Bottcher Mary Rose, Marincic Patricia Z, Nahay Katie L, Baerlocher Brittany E, Willis Amy W, Park Jieun, Gaillard Philippe, Greene Michael W
Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA.
College of Sciences and Mathematics, Auburn University, Auburn, AL 36849, USA.
Appetite. 2017 Apr 1;111:166-176. doi: 10.1016/j.appet.2016.12.029. Epub 2016 Dec 23.
The Mediterranean diet (MD) can reduce chronic disease risk and is a recommended diet for prevention and management of diabetes. Adherence to the MD in the southeast United States where obesity and diabetes are highly prevalent is unknown. The purpose of the present study was to: 1) construct a survey instrument relevant to the general population integrating both MD related nutrition knowledge and adherence questions from previously validated instruments, and 2) assess MD related nutrition knowledge and adherence in a sample population in the southest United States. Adherance was assessed using the validated short MD Adherence Screener (MEDAS). A MD nutrition knowledge (MDNK) questionnaire was developed from previously validated general nutrition knowledge questionnaires and was validated using 127 university students enrolled in three courses with varying levels of nutrition education. Cronbach's α for internal validity of MDNK was acceptable for a short questionnaire (0.653). Test-retest reliability was established (r = 0.853). Field validation of the three-part survey instrument (MEDAS, MDNK and demographic questions) was subsequently performed in 230 adults shopping at supermarkets and farmers markets in eastern Alabama. Total MDNK and MEDAS scores were significantly higher in students with formal nutrition education and in patrons of farmers markets. Greater MD adherence, assessed by dividing MEDAS scores into thirds, was found with increasing formal nutrition education in university students (p = 0.002) and in farmers market participants (p < 0.001). There was a weak but significant association between MDNK and MEDAS scores within university students and participants in the field. Together, the MDNK-MEDAS survey instrument is an effective tool for assessing baseline knowledge and adherence and can be used to target nutritional interventions to improve MD adherence for prevention and management of diabetes and other chronic disease.
地中海饮食（MD）可降低慢性病风险，是预防和管理糖尿病的推荐饮食。在美国东南部，肥胖和糖尿病高发地区，人们对地中海饮食的依从性尚不清楚。本研究的目的是：1）构建一份与普通人群相关的调查问卷，整合与地中海饮食相关的营养知识以及先前经过验证的工具中的依从性问题；2）评估美国东南部样本人群中与地中海饮食相关的营养知识和依从性。使用经过验证的简短地中海饮食依从性筛查工具（MEDAS）评估依从性。地中海饮食营养知识（MDNK）问卷是根据先前经过验证的一般营养知识问卷编制而成，并通过对127名修读三门不同营养教育水平课程的大学生进行验证。对于一份简短问卷而言，MDNK内部效度的克朗巴哈系数（Cronbach's α）是可以接受的（0.653）。建立了重测信度（r = 0.853）。随后，在阿拉巴马州东部超市和农贸市场购物的230名成年人中对三部分调查问卷工具（MEDAS、MDNK和人口统计学问题）进行了现场验证。接受过正规营养教育的学生以及农贸市场的顾客的MDNK和MEDAS总分显著更高。通过将MEDAS分数分成三等份来评估，发现大学生（p = 0.002）和农贸市场参与者（p < 0.001）中，随着正规营养教育程度的提高，地中海饮食的依从性更强。在大学生和现场参与者中，MDNK和MEDAS分数之间存在微弱但显著的关联。总之，MDNK - MEDAS调查问卷工具是评估基线知识和依从性的有效工具，可用于针对营养干预措施，以提高地中海饮食的依从性，从而预防和管理糖尿病及其他慢性病。
