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A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial.

Abstract

OBJECTIVE

Independently of total caloric intake, a better quality of the diet (for example, conformity to the Mediterranean diet) is associated with lower obesity risk. It is unclear whether a brief dietary assessment tool, instead of full-length comprehensive methods, can also capture this association. In addition to reduced costs, a brief tool has the interesting advantage of allowing immediate feedback to participants in interventional studies. Another relevant question is which individual items of such a brief tool are responsible for this association. We examined these associations using a 14-item tool of adherence to the Mediterranean diet as exposure and body mass index, waist circumference and waist-to-height ratio (WHtR) as outcomes.

DESIGN

Cross-sectional assessment of all participants in the "PREvención con DIeta MEDiterránea" (PREDIMED) trial.

SUBJECTS

7,447 participants (55-80 years, 57% women) free of cardiovascular disease, but with either type 2 diabetes or ≥ 3 cardiovascular risk factors. Trained dietitians used both a validated 14-item questionnaire and a full-length validated 137-item food frequency questionnaire to assess dietary habits. Trained nurses measured weight, height and waist circumference.

RESULTS

Strong inverse linear associations between the 14-item tool and all adiposity indexes were found. For a two-point increment in the 14-item score, the multivariable-adjusted differences in WHtR were -0.0066 (95% confidence interval, -0.0088 to -0.0049) for women and -0.0059 (-0.0079 to -0.0038) for men. The multivariable-adjusted odds ratio for a WHtR>0.6 in participants scoring ≥ 10 points versus ≤ 7 points was 0.68 (0.57 to 0.80) for women and 0.66 (0.54 to 0.80) for men. High consumption of nuts and low consumption of sweetened/carbonated beverages presented the strongest inverse associations with abdominal obesity.

CONCLUSIONS

A brief 14-item tool was able to capture a strong monotonic inverse association between adherence to a good quality dietary pattern (Mediterranean diet) and obesity indexes in a population of adults at high cardiovascular risk.

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  • Authors+Show Affiliations

    ,

    Prevención con Dieta Mediterránea Network RD 06/0045, Instituto de Salud Carlos III, Spanish Government, Madrid, Spain. mamartinez@unav.es

    , , , , , , , , , , , , , , , , , , ,

    Source

    PloS one 7:8 2012 pg e43134

    MeSH

    Aged
    Aged, 80 and over
    Body Mass Index
    Cross-Sectional Studies
    Diet
    Diet, Mediterranean
    Feeding Behavior
    Female
    Humans
    Male
    Middle Aged
    Obesity
    Odds Ratio
    Risk
    Surveys and Questionnaires
    Waist Circumference

    Pub Type(s)

    Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22905215

    Citation

    Martínez-González, Miguel Angel, et al. "A 14-item Mediterranean Diet Assessment Tool and Obesity Indexes Among High-risk Subjects: the PREDIMED Trial." PloS One, vol. 7, no. 8, 2012, pp. e43134.
    Martínez-González MA, García-Arellano A, Toledo E, et al. A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial. PLoS ONE. 2012;7(8):e43134.
    Martínez-González, M. A., García-Arellano, A., Toledo, E., Salas-Salvadó, J., Buil-Cosiales, P., Corella, D., ... Estruch, R. (2012). A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial. PloS One, 7(8), pp. e43134.
    Martínez-González MA, et al. A 14-item Mediterranean Diet Assessment Tool and Obesity Indexes Among High-risk Subjects: the PREDIMED Trial. PLoS ONE. 2012;7(8):e43134. PubMed PMID: 22905215.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial. AU - Martínez-González,Miguel Angel, AU - García-Arellano,Ana, AU - Toledo,Estefanía, AU - Salas-Salvadó,Jordi, AU - Buil-Cosiales,Pilar, AU - Corella,Dolores, AU - Covas,Maria Isabel, AU - Schröder,Helmut, AU - Arós,Fernando, AU - Gómez-Gracia,Enrique, AU - Fiol,Miquel, AU - Ruiz-Gutiérrez,Valentina, AU - Lapetra,José, AU - Lamuela-Raventos,Rosa Maria, AU - Serra-Majem,Lluís, AU - Pintó,Xavier, AU - Muñoz,Miguel Angel, AU - Wärnberg,Julia, AU - Ros,Emilio, AU - Estruch,Ramón, AU - ,, Y1 - 2012/08/14/ PY - 2012/03/20/received PY - 2012/07/17/accepted PY - 2012/8/21/entrez PY - 2012/8/21/pubmed PY - 2013/2/12/medline SP - e43134 EP - e43134 JF - PloS one JO - PLoS ONE VL - 7 IS - 8 N2 - OBJECTIVE: Independently of total caloric intake, a better quality of the diet (for example, conformity to the Mediterranean diet) is associated with lower obesity risk. It is unclear whether a brief dietary assessment tool, instead of full-length comprehensive methods, can also capture this association. In addition to reduced costs, a brief tool has the interesting advantage of allowing immediate feedback to participants in interventional studies. Another relevant question is which individual items of such a brief tool are responsible for this association. We examined these associations using a 14-item tool of adherence to the Mediterranean diet as exposure and body mass index, waist circumference and waist-to-height ratio (WHtR) as outcomes. DESIGN: Cross-sectional assessment of all participants in the "PREvención con DIeta MEDiterránea" (PREDIMED) trial. SUBJECTS: 7,447 participants (55-80 years, 57% women) free of cardiovascular disease, but with either type 2 diabetes or ≥ 3 cardiovascular risk factors. Trained dietitians used both a validated 14-item questionnaire and a full-length validated 137-item food frequency questionnaire to assess dietary habits. Trained nurses measured weight, height and waist circumference. RESULTS: Strong inverse linear associations between the 14-item tool and all adiposity indexes were found. For a two-point increment in the 14-item score, the multivariable-adjusted differences in WHtR were -0.0066 (95% confidence interval, -0.0088 to -0.0049) for women and -0.0059 (-0.0079 to -0.0038) for men. The multivariable-adjusted odds ratio for a WHtR>0.6 in participants scoring ≥ 10 points versus ≤ 7 points was 0.68 (0.57 to 0.80) for women and 0.66 (0.54 to 0.80) for men. High consumption of nuts and low consumption of sweetened/carbonated beverages presented the strongest inverse associations with abdominal obesity. CONCLUSIONS: A brief 14-item tool was able to capture a strong monotonic inverse association between adherence to a good quality dietary pattern (Mediterranean diet) and obesity indexes in a population of adults at high cardiovascular risk. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/22905215/A_14_item_Mediterranean_diet_assessment_tool_and_obesity_indexes_among_high_risk_subjects:_the_PREDIMED_trial_ L2 - http://dx.plos.org/10.1371/journal.pone.0043134 DB - PRIME DP - Unbound Medicine ER -