Cardiovascular Risk and Nutrition Research Group, IMIM-Institut de Recerca del Hospital del Mar, Barcelona 08003, Spain.
J Nutr. 2011 Jun;141(6):1140-5. doi: 10.3945/jn.110.135566. Epub 2011 Apr 20.
Ensuring the accuracy of dietary assessment instruments is paramount for interpreting diet-disease relationships. The present study assessed the relative and construct validity of the 14-point Mediterranean Diet Adherence Screener (MEDAS) used in the Prevención con Dieta Mediterránea (PREDIMED) study, a primary prevention nutrition-intervention trial. A validated FFQ and the MEDAS were administered to 7146 participants of the PREDIMED study. The MEDAS-derived PREDIMED score correlated significantly with the corresponding FFQ PREDIMED score (r = 0.52; intraclass correlation coefficient = 0.51) and in the anticipated directions with the dietary intakes reported on the FFQ. Using Bland Altman's analysis, the average MEDAS Mediterranean diet score estimate was 105% of the FFQ PREDIMED score estimate. Limits of agreement ranged between 57 and 153%. Multiple linear regression analyses revealed that a higher PREDIMED score related directly (P < 0.001) to HDL-cholesterol (HDL-C) and inversely (P < 0.038) to BMI, waist circumference, TG, the TG:HDL-C ratio, fasting glucose, and the cholesterol:HDL-C ratio. The 10-y estimated coronary artery disease risk decreased as the PREDIMED score increased (P < 0.001). The MEDAS is a valid instrument for rapid estimation of adherence to the Mediterranean diet and may be useful in clinical practice.
确保饮食评估工具的准确性对于解释饮食与疾病之间的关系至关重要。本研究评估了用于 Prevención con Dieta Mediterránea（PREDIMED）研究的 14 点地中海饮食依从性筛查器（MEDAS）的相对有效性和结构有效性，该研究是一项初级预防营养干预试验。对 PREDIMED 研究的 7146 名参与者进行了验证后的 FFQ 和 MEDAS 问卷调查。MEDAS 衍生的 PREDIMED 评分与相应的 FFQ PREDIMED 评分显著相关（r = 0.52；组内相关系数 = 0.51），并且与 FFQ 报告的饮食摄入量呈预期方向相关。使用 Bland Altman 分析，平均 MEDAS 地中海饮食评分估计值为 FFQ PREDIMED 评分估计值的 105%。一致性界限范围在 57 到 153%之间。多元线性回归分析显示，较高的 PREDIMED 评分与 HDL-胆固醇（HDL-C）直接相关（P < 0.001），与 BMI、腰围、TG、TG:HDL-C 比值、空腹血糖和胆固醇：HDL-C 比值呈负相关（P < 0.038）。随着 PREDIMED 评分的增加，10 年估计的冠心病风险降低（P < 0.001）。MEDAS 是一种快速评估地中海饮食依从性的有效工具，可能在临床实践中有用。
