7a7f45bc7410918294fd692669bfd52a pmc_30813581.pdf cad34052305e0fda1e9597f2a75e9fff0035dafe pmc_30813581.pdf d568eab4a339468b57106ca68d3234d74493c75e8dcf252300264849121b585a pmc_30813581.pdf Title: Agreement among Mediterranean Diet Pattern Adherence Indexes: MCC-Spain Study Subject: There are many different methods used to measure the degree of adherence to a Mediterranean diet (MD), limiting comparison and interpretation of their results. The concordance between different methodologies has been questioned and their evaluation recommended. The aim of this study was to evaluate the agreement among five indexes that measure adherence to a Mediterranean dietary pattern. The study population included healthy adults selected in the Multi-Case Control Spain (MCC-Spain) study recruited in 12 provinces. A total of 3640 controls were matched to cases by age and sex. To reach the aim, the following scores of adherence to a Mediterranean dietary pattern were calculated: Mediterranean diet score (MDS), alternative Mediterranean diet (aMED), relative Mediterranean diet (rMED), dietary score (DS) and literature-based adherence score (LBAS). The relative frequency of subjects with a high level of adherence to a MD varied from 22% (aMED index) to 37.2% (DS index). Similarly, a high variability was observed for the prevalence of a low level of MD: from 24% (rMED) to 38.4% (aMED). The correlation among MDS, aMED and rMED indexes was moderate, except for MDS and aMED with a high coefficient of correlation 0.75 (95% CI 0.74–0.77). The Cohen’s Kappa coefficient among indexes showed a moderate–fair concordance, except for MDS and aMED with a 0.56 (95% CI 0.55–0.59) and 0.67 (95% CI 0.66–0.68) using linear and quadratic weighting, respectively. The existing MD adherence indexes measured the same, although they were based on different constructing algorithms and varied in the food groups included, leading to a different classification of subjects. Therefore, concordance between these indexes was moderate or low. Keywords: adherence; Mediterranean diet pattern; indexes; agreement Author: Rocío Olmedo-Requena, Carmen González-Donquiles, Verónica Dávila-Batista, Dora Romaguera, Adela Castelló, Antonio José Molina de la Torre, Pilar Amiano, Trinidad Dierssen-Sotos, Marcela Guevara, Guillermo Fernández-Tardón, Macarena Lozano-Lorca, Juan Alguacil, Rosana Peiró, José María Huerta, Esther Gracia-Lavedan, Nuria Aragonés, Tania Fernández-Villa, Marta Solans, Inés Gómez-Acebo, Gemma Castaño-Vinyals, Manolis Kogevinas, Marina Pollán and Vicente Martín Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.18 CreationDate: Tue Feb 26 10:35:39 2019 CET ModDate: Tue Feb 26 10:35:39 2019 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 994747 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- 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NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: ぉのぴひはつふっぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸲ Item: Title: きちぴづひどちぬびぜ〴ぜ〰ちのつぜ〴ぜ〰きづぴとはつびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮ㄩ‾㸊⡜㌷㙜㌷㝜〰こぴふつべぜ〴ぜ〰いづびどでの〬ぜ〴ぜ〰こづぴぴどのでぜ〴ぜ〰ちのつぜ〴ぜ〰ぐちひぴどっどばちのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㈩‾㸊⡜㌷㙜㌷㝜〰いちぴちぜ〴ぜ〰ぃはぬぬづっぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㌩‾㸊⡜㌷㙜㌷㝜〰きづつどぴづひひちのづちのぜ〴ぜ〰いどづぴぜ〴ぜ〰ぐちぴぴづひのぜ〴ぜ〰ぁつとづひづのっづぜ〴ぜ〰ぉのつづへづびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㐩‾㸊⡜㌷㙜㌷㝜〰こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Children: Item: Title: こぴふつべぜ〴ぜ〰いづびどでの〬ぜ〴ぜ〰こづぴぴどのでぜ〴ぜ〰ちのつぜ〴ぜ〰ぐちひぴどっどばちのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㈩‾㸊⡜㌷㙜㌷㝜〰いちぴちぜ〴ぜ〰ぃはぬぬづっぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㌩‾㸊⡜㌷㙜㌷㝜〰きづつどぴづひひちのづちのぜ〴ぜ〰いどづぴぜ〴ぜ〰ぐちぴぴづひのぜ〴ぜ〰ぁつとづひづのっづぜ〴ぜ〰ぉのつづへづびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㐩‾㸊⡜㌷㙜㌷㝜〰こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: いちぴちぜ〴ぜ〰ぃはぬぬづっぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㌩‾㸊⡜㌷㙜㌷㝜〰きづつどぴづひひちのづちのぜ〴ぜ〰いどづぴぜ〴ぜ〰ぐちぴぴづひのぜ〴ぜ〰ぁつとづひづのっづぜ〴ぜ〰ぉのつづへづびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㐩‾㸊⡜㌷㙜㌷㝜〰こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: きづつどぴづひひちのづちのぜ〴ぜ〰いどづぴぜ〴ぜ〰ぐちぴぴづひのぜ〴ぜ〰ぁつとづひづのっづぜ〴ぜ〰ぉのつづへづびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㐩‾㸊⡜㌷㙜㌷㝜〰こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: げづびふぬぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸴ Item: Title: いどびっふびびどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㐮ㄩ‾㸊⡜㌷㙜㌷㝜〰きづぴとはつはぬはでどっちぬぜ〴ぜ〰いどててづひづのっづびぜ〴ぜ〰あづぴぷづづのぜ〴ぜ〰ぉのつどっづびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㐮㈩‾㸊⡜㌷㙜㌷㝜〰こぴひづのでぴとびぜ〴ぜ〰ちのつぜ〴ぜ〰がどねどぴちぴどはのびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸵ Children: Item: Title: きづぴとはつはぬはでどっちぬぜ〴ぜ〰いどててづひづのっづびぜ〴ぜ〰あづぴぷづづのぜ〴ぜ〰ぉのつどっづびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㐮㈩‾㸊⡜㌷㙜㌷㝜〰こぴひづのでぴとびぜ〴ぜ〰ちのつぜ〴ぜ〰がどねどぴちぴどはのびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸵ Item: Title: こぴひづのでぴとびぜ〴ぜ〰ちのつぜ〴ぜ〰がどねどぴちぴどはのびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸵ Item: Title: ぃはのっぬふびどはのびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸵ Item: Title: げづてづひづのっづび Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: MEJHZL+VnURWPalladioL FontSubset: true FirstChar: 160 LastChar: 243 FontDescriptor: FontName: MEJHZL+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: CHJGZT+CMSY10 FontSubset: true 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