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Agreement among Mediterranean Diet Pattern Adherence Indexes: MCC-Spain Study.
Rocío Olmedo-Requena1,2,3, Carmen González-Donquiles4,5,6, Verónica Dávila-Batista7,8,9
1Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain. rocioolmedo@ugr.es.
Nutrients
|March 1, 2019
Summary
Comparing Mediterranean diet adherence indexes reveals significant variability in results. These tools measure similar concepts but use different algorithms, leading to moderate or low agreement among healthy adults.
Area of Science:
- Nutrition Science
- Epidemiology
- Dietary Assessment
Background:
- Multiple indices exist to measure adherence to the Mediterranean diet (MD).
- Variability in methodologies hinders direct comparison and interpretation of MD adherence studies.
- Previous research suggests a need to evaluate the concordance between different MD adherence assessment tools.
Purpose of the Study:
- To evaluate the agreement and concordance among five distinct Mediterranean diet adherence indexes.
- To compare the classification of individuals based on their adherence levels using different MD scoring systems.
- To identify potential discrepancies in assessing adherence to a Mediterranean dietary pattern.
Main Methods:
- Utilized data from the Multi-Case Control Spain (MCC-Spain) study, including 3640 matched controls.
- Calculated five Mediterranean diet adherence scores: Mediterranean diet score (MDS), alternative Mediterranean diet (aMED), relative Mediterranean diet (rMED), dietary score (DS), and literature-based adherence score (LBAS).
- Assessed agreement using correlation coefficients and Cohen's Kappa statistic.
Main Results:
- The prevalence of high MD adherence varied substantially across indexes, ranging from 22% (aMED) to 37.2% (DS).
- Similarly, low MD adherence prevalence differed significantly, from 24% (rMED) to 38.4% (aMED).
- Correlation between MDS, aMED, and rMED was moderate, with MDS and aMED showing a high correlation (0.75). Cohen's Kappa indicated moderate to fair concordance, with MDS and aMED showing the highest values (0.56-0.67).
Conclusions:
- Existing Mediterranean diet adherence indexes measure similar dietary patterns but employ different algorithms and food group inclusions.
- These methodological differences result in considerable variability and moderate to low concordance in classifying individuals' adherence levels.
- Further research and standardization may be needed to improve the comparability of findings across studies using different MD adherence measures.
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