Mediterranean Diet Adherence Screener Research Articles

Association between diet quality and malnutrition: pooled results from two population-based studies in older adults

BackgroundThe role of diet quality on malnutrition in older adults is uncertain, due the paucity of the research conducted and the use of use of screening tools that did not consider phenotypic criteria of malnutrition.ObjectiveTo evaluate the association of two indices of diet quality, namely the Mediterranean Diet Adherence Screener (MEDAS) and the Alternative Healthy Eating Index (AHEI-2010), with malnutrition among community-dwelling older adults in Spain.MethodsCross-sectional analysis of data from 1921 adults aged ≥ 60 years from the Seniors-ENRICA-1 (SE-1) study, and 2652 adults aged ≥ 65 years from the Seniors-ENRICA-2 (SE-2) study. Habitual food consumption was assessed through a validated diet history. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) phenotypic criteria. Statistical analyses were performed with logistic regression with adjustment for socioeconomic and lifestyle variables as well as for total energy and protein intake.ResultsThe prevalence of malnutrition in the SE-1 study was 9.5% (95% confidence interval: 8.2 to 10.9) and 11.7% (10.5 to 13.9) in the SE-2. Adherence to the MEDAS score was associated with lower prevalence of malnutrition [pooled odds ratio for high (≥ 9 points) vs. low adherence (< 7 points): 0.64 (0.48–0.84); p-trend < 0.001]. Higher adherence to the AHEI-2010 also showed an inverse association with malnutrition (pooled odds ratio for quartile 4 vs. 1: 0.65 (0.49–0.86); p-trend 0.006). Among the individual components, higher consumption of fish and long-chain n-3 fatty acids in MEDAS and AHEI-2010, and of vegetables and nuts and legumes in AHEI-2010, and lower intake of trans-fat and sugar-sweetened beverages and fruit juice in AHEI-2010 were independently associated with lower odds of malnutrition.ConclusionAdherence to high diet-quality patterns was associated with lower frequency of malnutrition among older adults.Clinical trial registryClinicalTrials.gov identifier: NCT02804672. June 17, 2016.; ClinicalTrials.gov NCT03541135. May 30, 2018.

Adherence to the Mediterranean Diet, Sodium and Potassium Intake in People at a High Risk of Dementia

Adequate sodium and potassium intake, along with adherence to the Mediterranean diet (MedDiet), are key factors for preventing hypertension and cerebrovascular diseases. However, data on the consumption of these nutrients within the MedDiet are scarce. This cross-sectional study aims to assess the association between MedDiet adherence and sodium/potassium intake in the MIND-Matosinhos randomized controlled trial, targeting Portuguese adults at a high risk of dementia. Good adherence to the MedDiet was defined using the Portuguese Mediterranean Diet Adherence Screener questionnaire (≥10 points), and both sodium/potassium intakes were estimated from 24-hour urine collections. The association between MedDiet adherence and these nutrients’ intake (dichotomized by the median) was quantified by calculating odds ratios (OR) and respective 95% confidence intervals (95% CI) using a logistic regression. A total of 169 individuals (60.9% female; median age: 70 years; range: 36–85 years) were included. Good adherence to the MedDiet was observed among 18.3% of the sample. After adjusting for sex, age, education and using antihypertensive drugs, good MedDiet adherence was associated with higher sodium (OR = 3.11; 95% CI: 1.27–7.65) and potassium intake (OR = 9.74; 95% CI: 3.14–30.26). Increased adherence to the MedDiet may contribute to a higher potassium intake but seems to have limited effects on the adequacy of sodium levels.

Differences of skin carotenoids and adherence to the Mediterranean Diet pattern in adults from Southern Italy and Dominican Republic

BackgroundThe measurement of the skin carotenoids using the Veggie Meter® has emerged as a rapid objective method for assessing fruit and vegetable intake, highly recommended by the Mediterranean Diet (MD), which represents one of the healthiest dietary patterns, worldwide. This study aimed to examine differences in skin carotenoid content and degree of adherence to the MD pattern between two adult populations from Southern Italy and the Dominican Republic.MethodsThis cross-sectional study enrolled a total of 995 adults, 601 subjects from Italy and 394 from the Dominican Republic. All participants underwent anthropometric measurements and skin carotenoid assessment by Veggie Meter®. Adherence to the MD and lifestyle were evaluated using the Mediterranean Diet Adherence Screener (MEDAS) and the Mediterranean Lifestyle Index (MEDLIFE) questionnaires. Correlations between the skin carotenoid and MEDAS score were estimated using Pearson’s correlation coefficient. Multiple linear regression models were created to determine variables that affect skin carotenoid score for both populations.ResultsMean total skin carotenoids were higher in the Italian compared to the Dominican Republic population (342.4 ± 92.4 vs 282.9 ± 90.3; p < 0.005) regardless of sex (women: 318.5 ± 88.9 vs 277.3 ± 91.9, p < 0.005 and men: 371.7 ± 88.3 vs 289.5 ± 88.1, p < 0.005), and remaining statistically significant after age-adjustment of the Dominican Republic sample. Using the MEDAS questionnaire, we found a higher MD adherence score in the Italian than in the Dominican Republic population also after age-adjusting data (7.8 ± 2.1 vs 6.2 ± 3.7; p < 0.005) and even when categorized by sex (Italian vs age-adjusted Dominican Republic women: 7.9 ± 2.1 vs 6.3 ± 2.6; Italian vs age-adjusted Dominican Republic men: 7.7 ± 2.2 vs 6.0 ± 4.7; p < 0.005). Using the MEDLIFE test, total Italians presented a lower score with respect to the age-adjusted Dominican Republic population (3.2 ± 1.2 vs 3.4 ± 1.4; p < 0.05). In multiple regression analysis, skin carotenoids were associated with sex and negatively associated with BMI in the Italian population (sex: β: 54.95; 95% CI: 40.11, 69.78; p < 0.0001; BMI: β: − 1.60; 95% CI: − 2.98,0.86; p = 0.03), while they resulted associated with age and sex in the Dominican Republic population (age: β: 2.76; 95% CI: 1.92, 3.56; p < 0.001; sex: β: 23.29; 95% CI: 5.93, 40.64; p = 0.009). Interestingly, skin carotenoids were positively correlated with MEDAS score in both populations (Italy: r = 0.03, p < 0.0001, Dominican Republic: r = 0.16, p = 0.002).ConclusionsThis study provides the assessment of the adherence to the MD and skin carotenoid content in adults living in Southern Italy and the Dominican Republic, showing a higher MD adherence score and a skin carotenoid content in inhabitants from the Mediterranean region. Our findings highlight the need to globally encourage fruit and vegetable intake, particularly in non-Mediterranean area.

Adherence to the Mediterranean Diet in Saudi Arabia and Its Association with Socioeconomic Status and Depression.

Background and Objectives: Several RCTs have reported significant reductions in depression symptoms with the Mediterranean diet (MedDiet), but observational studies have reported inconsistent findings. Moreover, studies have rarely investigated the mediating role of socioeconomic status (SES), including objective material status, in adherence to the MedDiet and its impact on depressive symptoms in the same population. Therefore, this cross-sectional study investigated the relationship between adherence to the MedDiet, socioeconomic factors, and depression severity. Materials and Methods: A cross-sectional online survey was conducted between June and December 2022 across Saudia Arabia. The snowball sampling technique was used to recruit participants aged ≥18 years. Mediterranean diet adherence screener (MEDAS) and Patient Health Questionnaire-9 (PHQ-9) were used to assess adherence to the MedDiet and depression severity. An SES index, validated in the Saudi Arabian context, was used to assess SES. The data were analyzed using the Chi-square and Pearson's correlation tests. Results: Only 21% of our study population (n = 467) was MedDiet adherent. Adherence was significantly associated with education (p = 0.014) but not employment status among traditional SES indicators. Similarly, only television ownership (p = 0.009) was associated with MedDiet adherence among the 20 objective material possessions investigated. Nonetheless, the MedDiet-adherent group had a significantly lower PHQ-9 score than the non-adherent group (6.16 ± 0.68 vs. 8.35 ± 0.31, p = 0.002). A moderate but significantly negative correlation between MEDAS and PHQ-9 scores (r = -0.16, p = 0.001) was noted. Conclusions: MedDiet adherence was associated with lower depression severity scores. In addition to education and television ownership, adherence was not associated with any objective indicators of SES.

Association between inflammatory potential of diet and anthropometric indicators of adiposity among a sample of Turkish university

Purpose The inflammatory potential of diet may play a role in the regulation of low-grade chronic inflammation derived from obesity. This study aims to investigate the relationship between the dietary inflammatory index (DII) and anthropometric indicators of adiposity among Turkish adults. Design/methodology/approach The study sample consisted of 833 young adults (mean age = 23 ± 5.2 years). The inflammatory potential of the diet was evaluated with a DII. Data on dietary intake were collected by a single 24-h dietary recall, and DII was estimated from 25 dietary components. Also, the Mediterranean diet (Med-Diet) adherence screener was applied using the 14-item assessment tool. Findings The proinflammatory diet was statistically associated with young (p &lt; 0.001), singles (p &lt; 0.001), high school degree (p = 0.011), students (p &lt; 0.001), not working or unemployed (p &lt; 0.001), eating outside (p = 0.016) and lower adherence to a Med-Diet (p = 0.027). There was a statistically significant positive relationship between the DII score and body weight (BW), waist circumference and waist-to-height ratio (WHtR) (r = 0.107; p = 0.002, r = 0.092; p = 0.008, r = 0.115; p = 0.001, respectively). Besides, there was a statistically significant negative relationship between MED score and BW, WHtR and neck circumference (r = −0.101; p = 0.004, r = −0.084; p = 0.016, r = −0.175; p = 0.000, respectively). Originality/value To the best of the authors’ knowledge, this was the first Turkish study to assess the association between the anthropometric indicators of obesity and DII or adherence to Med-Diet in young adults. Lower DII scores and higher adherence to Med-Diet are related to the better status of anthropometric indicators of adiposity.

Mediterranean diet related to 3-year incidence of cognitive decline: results from a cohort study in Chinese rural elders

ABSTRACT Objective This study aims to examine the effect of the Mediterranean diet (MeDi) on cognitive decline among the Chinese elderly with a 3-year follow-up. Methods This study is divided into two waves: wave-1 January 2019 to June 2019 (n = 2313); wave-2 January 2022 to March 2022 (n = 1648). MeDi scores were calculated from the Mediterranean Diet Adherence Screener (MEDAS), with the scoring of low compliance (0–6 points) and high compliance (7–14 points). The Mini-Mental State Examination (MMSE) was used to assess cognitive function. An MMSE score dropping ≥ 2 points from baseline was defined as cognitive decline. The relationships between MeDi score and cognitive decline were analyzed by linear regression models or Binary logistic regression. Results During the 3-year follow-up, 23.8% of patients exhibited cognitive decline. The study revealed a significant difference in MMSE score changes between low and high MeDi adherence groups (p < 0.001). MeDi score was negatively correlated with cognitive deterioration (β = −0.020, p = 0.026). MeDi score was only negatively associated with cognitive decline in the female subgroup aged ≥65 years (β = −0.034, p = 0.033). The food beans (OR = 0.65, 95%CI:0.51, 0.84), fish (OR = 0.72, 95%CI:0.54, 0.97), and cooked vegetables (OR = 0.68, 95%CI:0.53, 0.84) were protective factors for cognitive decline. Conclusions This study suggests that greater adherence to the MeDi is linked to a reduced risk of cognitive decline in elderly people. However, this is found only in women who are 65 years old or older. It also found long-term adherence to beans, fish, and vegetables are more effective in improving cognitive function.

Adherence to a Mediterranean Diet is inversely associated with anxiety and stress but not depression: a cross-sectional analysis of community-dwelling older Australians

An increasing body of evidence has emerged suggesting that lifestyle behaviours, including diet quality, may be an important modifiable risk factor for mental health disorders. The Mediterranean diet (MedDiet), which is often heralded as an anti-inflammatory diet, has been widely investigated and promoted as one of the ‘healthiest’ dietary patterns for reducing chronic disease risk and promoting healthy ageing(1). Greater adherence to a MedDiet and/or anti-inflammatory diet is inversely associated with the risk of depression or depressive symptoms in younger and middle-aged adults(2). However, these findings have been inconsistent, particularly in older adults. We therefore explored the independent associations between adherence to a MedDiet and severity of symptoms related to depression, anxiety and stress in community-dwelling older adults from Australia. We conducted a cross-sectional study of older Australians aged ≥ 60 years. Older adults who were permanent residents of Australia, free from dementia or cognitive decline and could independently complete an anonymous online survey in English were invited to participate. A 75-item self-administered questionnaire was used to assess the relationship between adherence to a MedDiet and severity of symptoms related to depression, anxiety, and stress. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS)(3) and the Depression, Anxiety and Stress Scale (DASS-21)(4) was used to assess the severity of negative emotional symptoms. Multivariable linear regression analysis (and 95% CI) was used to investigate the independent association between adherence to a MedDiet and severity of symptoms related depression, anxiety and stress using one unadjusted and six adjusted predictor models. A total of n = 294 participants were included in the final analyses (70.4 ± 6.2 years; Females, n = 201; Males, n = 91; n = 2 unspecified). Adherence to a MedDiet was inversely associated with severity of anxiety symptoms (β = −0.118; CI: −0.761, −0.012; P = 0.043) independent of age, gender, BMI, physical activity, sleep, cognitive risk and ability to perform activities of daily living. Furthermore, MedDiet adherence was inversely associated with symptoms of stress (β = −0.151; CI: −0.680, −0.073; P = 0.015) independent of age, gender, BMI, physical activity and sleep. However, no relationship between MedDiet adherence and depressive symptoms was observed. We showed that adherence to a MedDiet is inversely associated with severity of symptoms related to anxiety and stress but not for depression. Exploration of these findings using longitudinal analyses and robust clinical trials are needed to better elucidate these findings in older adults.

Adherence to a Mediterranean diet is not associated with severity of menopausal symptoms: a cross-sectional analysis of Australian peri-menopausal and menopausal women

During the menopausal transition, women often encounter a range of physical and psychological symptoms which negatively impact on health-related quality of life (HRQoL)(1). Diet quality has previously been identified as a modifiable factor associated with mitigating the severity of these symptoms in peri-menopausal and menopausal women(2). We therefore explored the independent associations between adherence to a Mediterranean diet (MedDiet) and the severity of menopausal symptoms in peri-menopausal and menopausal women living in Australia. We also explored the association between MedDiet adherence and HRQoL in this same cohort of women. We conducted a cross-sectional study of Australian peri-menopausal or menopausal women aged between 40 to 60 years. An 86-item self-administered questionnaire was used to assess the relationship between adherence to a MedDiet and severity of symptoms. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS), the Menopause Rating Scale (MRS) was used to assess the severity of menopausal symptoms related to somatic, psychological and urinary-genital symptoms and the 36-item short form survey instrument (SF-36) was used to assess HRQoL. Multivariable linear regression analysis (and 95% CI) was used to investigate the independent association between adherence to a MedDiet, severity of menopausal symptoms and HRQoL subscales using one unadjusted and five adjusted predictor models. A total of n = 207 participants (50.7 ± 4.3 years; BMI: 28.0 ± 7.4 kg/m2) were included in the final analyses. Participants reported low-moderate adherence to a MedDiet (5.2 ± 1.8; range: 1-11). We showed that MedDiet adherence was not associated with severity of menopausal symptoms. However, when assessing individual dietary constituents of the MEDAS, we showed that low consumption of sugar-sweetened beverages (&lt;250ml per day) was inversely associated with joint and muscle complaints, independent of all covariates (β = −0.149; CI: −0.118, −0.022; P = 0.042). Furthermore, adherence to a MedDiet was positively associated with the physical function subscale of HRQoL (β = 0.173, CI: 0.001, 0.029; P = 0.031) and a low intake of red and processed meats (≤ 1 serve per day) was positively associated with the general health subscale (β = 0.296, CI: 0.005, 0.014; P = &lt;0.001), independent of all covariates used in the fully adjusted model. Our results suggest that diet quality may be related to severity of menopausal symptoms and HRQoL in peri-menopausal and menopausal women. However, exploration of these findings using longitudinal analyses and robust clinical trials are needed to better elucidate these findings.

Higher adherence to the Mediterranean Diet is associated with better academic achievement in Spanish university students: a multicentre cross-sectional study

To assess the association of the overall score and different items of the Mediterranean Diet Adherence Screener (MEDAS) questionnaire with academic achievement in Spanish university students. We hypothesized that university students with greater adherence to the Mediterranean Diet (MedDiet) would have better academic achievement A cross-sectional study was performed involving 266 first-year students from the University of Castilla-La Mancha, Spain, during the 2017-2018 academic year. Adherence to the Mediterranean diet was evaluated with the 14-item MEDAS questionnaire. As an indicator variable for academic achievement, the average marks of the exams required for access to Spanish universities were used. A total of 63 participants (23.6%) adhered to MedDiet recommendations. ANCOVA models showed that participants with higher adherence to the MedDiet had significantly higher scores on academic achievement than their peers with low adherence (p<0.001) after controlling for potential confounders. Additionally, the evaluation of each item of the MEDAS questionnaire showed that a diet rich in olive oil, vegetables, fruits, legumes, fish and shellfish and a low consumption of sweets and carbonated beverages were positively associated with academic achievement; nevertheless, wine intake was inversely associated. This study showed that Spanish university students had a low prevalence of good adherence to the MedDiet. Additionally, our results suggested that higher adherence to the MedDiet is associated with better academic achievement in Spanish university students. From a public health perspective and due to low adherence, it is important to continue to focus on promoting adherence to the MedDiet as part of a healthy lifestyle pattern to improve the academic performance of young university students.

Chronotype is associated with Mediterranean dietary adherence and environmental footprints

ABSTRACT This cross-sectional study was carried out to determine the relationship between nutrition according to chronotype and the Mediterranean diet and environmental footprints. “Morningness Eveningness Questionnaire” was used to determine the chronotype classification, and “Mediterranean Diet Adherence Screener” was used to evaluate adherence to the Mediterranean diet. In addition, the food consumption record of the participants was taken and the carbon and water footprints were calculated. A total of 472 adults with a mean age of 22.7 ± 5.0 years participated in the study. Accordingly, 61.0% of the participants were morning type, 15.7% were intermediate type, and 23.3% were evening type. Individuals with higher chronotype values (morning) tended to be more adherent to the Mediterranean diet and had lower environmental (carbon and water) footprints (p < 0.05). The results of this study; showed that diet according to chronotype affects adherence to the Mediterranean diet and environmental footprints.

A Study on Footballers: Is the Mediterranean diet a Good Defender of the Gastrointestinal System?

In football, diet has a highly important role in the development of performance. Assessing the nutrition-related knowledge of footballers and increasing their awareness may affect their health and performance. In this study, which was carried out for this purpose, whether the Mediterranean diet had an effect on the gastrointestinal health of professional footballers was investigated. The sample of the study included a total of 196 active licensed male footballers who were professional players in the 2nd and 3rd football leagues of Turkey. The mean age of the participants was 23.46±4.18 and their mean experience in licensed football was 11.73±5.07 years. The adherence of the participants to the Mediterranean diet was assessed using the Mediterranean Diet Adherence Screener, while the frequencies of gastrointestinal symptoms were examined using the Gastrointestinal Symptom Rating Scale. The data were transferred to the SPSS 26.0 program and analyzed using Pearson’s Correlation Analysis, Independent-Samples T-Tests, One-Way ANOVA and descriptive statistics. According to the results of the analyses, no significant relationship was found between adherence to the Mediterranean diet and gastrointestinal symptoms (p&gt;0.05). While the gastrointestinal symptom scores of the participants did not vary significantly based on their league tiers or positions (p&gt;0.05), their Mediterranean diet adherence scores varied significantly based on their league tiers (p&lt;0.05). Consequently, it was determined that the adherence of the participants to the Mediterranean diet increased as their league tier increased, but adherence to the Mediterranean diet did not create any positive or negative effect on their gastrointestinal system symptoms.

Lifestyle and eating habits changes among adults during COVID-19 era in Egypt: a population-based study

BackgroundThe 2019 recent Coronavirus is without a doubt one of the most complicated viruses to ever pose a threat to humanity. Numerous viral containment strategies forced sedentary behaviors and dietary changes that would–otherwise- increase the chances of acquiring non-communicable diseases.ObjectivesThe objectives of the current study are to identify any changes in eating behaviors through the Mediterranean Diet Adherence in a sample of Egyptians throughout the COVID-19 era.MethodsA cross-sectional study was done on a sample of 205 Egyptians by an online self-administered questionnaire. The questionnaire included socio-demographic factors, self-reported weights and heights, a validated Arabic form of the well-known International Physical Activity Questionnaire Short Form (IPAQ-SF), a validated Arabic version of 14-items Mediterranean Diet Adherence Screener (MEDAS), in addition to a section assessing dietetic changes. The data was then analyzed using the SPSS version 20 (Statistical Package for Social Sciences).ResultsThe majority of the study sample were females (74.6%); had a high level of education (93.2%); and about 75% were married. Most of the participants were non-smokers, with around a 7% increased frequency of smoking after the COVID-19 pandemic. Fast food consumption was also reported by a major percentage of study participants (60%). Low Mediterranean Diet Adherence was found in 52.7%. Moreover, Physical Activity (PA) decreased to 61%. Moreover, there was a statistically significant increase seen in the participants’ BMI as well as the number of sleeping hours (p = 0.001 and 0.043 respectively) after the pandemic. Both changed hunger sensation and any changes in physical activity were significantly associated with increased BMI (p < 0.001).Conclusion and recommendationsA substantial proportion of the participants showed unhealthy changes in their dietary habits as well as physical activity. Consequently, this calls for urgent public health policies and interventions to guard against the consequences of such unhealthy behaviors.

Lower Multiple Sclerosis Severity Score Is Associated with Higher Adherence to Mediterranean Diet in Subjects with Multiple Sclerosis from Northwestern Italy.

The Mediterranean Diet (MD) is described in the literature as a beneficial dietary pattern for neurodegenerative diseases such as Multiple Sclerosis (MS). The objective of this study was to evaluate the dietary habits in people with MS (pwMS) and to test whether adherence to the MD could have an impact on the severity of the disease measured as the MS severity score (MSSS). Adherence to the MD was assessed in 31 PwMS using the Mediterranean Diet Adherence Screener (MEDAS), the Pyramid-based Mediterranean Diet Score (PyrMDS) index, and the Italian Mediterranean Index (IMI), and their eating habits were recorded in a food diary for a one-year follow-up. When data obtained from dietary analysis were compared to the MSSS, results showed that pwMS with lower MSSS adhere more to the MD than the other pwMS groups according to the MEDAS index. Furthermore, a high consumption of fiber in the MS mild severity class was observed. Further studies are needed to clarify which of the nutritional components of the MD may impact the course of MS and if the sensitization of pwMS to MD adherence can be a strategy for mitigating the disease.

Assessment of the Relationship between Periodontitis and Cardiac Parameters in Patients with Early Chronic Heart Failure: A Cross-Sectional Study.

Periodontal disease (PD) is considered a risk factor for cardiovascular events. However, its relationship to chronic heart failure (CHF) is unclear. The aim was to compare cardiac and inflammatory parameters in CHF patients with (PG) versus without periodontitis (NPG). The following parameters were recorded in 58 patients: periodontal screening and recording (PSR), troponin T, NT-proBNP, C-reactive protein (CRP), interleukin-6 (IL-6), blood pressure, heart rate, ejection fraction (EF), ventricular systolic and diastolic function parameters, incremental test, and three questionnaires (Mediterranean Diet Adherence Screener, MEDAS; Oral Health Impact Profile, OHIP-14; Patient Health Questionnaire, PHQ). The serum levels of NT-proBNP and troponin T were significantly higher in the PG, and the left ventricular systolic and diastolic function parameters were significantly lower. The correlation analysis showed age as the only independent risk factor for periodontitis and cardiac biomarkers. No significant group differences were found in the MEDAS, OHIP-14, and PHQ scores, or in CRP, IL-6, and cardiocirculatory parameters. Overall, the BMI correlated significantly with the mean PSR and total cholesterol. The occurrence of increased PSR together with increased age and cardiac risk parameters does not exclude an association between periodontitis and CHF, though no positive correlation was calculated. Periodontitis may be a modifiable risk factor for CHF. Its treatment may help to control the inflammatory burden.

Self-perceived muscular strength, physical activity, and Mediterranean Diet: Impact on health-related quality of life in older adults

The global rise in life expectancy poses challenges for individuals in maintaining independence, health, and quality of life. Health-related quality of life (HRQoL), a key indicator encompassing physical and mental well-being, is crucial for population health monitoring. Regular physical activity (PA), especially muscle-strengthening routines and adherence to the Mediterranean Diet (MD), positively influence HRQoL. Understanding the link between muscular strength and HRQoL is essential for effective physical activity interventions. This study explores the association between self-perceived muscular strength (MS), HRQoL, MD, and sports habits in older adults.The study followed a cross-sectional, descriptive and comparative design, with a sample of 433 physically active Spanish subjects aged 41 to 80. Stratified by MS levels, the high-level group (n= 210; 74.76% men; 57.00 years old (SD: 8.28), and the low level (n= 223; 51.50%; 71.30% men; 55.64 years (SD: 8.56). Self-reported data on MS, HRQoL, MD and PA were collected using the Physical Self-Perception Profile (PSPP 30), Health-Related Quality of Life (SF-36), Mediterranean Diet Adherence Screener (MEDAS) and Rapid Assessment of Physical Activity Questionnaire (RAPA-Q) questionnaires, respectively. An ad-hoc questionnaire captured sports habits and sociodemographic data.The higher MS group exhibited superior physical function (p=0.002, d=0.16), physical role (p=0.023, d=0.22), general health (p<0.001, d=0.61), vitality (p<0.001, d=0.52), and mental health (p<0.001, d=0.29), along with stronger adherence to the Mediterranean Diet (p<0.001, d=0.31). Logistic regression models indicated that a high MS level is associated with engagement in maintenance sports (ORcr = 1.71, 95% CI 1.17-2.50, p=0.005), practicing 3 or more sports (ORadj = 1.78, 95% CI 0.95–3.36, p = 0.028), leading a very active lifestyle (ORadj = 1.96, 95% CI 1.32–2.94, p < 0.001), and adherence to MD (ORadj = 1.64, 95% CI 1.10–2.45, p < 0.016).Engaging in diverse sports, giving priority to maintenance activities and including daily muscle-strengthening routines beyond WHO guidelines, correlates with higher self-perceived strength in older adults. This, in turn, aligns with an elevated quality of life encompassing both physical and mental health, as well as increased adherence to the Mediterranean Diet. Consideration of these factors is crucial when prescribing physical activity for this population and designing institutional health programs.

Acne Vulgaris and adherence to the mediterranean diet among university students: a case‒control study

BackgroundWestern diets, characterized by a high glycemic index and dairy content, can be risk factors for acne vulgaris. A few studies have suggested that adherence to non-Western diets, such as the Mediterranean diet (MD), may be protective against acne. This study aimed to explore the relationships between adherence to the MD and acne diagnosis and severity.MethodsThis was a matched case‒control study carried out among university students studying health sciences to explore the relationship between adhering to the MD and an acne diagnosis. Convenience sampling was utilized for the initial recruitment of eligible participants, who were then 1:1 individually matched for age, gender, and body mass index (BMI). Adherence to the MD was assessed using the Mediterranean Diet Adherence Screener (MEDAS) tool, and acne severity was assessed using the Global Acne Grading System (GAGS). The data were analyzed using descriptive statistics, bivariate analysis, and conditional logistic regression, which included two models based on clinical data and the backward elimination technique.ResultsA final sample of 121 cases was individually matched to 121 controls. Each group consisted of 28.9% males and 71.1% females, with most having a BMI within the healthy range (71.9%). Both the case (80.2%) and control groups (77.7%) demonstrated a predominant pattern of low adherence to the MD. At the bivariate level, family history significantly differed between the case and control groups (OR = 2.01, CI = 1.17–3.44), while adherence to the MD (OR = 0.86, CI = 0.46–1.60) did not reach statistical significance. According to the regression analysis, family history remained significant in the backward elimination model (aOR = 1.94, CI = 1.14–3.34), while it disappeared in the full model (aOR = 1.95, CI = 1.14–3.34). Neither model revealed a significant association between acne and the other variables. Among the participants in the case group, neither adherence to the MD nor adherence to its components was significantly associated with acne severity, except for vegetables (p = 0.022).ConclusionsAdherence to the MD was not correlated with acne diagnosis or clinical severity. More research on the association between acne and adherence to the MD is needed, as earlier studies are few, were conducted in specific settings, and used variable methodologies. To improve the validity and reliability of the research methodology, the development of detailed and culturally adapted MD definitions and practical guides is recommended.

Association of level of adherence to Mediterranean diet with cognitive and dementia status in subjects with chronic diseases: a cross-sectional study

ABSTRACT Background: The Mediterranean diet has been linked to brain neuroprotection. Evidence from meta-analyses showed reduced risk of dementia with greater intake of vegetables and fruits, fish, and the Mediterranean diet. The current study raises important questions about the association between low risk dementia and Mediterranean diet. Objective: The objective was to evaluate the association between levels of adherence to the Mediterranean diet and dementia and cognitive status in subjects 50 years of age and older. Method: The Mediterranean Diet Adherence Screener (MEDAS), the modified 30-item ‘Diagnostic and Statistical Manual of Mental Disorders Third Edition (DSM-III) risk of dementia, and the Standard Mini-Mental Status Examination (SMMSE) cognitive status scores were used to assess the levels of adherence to the Mediterranean diet’. Results: A total of 150 subjects were enrolled in the study. Forty-one (27.3%) had ‘suspected or confirmed dementia, while 48 individuals (32%) were categorized as having moderate to severe cognitive decline. Subjects who reported moderate to high adherence to the Mediterranean diet (55, 36.7%) had significantly lower dementia scores (7.0 3.8 versus 17.6 5.1) and higher cognitive (25.4 3.8 versus 8.6 7.2) scores compared to those (38, 25.3%) who reported low adherence to the Mediterranean diet. Conclusion: Subjects who were highly or moderately adherent to the Mediterranean diet had significantly lower dementia scores and better cognitive status than those with low adherence.

A Plant-Based Cholesterol-Lowering Diet Score Correlates with Serum LDL-Cholesterol Levels.

A cholesterol-lowering diet score was previously developed for epidemiological studies; its association with serum lipid profile was not confirmed yet. The score was developed as an adaptation of the dietary portfolio for cholesterol reduction, assigning one point for adherence to seven dietary indicators and ranging from 0 (null adherence) to 7 (highest adherence). The score was calculated for breast cancer patients enrolled in the DEDiCa study using a 7-day food record; serum lipid profile, including total and low-density lipoprotein cholesterol (LDL-C), was evaluated in serum at baseline. Patients with the highest adherence to the cholesterol-lowering diet (i.e., score ≥ 4) reported lower LDL-C level than women with score 0-1 (median: 107 mg/dL and 122 mg/dL, respectively; p < 0.01). The proportion of women with LDL-C above the recommended limit of 116 mg/dL was 60.0% with score 0-1 and 42.6% with score ≥4. Although the score directly correlates with consumption of foods from vegetal sources, it was mildly associated with the healthful plant-based diet index (r-Spearman = 0.51) and the Mediterranean Diet Adherence Screener (r-Spearman = 0.30) Conclusions: These results provide experimental evidence that the cholesterol-lowering diet score is capable of detecting a specific plant-based dietary pattern that affects circulating cholesterol levels.

Adherence to a Mediterranean Diet Is Inversely Associated with Anxiety and Stress but Not Depression: A Cross-Sectional Analysis of Community-Dwelling Older Australians.

Diet quality may be an important modifiable risk factor for mental health disorders. However, these findings have been inconsistent, particularly in older adults. We explored the independent associations between adherence to a Mediterranean diet (MedDiet) and severity of symptoms related to depression, anxiety and stress in older adults from Australia. This was a cross-sectional analysis of older Australians ≥ 60 years. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS), and the Depression, Anxiety and Stress Scale (DASS-21) was used to assess the severity of negative emotional symptoms. A total of n = 294 participants were included in the final analyses (70.4 ± 6.2 years). Adherence to a MedDiet was inversely associated with the severity of anxiety symptoms (β = -0.118; CI: -0.761, -0.012; p = 0.043) independent of age, gender, BMI, physical activity, sleep, cognitive risk and ability to perform activities of daily living. Furthermore, MedDiet adherence was inversely associated with symptoms of stress (β = -0.151; CI: -0.680, -0.073; p = 0.015) independent of age, gender, BMI, physical activity and sleep. However, no relationship between MedDiet adherence and depressive symptoms was observed. We showed that adherence to a MedDiet is inversely associated with the severity of symptoms related to anxiety and stress but not depression. Exploring these findings with the use of longitudinal analyses and robust clinical trials are needed to better elucidate these findings in older adults.

Alcohol consumption patterns and adherence to the Mediterranean diet in the adult population of Spain

PurposeThe objective is to evaluate the association between various indicators of alcohol consumption and the degree of adherence to the Mediterranean diet among the Spanish adult population.MethodsA cross-sectional study including 44,834 participants ≥ 15 years of age from the 2017 National Health Survey and the 2020 European Health Survey in Spain. Alcohol patterns were defined based on (1) average intake: individuals were classified as low risk (1–20 g/day in men and 1–10 g/day in women) and high risk (> 20 g/day in men or > 10 g/day in women), (2) binge drinking, and (3) alcoholic beverage preference. Non-adherence to the Mediterranean diet was defined as scoring < 7 points on an adapted Mediterranean Diet Adherence Screener index (range 0–10). Odds ratios (OR) were estimated using logistic regression models adjusted for relevant covariates.ResultsCompared to non-drinkers, low and high-risk drinkers were more likely to report non-adherence to the Mediterranean diet: ORs 1.35 (95% CI 1.23; 1.49) and 1.54 (95% CI 1.34; 1.76), respectively. Similarly, reports of binge drinking less than once a month was associated with higher likelihood of non-adherence (OR 1.17; 95% CI 1.04; 1.31). Individuals reporting no preference for a specific beverage and those with a preference for beer or for spirits had lower adherence: ORs 1.18 (95% CI 1.05; 1.33), 1.31 (95% CI 1.17; 1.46), and 1.72 (95% CI 1.17; 2.54), respectively, while a preference for wine showed no association (OR 1.01; 95% CI 0.90; 1.13).ConclusionAlcohol consumption, even in low amounts, is associated with lower adherence to the Mediterranean diet. Therefore, alcoholic beverages should not be included in measures that define the Mediterranean diet.