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- Exploring the Validity of the 14-Item Mediterranean Diet Adherence Screener (MEDAS): A Cross-National Study in Seven European Countries around the Mediterranean RegionPublication . García-Conesa, María-Teresa; Philippou, Elena; Pafilas, Christos; Massaro, Marika; Quarta, Stefano; Andrade, Vanda; Jorge, Rui; Chervenkov, Mihail; Ivanova, Teodora; Dimitrova, Dessislava; Maksimova, Viktorija; Smilkov, Katarina; Ackova, Darinka Gjorgieva; Miloseva, Lence; Ruskovska, Tatjana; Deligiannidou, Georgia Eirini; Kontogiorgis, Christos A.; Pinto, PaulaThis study provides comprehensive validation of the 14-item Mediterranean Diet Adherence Screener (14-MEDAS) in an adult population from Greece (GR), Portugal (PT), Italy (IT), Spain (SP), Cyprus (CY), Republic of North Macedonia (NMK), and Bulgaria (BG). A moderate association between the 14-MEDAS and the reference food diary was estimated for the entire population (Pearson r = 0.573, p-value < 0.001; Intraclass Correlation Coefficient (ICC) = 0.692, p-value < 0.001) with the strongest correlation found in GR, followed by PT, IT, SP, and CY. These results were supported by kappa statistics in GR, PT, IT, and SP with ≥50% of food items exhibiting a fair or better agreement. Bland-Altman analyses showed an overestimation of the 14-MEDAS score in the whole population (0.79 ± 1.81, 95%Confidence Interval (CI) 0.61, 0.96), but this value was variable across countries, with GR, NMK, and BG exhibiting the lowest bias. Taking all analyses together, the validation achieved slightly better results in the Mediterranean countries but a definitive validation ranking order was not evident. Considering growing evidence of the shift from Mediterranean Diet (MD) adherence and of the importance of culture in making food choices it is crucial that we further improve validation protocols with specific applications to compare MD adherence across countries.
- Mediterranean diet adherence and subjective well-being in a sample of portuguese adultsPublication . Andrade, Vanda; Jorge, Rui; García-Conesa, María-Teresa; Philippou, Elena; Massaro, Marika; Chervenkov, Mihail; Ivanova, Teodora; Maksimova, Viktorija; Smilkov, Katarina; Ackova, Darinka Gjorgieva; Miloseva, Lence; Ruskovska, Tatjana; Deligiannidou, Georgia Eirini; Kontogiorgis, Christos A.; Pinto, PaulaThe Mediterranean diet (MD) and other lifestyle characteristics have been associated with well-being, a broad multiparameter concept that includes individual’s subjective assessment of their own well-being (SWB). Some studies have suggested that diet influences SWB, thus, this work aimed to add novel information on the association of MD and SWB in a sample of Portuguese adults. Data on sociodemographic, economic, lifestyle, diet, and SWB were collected through a self-filled online questionnaire. MD adherence was assessed by the Mediterranean Diet Adherence Screener (MEDAS) score. Results showed a moderate adherence to the MD in 490 Portuguese adults (mean MEDAS of 7.4 ± 2.1). A higher MD adherence was found to be significantly positively associated with women, employed individuals, a higher number of meals per day, and those with frequent contact with nature (p-value < 0.0025, using Bonferroni adjustment). As a novelty, this study divided the participants into low SWB, medium SWB, and medium to high SWB profiles (3.9 ± 1.0; 6.2 ± 1.0; 8.2 ± 1.3, respectively; p-value < 0.05), which reported significantly increasing MEDAS scores (6.5 ± 2.1; 7.3 ± 2.1; 7.8 ± 1.9; respectively, p-value < 0.05)