and emotional eating (β range [95% CI] = 0.03 [0, 0.05]–0.12 [0.09, 0.15]). Increasing BMI was associated with body dissatisfaction (β = 0.36 [0.33, 0.38]) and poorer quality of life (β = −0.06 [−0.09, −0.03]) at 4-year follow-up after adjustment for anxiety and depressive symptoms at baseline. Emotional eating partly mediated the association between anxiety and depressive symptoms at baseline and increasing BMI, and between financial hardship and increasing BMI. Body dissatisfaction and poorer self-rated health partly mediated the association between increasing BMI and quality of life at follow-up.
Conclusions
Emotional eating and body dissatisfaction contribute to the association between BMI trajectories and mental health and should be considered in weight management and mental health promotion strategies.
... Its broader applicability and ease of use make it a valuable tool, especially in resource-constrained settings where the adoption of complex dietary patterns like the Med-Diet may be It is important to note that while some Med-Diet scoring tools incorporate the calculation of saturatedto-unsaturated fat ratios, this is a limitation of the specific scoring tool chosen rather than a fundamental characteristic of all Med-Diet scoring systems. For instance, the validated 14-point Med-Diet scoring tool developed by Martínez-González et al. 28 does not require nutrient composition analysis, making it more feasible for large-scale epidemiological studies. ...
The Mediterranean diet (Med-Diet) is widely recognized for its protective effect in cardiovascular diseases (CVDs), less is known about the associations between health and adherence to the Prime Diet Quality Score (PDQS). This study investigates the relationship between adherence to the Med-Diet and PDQS with the risk of premature coronary artery disease (PCAD) in an Iranian population. A total of 3287 participants were included in this multicenter case-control study across various ethnic groups in Iran, categorized into PCAD cases (n = 2106) and controls (n = 1181). PCAD cases were defined as individuals with at least one coronary artery exhibiting ≥ 75% stenosis or a left main coronary artery with ≥ 50% stenosis, while controls had normal coronary arteries. Dietary intake was assessed using a semi-quantitative food frequency questionnaire (FFQ), previously validated for accuracy in the Iranian population Adherence to the Med-Diet was assessed using a standardized scoring system, awarding one point for higher consumption of beneficial food groups (such as vegetables, whole grains, legumes, fish, nuts, and a high monounsaturated-to-saturated fat ratio) and one point for lower consumption of less favorable foods (such as red and processed meats). The total score ranged from 0 to 9, with higher scores indicating greater adherence to the Med-Diet. The PDQS, a dietary quality index, evaluated adherence across 14 healthy and 7 unhealthy food groups, with higher scores reflecting better diet quality. Logistic regression models were employed to examine the association between dietary scores and PCAD risk. Participants with higher adherence to both the Med-Diet and PDQS had significantly lower odds of PCAD (OR = 0.30, 95% CI: 0.22, 0.40; P for trend < 0.001 for PDQS), with a stronger association observed for the Med-Diet (OR = 0.08, 95% CI: 0.06, 0.10; P for trend < 0.001). Additionally, higher adherence to the Med-Diet (OR = 0.04, 95% CI 0.03, 0.05) and PDQS (OR = 0.21, 95% CI: 0.17, 0.26) was inversely associated with PCAD severity in the fully adjusted model. This study showed a protective association of the Med-Diet and PDQS with reduced risk of PCAD in the Iranian population.
... Different variables are recorded that may influence the study results even though they are not part of the intervention: sex, age, educational level, marital status, occupational status, and income level; personal history of depression (depression duration) and medication use; information on the presence of comorbidities; sleep time and quality (accelerometer); adherence to a Mediterranean diet, measured using the PREDIMED questionnaire [75,76]; and usual intake estimates of food groups, energy, and nutrients using a self-administered semi-quantitative food-frequency questionnaire (FFQ) [77] and 5-day recalls [78]. Participants randomly assigned to the CG received standard care throughout the study. ...
The COVID-19 pandemic has intensified depression due to isolation and reduced physical activity, highlighting the need for accessible remote treatments. The SONRIE study evaluates the effectiveness of a 12-week online intervention combining physical exercise and internet-based cognitive–behavioral therapy on depressive symptoms in adults with mild-to-moderate depression. This randomized controlled trial involved 80 adults aged 25–65 years diagnosed with depression according to the ICD-10 criteria. Participants were randomized to an experimental group receiving the combined online intervention or to a control group receiving standard care. The primary outcome was the change in depression severity, assessed by the Beck Depression Inventory, with outcomes measured at baseline, immediately post-intervention, and after an 8-week follow-up phase. Statistical analyses include analysis of covariance to compare group changes over time, with effect sizes quantifying the intervention’s impact. The SONRIE study demonstrates a promising online approach for treating depression, with potential implications for clinical practice and public health strategies.
... The higher the score, the greater the adherence to the Mediterranean dietary pattern [24]. The classification of this adherence was categorized according to the following criteria: low adherence ( ≤ 5 points), moderate adherence (6 to 9 points), and high adherence (≥10 points) [25]. For the evaluation of food self-efficacy, the Global Food Self-Efficacy Scale [GFSES], validated for the Portuguese population, was used [17]. ...
When students begin their academic life, they are subject to psychological, environmental, and economic changes, which may have implications for their dietary habits. This study aims to assess the relationship between adherence to the Mediterranean food pattern (MFP), nutritional status, and food self-efficacy among a sample of higher education students in Portugal. This cross-sectional study was conducted between May and June 2023, through an online questionnaire. A total of 114 students from public and private higher education participated in this study, predominantly female (68.7%) with a median age of 23 (20; 27) years. It was found that higher body mass index (BMI), older age (p > 0.003; r: 0.273), and greater adherence to the MFP were associated with higher food self-efficacy (p > 0.003; r: 0.273). No correlations were found between the other variables. When feeling stressed, students tend to consume more sweets, fast food, and fewer fruits and vegetables. Based on the correlations between BMI, adherence to the MFP, perceived stress, and food self-efficacy, it can be concluded that higher BMI, older age, and greater adherence to the MFP are associated with higher food self-efficacy. These results can be explored for future dietary interventions in this population group.
... Adherence toward the MedDiet intervention was assessed at baseline and week 12 using the validated 14-item MEDAS [63]. This tool assesses adherence based on the habitual frequency of consumption of 12 main dietary components and two food habits consistent with a traditional MedDiet pattern. ...
Background/Objectives: A healthy diet is essential for managing Polycystic Ovary Syndrome (PCOS), yet optimal recommendations remain unclear, highlighting the need to explore alternative lifestyle interventions. The Mediterranean diet (MedDiet) supports cardiometabolic health; however, challenges with adherence within this population are unknown. This study examines the acceptability and experiences of an ad libitum MedDiet in women with PCOS, offering recommendations for implementation. Methods: A 12-week MedDiet intervention was conducted with women aged 18–45 years, diagnosed with PCOS and a BMI ≥ 25 kg/m² (n = 12). Adherence was assessed using the Mediterranean Diet Adherence Screener. Surveys and semi-structured interviews, guided by the Capability, Opportunity, Motivation–Behaviour (COM-B) model, explored participants’ experiences. Thematic analysis identified barriers and facilitators, which were mapped to the COM-B and Theoretical Domains Framework (TDF), with all findings subsequently aligned with the Behaviour Change Wheel to inform implementation strategies. Results: MedDiet adherence significantly improved from baseline to week 12 (Baseline: 4.1 ± 1.8; week 12: 8.3 ± 2.3; p = 0.001), alongside increases in knowledge (p = 0.004), cooking confidence (p = 0.01), and time management (p = 0.01). Adherence factors were mapped to 12 of the 14 TDF domains. Key facilitators included health benefits, reduced weight pressure, educational resources, and simple guidelines. Barriers involved organisation, food availability, and external influences. Effective implementation should integrate MedDiet education, behaviour change support, practical resources, and professional training for nutrition professionals and healthcare providers to support referrals and weight-neutral dietary management. Conclusions: A short-term ad libitum MedDiet is acceptable for women with PCOS. Strategies for patients and healthcare providers, aligned with the intervention functions of education, training, and enablement, are key to supporting adherence.
... Each Mediterranean diet-compliant response is awarded +1 point [15]. Scoring is based on the total score, with ≤6 points indicating 'low', 7-8 points indicating 'moderate', and ≥9 points indicating 'high' adherence to the Mediterranean diet [16]. The Turkish validity and reliability study of MEDAS was conducted by Pehlivanoglu et al. in 2020, and it was deemed to be suitable for use in the Turkish population [17]. ...
Background/Objectives: Hashimoto’s thyroiditis (HT) is the most common autoimmune disease which lowers a patient’s quality of life. Our study aimed to assess the association between Mediterranean lifestyle and anthropometric measurements in patients with HT. Methods: This study was conducted with 120 female patients previously diagnosed with HT. The ‘Mediterranean Diet Adherence Screener-(MEDAS)’ and ‘MEDiterranean LIFEstyle-(MEDLIFE)’ scales were used to assess diet quality and lifestyle. Also, some anthropometric measurements were collected. Spearman’s Correlation Test was used to determine correlations between two quantitative variables. Results: The average age of the participants was 37.49 ± 7.47 years. The average diet quality scores were 7.80 ± 1.93 for MEDAS and the total life quality score was 16.41 ± 3.74 for MEDLIFE. Significant negative correlations were observed between the MEDLIFE total score and hip and waist circumferences, body weight, and body fat (%) (p < 0.05), as well as with the score of physical activity, rest, social habits, and conviviality (p < 0.05). Furthermore, an increase the Mediterranean dietary habits score was associated with a decrease in these measurements (p < 0.05). Conclusions: The MEDLIFE score, beyond only the Mediterranean dietary habits sub-score, was found to be associated with lower anthropometric measurements in patients with HT, who are at higher risk of pre-obesity and obesity.
