Validation of a short questionnaire to record adherence to the Mediterranean diet: An Italian experience

Research output: Contribution to journalArticle

Abstract

Background and aims: A greater adherence to the Mediterranean diet has been associated with a reduced risk of major chronic diseases and cancer. The aim of the study was to assess the validity of a new short self-administered 15-item questionnaire (QueMD) to measure adherence to the Mediterranean diet in Italy. Methods and results: Four-hundred and eighty three participants to cancer-screening programmes at the European Institute of Oncology, Milan (Italy) were invited to join this study. Those interested compiled the QueMD and a validated Food Frequency Questionnaire (FFQ) reporting their usual food consumption during the previous six months. We derived the alternate Mediterranean score (aMED) from both questionnaires with values ranging from 0 (minimal adherence) to 9 (maximal adherence). Complete dietary data were available for 343 individuals (participation rates 71.0%). Spearman correlation coefficient between the responses to the 15 questions of the QueMD and corresponding food intake derived from the FFQ ranged from 0.15 to 0.84. A moderate correlation was found between the aMED scores calculated from the QueMD and the FFQ (intraclass correlation coefficient 0.50; 95% CI, 0.42–0.58), while agreement between the two instruments was only poor to fair for 7 of the 9 single items composing the aMED score, with values ranging from 53.0% for wholegrain products to 79.5% for fruits. Conclusion: This new self-administered 15-item questionnaire could be a useful tool to assess adherence to the Mediterranean diet in the Italian population. © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University
Original languageEnglish
Pages (from-to)1140-1147
Number of pages8
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume28
Issue number11
DOIs
Publication statusPublished - 2018

Fingerprint

Mediterranean Diet
Food
Italy
Clinical Medicine
Early Detection of Cancer
Surveys and Questionnaires
Fruit
Atherosclerosis
Chronic Disease
Eating
Population
Neoplasms

Keywords

  • Mediterranean diet
  • Questionnaire
  • Validation study
  • fat
  • olive oil
  • saturated fatty acid
  • yoghurt
  • adult
  • aged
  • Article
  • beverage
  • breast cancer
  • butter
  • caloric intake
  • cancer risk
  • cancer screening
  • cereal
  • chicken
  • correlation coefficient
  • correlational study
  • dairy product
  • dietary compliance
  • dietary fiber
  • dietary intake
  • female
  • fish
  • food composition
  • food frequency questionnaire
  • food intake
  • fruit
  • grain legume
  • human
  • hypertension
  • legume
  • major clinical study
  • male
  • meat
  • milk
  • nutrient
  • nutritional assessment
  • obesity
  • observational study
  • priority journal
  • questionnaire
  • self-concept assessment
  • underweight
  • vegetable
  • whole grain
  • wine

Cite this

@article{0ff2ff7b5f3f4ea988936f9becf81f86,
title = "Validation of a short questionnaire to record adherence to the Mediterranean diet: An Italian experience",
abstract = "Background and aims: A greater adherence to the Mediterranean diet has been associated with a reduced risk of major chronic diseases and cancer. The aim of the study was to assess the validity of a new short self-administered 15-item questionnaire (QueMD) to measure adherence to the Mediterranean diet in Italy. Methods and results: Four-hundred and eighty three participants to cancer-screening programmes at the European Institute of Oncology, Milan (Italy) were invited to join this study. Those interested compiled the QueMD and a validated Food Frequency Questionnaire (FFQ) reporting their usual food consumption during the previous six months. We derived the alternate Mediterranean score (aMED) from both questionnaires with values ranging from 0 (minimal adherence) to 9 (maximal adherence). Complete dietary data were available for 343 individuals (participation rates 71.0{\%}). Spearman correlation coefficient between the responses to the 15 questions of the QueMD and corresponding food intake derived from the FFQ ranged from 0.15 to 0.84. A moderate correlation was found between the aMED scores calculated from the QueMD and the FFQ (intraclass correlation coefficient 0.50; 95{\%} CI, 0.42–0.58), while agreement between the two instruments was only poor to fair for 7 of the 9 single items composing the aMED score, with values ranging from 53.0{\%} for wholegrain products to 79.5{\%} for fruits. Conclusion: This new self-administered 15-item questionnaire could be a useful tool to assess adherence to the Mediterranean diet in the Italian population. {\circledC} 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University",
keywords = "Mediterranean diet, Questionnaire, Validation study, fat, olive oil, saturated fatty acid, yoghurt, adult, aged, Article, beverage, breast cancer, butter, caloric intake, cancer risk, cancer screening, cereal, chicken, correlation coefficient, correlational study, dairy product, dietary compliance, dietary fiber, dietary intake, female, fish, food composition, food frequency questionnaire, food intake, fruit, grain legume, human, hypertension, legume, major clinical study, male, meat, milk, nutrient, nutritional assessment, obesity, observational study, priority journal, questionnaire, self-concept assessment, underweight, vegetable, whole grain, wine",
author = "P. Gnagnarella and D. Drag{\`a} and A.M. Misotti and S. Sieri and L. Spaggiari and E. Cassano and F. Baldini and L. Soldati and P. Maisonneuve",
note = "Export Date: 5 February 2019 Correspondence Address: Gnagnarella, P.; Divisione di Epidemiologia e Biostatistica, Istituto Europeo di Oncologia, Via Ripamonti 435, Italy; email: patrizia.gnagnarella@ieo.it Chemicals/CAS: olive oil, 8001-25-0 References: Dinu, M., Pagliai, G., Casini, A., Sofi, F., Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials (2018) Eur J Clin Nutr, 72, pp. 30-43; Schwingshackl, L., Hoffmann, G., Adherence to Mediterranean diet and risk of cancer: a systematic review and meta-analysis of observational studies (2014) Int J Cancer, 135, pp. 1884-1897; Bach, A., Serra-Majem, L., Carrasco, J.L., Roman, B., Ngo, J., Bertomeu, I., The use of indexes evaluating the adherence to the mediterranean diet in epidemiological studies: a review (2006) Publ Health Nutr, 9, pp. 132-146; England, C.Y., Andrews, R.C., Jago, R., Thompson, J.L., A systematic review of brief dietary questionnaires suitable for clinical use in the prevention and management of obesity, cardiovascular disease and type 2 diabetes (2015) Eur J Clin Nutr, 69, pp. 977-1003; Schulze, M.B., Hoffmann, K., Methodological approaches to study dietary patterns in relation to risk of coronary heart disease and stroke (2006) Br J Nutr, 95, pp. 860-869; Kourlaba, G., Panagiotakos, D.B., Dietary quality indices and human health: a review (2009) Maturitas, 62, pp. 1-8; Wirt, A., Collins, C.E., Diet quality–what is it and does it matter? (2009) Publ Health Nutr, 12, pp. 2473-2492; Martinez-Gonzalez, M.A., Bes-Rastrollo, M., Serra-Majem, L., Lairon, D., Estruch, R., Trichopoulou, A., Mediterranean food pattern and the primary prevention of chronic disease: recent developments (2009) Nutr Rev, 67, pp. S111-S116; Mart{\'i}nez-Gonz{\'a}lez, M.A., Fern{\'a}ndez-Jarne, E., Serrano-Mart{\'i}nez, M., Wright, M., Gomez-Gracia, E., Development of a short dietary intake questionnaire for the quantitative estimation of adherence to a cardioprotective Mediterranean diet (2004) Eur J Clin Nutr, 58, pp. 1550-1552; Rumawas, M.E., Dwyer, J.T., McKeown, N.M., Meigs, J.B., Rogers, G., Jacques, P.F., The development of the Mediterranean-style dietary pattern score and its application to the American diet in the Framingham Offspring Cohort (2009) J Nutr, 139, pp. 1150-1156; Schr{\"o}der, H., Fit{\'o}, M., Estruch, R., Mart{\'i}nez-Gonz{\'a}lez, M.A., Corella, D., Salas-Salvad{\'o}, J., A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women (2011) J Nutr, 141, pp. 1140-1145; Athanasiadou, E., Kyrkou, C., Fotiou, M., Tsakoumaki, F., Dimitropoulou, A., Polychroniadou, E., Development and validation of a mediterranean oriented culture-specific semi-quantitative food frequency questionnaire (2016) Nutrients, 8 (9); Hebestreit, K., Yahiaoui-Doktor, M., Engel, C., Vetter, W., Siniatchkin, M., Erickson, N., Validation of the German version of the mediterranean diet adherence screener (MEDAS) questionnaire (2017) BMC Cancer., 17, p. 341; Sofi, F., Dinu, M., Pagliai, G., Marcucci, R., Casini, A., Validation of a literature-based adherence score to Mediterranean diet: the MEDI-LITE score (2017) Int J Food Sci Nutr, 68, pp. 757-762; Panagiotakos, D.B., Pitsavos, C., Arvaniti, F., Stefanadis, C., Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; the accuracy of the MedDietScore (2007) Prev Med, 44, pp. 335-340; Gnagnarella, P., Maisonneuve, P., Bellomi, M., Rampinelli, C., Bertolotti, R., Spaggiari, L., Red meat, Mediterranean diet and lung cancer risk among heavy smokers in the COSMOS screening study (2013) Ann Oncol, 24, pp. 2606-2611; Naska, A., Trichopoulou, A., Back to the future: the Mediterranean diet paradigm (2014) Nutr Metabol Cardiovasc Dis, 24, pp. 216-219; World Cancer Research Fund International/American Institute for Cancer Research, Continuous update project report: diet, nutrition, physical activity and colorectal cancer (2017); World Cancer Research Fund International/American Institute for Cancer Research, Continuous update project report: diet, nutrition, physical activity and prostate cancer (2014); LARN, IV Revisione dei Livelli di Assunzione di Riferimento di Nutrienti ed energia per la popolazione italiana (2014), Societ{\`a} Italiana di Nutrizione Umana (SINU); Pisani, P., Faggiano, F., Krogh, V., Palli, D., Vineis, P., Berrino, F., Relative validity and reproducibility of a food frequency dietary questionnaire for use in the Italian EPIC centres (1997) Int J Epidemiol, 26, pp. S152-S160; Pala, V., Sieri, S., Palli, D., Salvini, S., Berrino, F., Bellegotti, M., Diet in the Italian EPIC cohorts: presentation of data and methodological issues (2003) Tumori, 89, pp. 594-607; Gnagnarella, P., Parpinel, M., Salvini, S., Franceschi, S., Palli, D., Boyle, P., The update of the Italian food composition database (2004) J Food Compos Anal, 17, pp. 509-522; Trichopoulou, A., Kouris-Blazos, A., Wahlqvist, M.L., Gnardellis, C., Lagiou, P., Polychronopoulos, E., Diet and overall survival in elderly people (1995) BMJ, 311, pp. 1457-1460; Hoffman, R., Gerber, M., Evaluating and adapting the Mediterranean diet for non-Mediterranean populations: a critical appraisal (2013) Nutr Rev, 71, pp. 573-584; AAVV, Gruppo di esperti costituito presso l'Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione (INRAN). Linee guida per una sana alimentazione italiana. Ministero delle Politiche Agricole e Forestali e INRAN (2003); Bach-Faig, A., Berry, E.M., Lairon, D., Reguant, J., Trichopoulou, A., Dernini, S., Mediterranean Diet Foundation Expert Group. Mediterranean diet pyramid today. Science and cultural updates (2011) Publ Health Nutr, 14, pp. 2274-2284; Leclercq, C., Arcella, D., Piccinelli, R., Sette, S., Le Donne, C., Turrini, A., INRAN-scai 2005-06 study group. The Italian national food consumption survey INRAN-SCAI 2005-06: main results in terms of food consumption (2009) Publ Health Nutr, 12, pp. 2504-2532; Sette, S., D'Addezio, L., Piccinelli, R., Hopkins, S., Le Donne, C., Ferrari, M., Intakes of whole grain in an Italian sample of children, adolescents and adults (2017) Eur J Nutr, 56, pp. 521-533; Svilaas, A., Str{\"o}m, E.C., Svilaas, T., Borgejordet, A., Thoresen, M., Ose, L., Reproducibility and validity of a short food questionnaire for the assessment of dietary habits (2002) Nutr Metabol Cardiovasc Dis, 12, pp. 60-70; Rockett, H.R., Berkey, C.S., Colditz, G.A., Comparison of a short food frequency questionnaire with the youth/adolescent questionnaire in the growing up today study (2007) Int J Pediatr Obes, 2 (1), pp. 31-39; Goldberg, D.P., Hillier, V.F., A scaled version of the general health questionnaire (1979) Psychol Med, 9, pp. 139-145; Selzer, M.L., Vinokur, A., van Rooijen, L., A self-administered short Michigan alcoholism screening test (SMAST) (1975) J Stud Alcohol, 36, pp. 117-126; Edwards, P., Roberts, I., Sandercock, P., Frost, C., Follow-up by mail in clinical trials: does questionnaire length matter? (2004) Contr Clin Trials, 25, pp. 31-52; Sotos-Prieto, M., Santos-Beneit, G., Bodega, P., Pocock, S., Mattei, J., Pe{\~n}alvo, J.L., Validation of a questionnaire to measure overall mediterranean lifestyle habits for research application: the mediterranean lifestyle index (MEDLIFE) (2015) Nutr Hosp, 32, pp. 1153-1163; Zito, F.P., Polese, B., Vozzella, L., Gala, A., Genovese, D., Verlezza, V., Good adherence to Mediterranean diet can prevent gastrointestinal symptoms: a survey from Southern Italy (2016) World J Gastrointest Pharmacol Therapeut, 7, pp. 564-571; Pignatelli, P., Pastori, D., Farcomeni, A., Nocella, C., Bartimoccia, S., Vicario, T., Mediterranean diet reduces thromboxane A2 production in atrial fibrillation patients (2015) Clin Nutr, 34, pp. 899-903; Willett, W., , 30, pp. 1998-514. , Nutritional Epidemiology,;Volume Oxford University Press, USA, 11 giu; Kipnis, V., Midthune, D., Freedman, L., Bingham, S., Day, N.E., Riboli, E., Bias in dietary-report instruments and its implications for nutritional epidemiology (2002) Publ Health Nutr, 5, pp. 915-923; Sette, S., Le Donne, C., Piccinelli, R., Arcella, D., Turrini, A., Leclercq, C., INRAN-scai 2005-6 study group. The third Italian national food consumption survey, INRAN-SCAI 2005-06–part 1: nutrient intakes in Italy (2011) Nutr Metabol Cardiovasc Dis, 21, pp. 922-932; Goulet, J., Lamarche, B., Nadeau, G., Lemieux, S., Effect of a nutritional intervention promoting the Mediterranean food pattern on plasma lipids, lipoproteins and body weight in healthy French-Canadian women (2003) Atherosclerosis, 170, pp. 115-124",
year = "2018",
doi = "10.1016/j.numecd.2018.06.006",
language = "English",
volume = "28",
pages = "1140--1147",
journal = "Nutrition, Metabolism and Cardiovascular Diseases",
issn = "0939-4753",
publisher = "Elsevier B.V.",
number = "11",

}

TY - JOUR

T1 - Validation of a short questionnaire to record adherence to the Mediterranean diet: An Italian experience

AU - Gnagnarella, P.

AU - Dragà, D.

AU - Misotti, A.M.

AU - Sieri, S.

AU - Spaggiari, L.

AU - Cassano, E.

AU - Baldini, F.

AU - Soldati, L.

AU - Maisonneuve, P.

N1 - Export Date: 5 February 2019 Correspondence Address: Gnagnarella, P.; Divisione di Epidemiologia e Biostatistica, Istituto Europeo di Oncologia, Via Ripamonti 435, Italy; email: patrizia.gnagnarella@ieo.it Chemicals/CAS: olive oil, 8001-25-0 References: Dinu, M., Pagliai, G., Casini, A., Sofi, F., Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials (2018) Eur J Clin Nutr, 72, pp. 30-43; Schwingshackl, L., Hoffmann, G., Adherence to Mediterranean diet and risk of cancer: a systematic review and meta-analysis of observational studies (2014) Int J Cancer, 135, pp. 1884-1897; Bach, A., Serra-Majem, L., Carrasco, J.L., Roman, B., Ngo, J., Bertomeu, I., The use of indexes evaluating the adherence to the mediterranean diet in epidemiological studies: a review (2006) Publ Health Nutr, 9, pp. 132-146; England, C.Y., Andrews, R.C., Jago, R., Thompson, J.L., A systematic review of brief dietary questionnaires suitable for clinical use in the prevention and management of obesity, cardiovascular disease and type 2 diabetes (2015) Eur J Clin Nutr, 69, pp. 977-1003; Schulze, M.B., Hoffmann, K., Methodological approaches to study dietary patterns in relation to risk of coronary heart disease and stroke (2006) Br J Nutr, 95, pp. 860-869; Kourlaba, G., Panagiotakos, D.B., Dietary quality indices and human health: a review (2009) Maturitas, 62, pp. 1-8; Wirt, A., Collins, C.E., Diet quality–what is it and does it matter? (2009) Publ Health Nutr, 12, pp. 2473-2492; Martinez-Gonzalez, M.A., Bes-Rastrollo, M., Serra-Majem, L., Lairon, D., Estruch, R., Trichopoulou, A., Mediterranean food pattern and the primary prevention of chronic disease: recent developments (2009) Nutr Rev, 67, pp. S111-S116; Martínez-González, M.A., Fernández-Jarne, E., Serrano-Martínez, M., Wright, M., Gomez-Gracia, E., Development of a short dietary intake questionnaire for the quantitative estimation of adherence to a cardioprotective Mediterranean diet (2004) Eur J Clin Nutr, 58, pp. 1550-1552; Rumawas, M.E., Dwyer, J.T., McKeown, N.M., Meigs, J.B., Rogers, G., Jacques, P.F., The development of the Mediterranean-style dietary pattern score and its application to the American diet in the Framingham Offspring Cohort (2009) J Nutr, 139, pp. 1150-1156; Schröder, H., Fitó, M., Estruch, R., Martínez-González, M.A., Corella, D., Salas-Salvadó, J., A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women (2011) J Nutr, 141, pp. 1140-1145; Athanasiadou, E., Kyrkou, C., Fotiou, M., Tsakoumaki, F., Dimitropoulou, A., Polychroniadou, E., Development and validation of a mediterranean oriented culture-specific semi-quantitative food frequency questionnaire (2016) Nutrients, 8 (9); Hebestreit, K., Yahiaoui-Doktor, M., Engel, C., Vetter, W., Siniatchkin, M., Erickson, N., Validation of the German version of the mediterranean diet adherence screener (MEDAS) questionnaire (2017) BMC Cancer., 17, p. 341; Sofi, F., Dinu, M., Pagliai, G., Marcucci, R., Casini, A., Validation of a literature-based adherence score to Mediterranean diet: the MEDI-LITE score (2017) Int J Food Sci Nutr, 68, pp. 757-762; Panagiotakos, D.B., Pitsavos, C., Arvaniti, F., Stefanadis, C., Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; the accuracy of the MedDietScore (2007) Prev Med, 44, pp. 335-340; Gnagnarella, P., Maisonneuve, P., Bellomi, M., Rampinelli, C., Bertolotti, R., Spaggiari, L., Red meat, Mediterranean diet and lung cancer risk among heavy smokers in the COSMOS screening study (2013) Ann Oncol, 24, pp. 2606-2611; Naska, A., Trichopoulou, A., Back to the future: the Mediterranean diet paradigm (2014) Nutr Metabol Cardiovasc Dis, 24, pp. 216-219; World Cancer Research Fund International/American Institute for Cancer Research, Continuous update project report: diet, nutrition, physical activity and colorectal cancer (2017); World Cancer Research Fund International/American Institute for Cancer Research, Continuous update project report: diet, nutrition, physical activity and prostate cancer (2014); LARN, IV Revisione dei Livelli di Assunzione di Riferimento di Nutrienti ed energia per la popolazione italiana (2014), Società Italiana di Nutrizione Umana (SINU); Pisani, P., Faggiano, F., Krogh, V., Palli, D., Vineis, P., Berrino, F., Relative validity and reproducibility of a food frequency dietary questionnaire for use in the Italian EPIC centres (1997) Int J Epidemiol, 26, pp. S152-S160; Pala, V., Sieri, S., Palli, D., Salvini, S., Berrino, F., Bellegotti, M., Diet in the Italian EPIC cohorts: presentation of data and methodological issues (2003) Tumori, 89, pp. 594-607; Gnagnarella, P., Parpinel, M., Salvini, S., Franceschi, S., Palli, D., Boyle, P., The update of the Italian food composition database (2004) J Food Compos Anal, 17, pp. 509-522; Trichopoulou, A., Kouris-Blazos, A., Wahlqvist, M.L., Gnardellis, C., Lagiou, P., Polychronopoulos, E., Diet and overall survival in elderly people (1995) BMJ, 311, pp. 1457-1460; Hoffman, R., Gerber, M., Evaluating and adapting the Mediterranean diet for non-Mediterranean populations: a critical appraisal (2013) Nutr Rev, 71, pp. 573-584; AAVV, Gruppo di esperti costituito presso l'Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione (INRAN). Linee guida per una sana alimentazione italiana. Ministero delle Politiche Agricole e Forestali e INRAN (2003); Bach-Faig, A., Berry, E.M., Lairon, D., Reguant, J., Trichopoulou, A., Dernini, S., Mediterranean Diet Foundation Expert Group. Mediterranean diet pyramid today. Science and cultural updates (2011) Publ Health Nutr, 14, pp. 2274-2284; Leclercq, C., Arcella, D., Piccinelli, R., Sette, S., Le Donne, C., Turrini, A., INRAN-scai 2005-06 study group. The Italian national food consumption survey INRAN-SCAI 2005-06: main results in terms of food consumption (2009) Publ Health Nutr, 12, pp. 2504-2532; Sette, S., D'Addezio, L., Piccinelli, R., Hopkins, S., Le Donne, C., Ferrari, M., Intakes of whole grain in an Italian sample of children, adolescents and adults (2017) Eur J Nutr, 56, pp. 521-533; Svilaas, A., Ström, E.C., Svilaas, T., Borgejordet, A., Thoresen, M., Ose, L., Reproducibility and validity of a short food questionnaire for the assessment of dietary habits (2002) Nutr Metabol Cardiovasc Dis, 12, pp. 60-70; Rockett, H.R., Berkey, C.S., Colditz, G.A., Comparison of a short food frequency questionnaire with the youth/adolescent questionnaire in the growing up today study (2007) Int J Pediatr Obes, 2 (1), pp. 31-39; Goldberg, D.P., Hillier, V.F., A scaled version of the general health questionnaire (1979) Psychol Med, 9, pp. 139-145; Selzer, M.L., Vinokur, A., van Rooijen, L., A self-administered short Michigan alcoholism screening test (SMAST) (1975) J Stud Alcohol, 36, pp. 117-126; Edwards, P., Roberts, I., Sandercock, P., Frost, C., Follow-up by mail in clinical trials: does questionnaire length matter? (2004) Contr Clin Trials, 25, pp. 31-52; Sotos-Prieto, M., Santos-Beneit, G., Bodega, P., Pocock, S., Mattei, J., Peñalvo, J.L., Validation of a questionnaire to measure overall mediterranean lifestyle habits for research application: the mediterranean lifestyle index (MEDLIFE) (2015) Nutr Hosp, 32, pp. 1153-1163; Zito, F.P., Polese, B., Vozzella, L., Gala, A., Genovese, D., Verlezza, V., Good adherence to Mediterranean diet can prevent gastrointestinal symptoms: a survey from Southern Italy (2016) World J Gastrointest Pharmacol Therapeut, 7, pp. 564-571; Pignatelli, P., Pastori, D., Farcomeni, A., Nocella, C., Bartimoccia, S., Vicario, T., Mediterranean diet reduces thromboxane A2 production in atrial fibrillation patients (2015) Clin Nutr, 34, pp. 899-903; Willett, W., , 30, pp. 1998-514. , Nutritional Epidemiology,;Volume Oxford University Press, USA, 11 giu; Kipnis, V., Midthune, D., Freedman, L., Bingham, S., Day, N.E., Riboli, E., Bias in dietary-report instruments and its implications for nutritional epidemiology (2002) Publ Health Nutr, 5, pp. 915-923; Sette, S., Le Donne, C., Piccinelli, R., Arcella, D., Turrini, A., Leclercq, C., INRAN-scai 2005-6 study group. The third Italian national food consumption survey, INRAN-SCAI 2005-06–part 1: nutrient intakes in Italy (2011) Nutr Metabol Cardiovasc Dis, 21, pp. 922-932; Goulet, J., Lamarche, B., Nadeau, G., Lemieux, S., Effect of a nutritional intervention promoting the Mediterranean food pattern on plasma lipids, lipoproteins and body weight in healthy French-Canadian women (2003) Atherosclerosis, 170, pp. 115-124

PY - 2018

Y1 - 2018

N2 - Background and aims: A greater adherence to the Mediterranean diet has been associated with a reduced risk of major chronic diseases and cancer. The aim of the study was to assess the validity of a new short self-administered 15-item questionnaire (QueMD) to measure adherence to the Mediterranean diet in Italy. Methods and results: Four-hundred and eighty three participants to cancer-screening programmes at the European Institute of Oncology, Milan (Italy) were invited to join this study. Those interested compiled the QueMD and a validated Food Frequency Questionnaire (FFQ) reporting their usual food consumption during the previous six months. We derived the alternate Mediterranean score (aMED) from both questionnaires with values ranging from 0 (minimal adherence) to 9 (maximal adherence). Complete dietary data were available for 343 individuals (participation rates 71.0%). Spearman correlation coefficient between the responses to the 15 questions of the QueMD and corresponding food intake derived from the FFQ ranged from 0.15 to 0.84. A moderate correlation was found between the aMED scores calculated from the QueMD and the FFQ (intraclass correlation coefficient 0.50; 95% CI, 0.42–0.58), while agreement between the two instruments was only poor to fair for 7 of the 9 single items composing the aMED score, with values ranging from 53.0% for wholegrain products to 79.5% for fruits. Conclusion: This new self-administered 15-item questionnaire could be a useful tool to assess adherence to the Mediterranean diet in the Italian population. © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University

AB - Background and aims: A greater adherence to the Mediterranean diet has been associated with a reduced risk of major chronic diseases and cancer. The aim of the study was to assess the validity of a new short self-administered 15-item questionnaire (QueMD) to measure adherence to the Mediterranean diet in Italy. Methods and results: Four-hundred and eighty three participants to cancer-screening programmes at the European Institute of Oncology, Milan (Italy) were invited to join this study. Those interested compiled the QueMD and a validated Food Frequency Questionnaire (FFQ) reporting their usual food consumption during the previous six months. We derived the alternate Mediterranean score (aMED) from both questionnaires with values ranging from 0 (minimal adherence) to 9 (maximal adherence). Complete dietary data were available for 343 individuals (participation rates 71.0%). Spearman correlation coefficient between the responses to the 15 questions of the QueMD and corresponding food intake derived from the FFQ ranged from 0.15 to 0.84. A moderate correlation was found between the aMED scores calculated from the QueMD and the FFQ (intraclass correlation coefficient 0.50; 95% CI, 0.42–0.58), while agreement between the two instruments was only poor to fair for 7 of the 9 single items composing the aMED score, with values ranging from 53.0% for wholegrain products to 79.5% for fruits. Conclusion: This new self-administered 15-item questionnaire could be a useful tool to assess adherence to the Mediterranean diet in the Italian population. © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University

KW - Mediterranean diet

KW - Questionnaire

KW - Validation study

KW - fat

KW - olive oil

KW - saturated fatty acid

KW - yoghurt

KW - adult

KW - aged

KW - Article

KW - beverage

KW - breast cancer

KW - butter

KW - caloric intake

KW - cancer risk

KW - cancer screening

KW - cereal

KW - chicken

KW - correlation coefficient

KW - correlational study

KW - dairy product

KW - dietary compliance

KW - dietary fiber

KW - dietary intake

KW - female

KW - fish

KW - food composition

KW - food frequency questionnaire

KW - food intake

KW - fruit

KW - grain legume

KW - human

KW - hypertension

KW - legume

KW - major clinical study

KW - male

KW - meat

KW - milk

KW - nutrient

KW - nutritional assessment

KW - obesity

KW - observational study

KW - priority journal

KW - questionnaire

KW - self-concept assessment

KW - underweight

KW - vegetable

KW - whole grain

KW - wine

U2 - 10.1016/j.numecd.2018.06.006

DO - 10.1016/j.numecd.2018.06.006

M3 - Article

VL - 28

SP - 1140

EP - 1147

JO - Nutrition, Metabolism and Cardiovascular Diseases

JF - Nutrition, Metabolism and Cardiovascular Diseases

SN - 0939-4753

IS - 11

ER -