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      Association between adherence to the Mediterranean diet and the prevalence of cardiovascular risk factors Translated title: Associação entre adesão à dieta mediterrânea e prevalência de fatores de risco cardiovascular Translated title: Asociación entre la adherencia a la dieta mediterránea y la prevalencia de factores de riesgo cardiovascular

      research-article
      1 , 4 , 2 , 3 , 4 , 3 , 4 , 1 , 1
      Revista Latino-Americana de Enfermagem
      Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
      Diet, Mediterranean, Cardiovascular Diseases, Risk Factors, Cross-Sectional Studies, Workers, Occupational Health Nursing, Dieta Mediterrânea, Doenças Cardiovasculares, Fatores de Risco, Estudos Transversais, Trabalhadores, Enfermagem do Trabalho, Dieta Mediterránea, Enfermedades Cardiovasculares, Factores de Riesgo, Estudios Transversales, Trabajadores, Enfermería del Trabajo

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          Abstract

          Objective:

          to determine the prevalence of cardiovascular risk factors in a cohort of workers and to quantify its association with compliance with the Mediterranean diet follow-up.

          Method:

          a cross-sectional descriptive study was carried out on a cohort of 23,729 workers. Clinical data from annual medical examinations and the Mediterranean Diet Adherence Screener were used to assess adherence to the Mediterranean diet.

          Results:

          51.3% of the participants showed good adherence to the Mediterranean diet. The multivariate analysis showed an inverse and significant association between the follow-up of the Mediterranean diet and the prevalence of abdominal obesity (Odds Ratio = 0.64, 95% CI 0.56; 0.73), dyslipidemia (Odds Ratio = 0.55, 95% CI 0.42; 0.73), and metabolic syndrome (Odds Ratio = 0.76, 95% CI 0.67; 0.86).

          Conclusions:

          our results suggest that the Mediterranean diet is potentially effective in promoting cardiovascular health. Implementing the interventions promoting the Mediterranean diet in the working population seems justified.

          Translated abstract

          Objetivo:

          determinar a prevalência de fatores de risco cardiovascular em uma coorte de trabalhadores e quantificar sua associação com o monitoramento da dieta mediterrânea.

          Método:

          estudo descritivo transversal, realizado em uma coorte de 23.729 trabalhadores. Dados clínicos dos exames médicos anuais e a Mediterranean Diet Adherence Screener foram usados para avaliar a adesão à dieta mediterrânea.

          Resultados:

          51,3% dos participantes apresentaram boa adesão à dieta mediterrânea. A análise multivariada mostrou associação inversa e significativa entre o acompanhamento da dieta mediterrânea e a prevalência de obesidade abdominal ( Odds Ratio = 0,64, IC 95% 0,56, 0,73), dislipidemia ( Odds Ratio = 0,55, IC 95% 0,42, 0,73) e de síndrome metabólica ( Odds Ratio = 0,76, IC 95% 0,67, 0,86).

          Conclusões:

          nossos resultados sugerem que a dieta mediterrânea é potencialmente eficaz na promoção da saúde cardiovascular. A implementação de intervenções que promovem a dieta mediterrânea na população trabalhadora parece justificada.

          Translated abstract

          Objetivo:

          determinar la prevalencia de factores de riesgo cardiovascular en una cohorte de trabajadores y cuantificar su asociación con el seguimiento de la dieta mediterránea.

          Método:

          se llevó a cabo un estudio descriptivo transversal sobre una cohorte de 23.729 trabajadores. Se utilizaron los datos clínicos procedentes de los exámenes médicos anuales y el Mediterranean Diet Adherence Screener para evaluar la adherencia a la dieta mediterránea.

          Resultados:

          el 51,3% de los participantes presentó una buena adherencia a la dieta mediterránea. El análisis multivariante evidenció una asociación inversa y significativa entre el seguimiento de la dieta mediterránea y la prevalencia de obesidad abdominal ( Odds Ratio = 0,64, IC 95% 0,56; 0,73), dislipidemia ( Odds Ratio = 0,55, IC 95% 0,42; 0,73) y de síndrome metabólico ( Odds Ratio = 0,76, IC 95% 0,67; 0,86).

          Conclusión:

          nuestros resultados sugieren que la dieta mediterránea es potencialmente eficaz en la promoción de la salud cardiovascular. Parece justificada la implementación de intervenciones que promuevan la dieta mediterránea en la población trabajadora.

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          Adherence to the Mediterranean diet is inversely associated with metabolic syndrome occurrence: a meta-analysis of observational studies.

          Diet plays a role in the onset and progression of metabolic disorders, including metabolic syndrome (MetS). We aimed to systematically review and conduct a quantitative meta-analysis of results from observational cross-sectional and prospective cohort studies on adherence to the Mediterranean dietary pattern and risk of MetS. Literature databases including PubMed, SCOPUS and EMBASE were searched from the beginning to May 2016. Eight cross-sectional and four prospective studies were included in this meta-analysis, accounting for a total of 33,847 individuals and 6342 cases of MetS. High adherence to the Mediterranean diet was associated with a risk of MetS (RR: 0.81, 95%CI: 0.71, 0.92). Regarding individual components of the MetS, the inverse associations were significant for waist circumference, blood pressure and low HDL-C levels. In conclusion, adoption of a Mediterranean dietary pattern was associated with lower risk of the MetS and it can be proposed for the primary prevention of the MetS.
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            Evaluation of Mediterranean diet adherence scores: a systematic review

            Objective The aim of this review was to evaluate the conceptual suitability, applicability and psychometric properties of scores used internationally to measure adherence to the Mediterranean diet (MD). Design This was a systematic review to identify original articles that examined some aspects of the conceptual suitability, applicability or psychometric properties of the MD adherence score. Electronic searches were carried out on the international databases MEDLINE, Scopus, Web of Science and EMBASE (from January 1980 to 31 December 2015). Eligibility criteria for selecting studies The study included original articles that examined some aspects of the conceptual suitability, applicability or psychometric properties of the MD adherence score. The studies where MD adherence scores were administered but did not bring forward any evidence about their performance related to conceptual suitability, applicability or psychometric properties were excluded. Data extraction Information relating to the scales was extracted in accordance with the quality criteria defined by the Scientific Advisory Committee of the Medical Outcomes Trust for measurement of health results and the quality criteria recommended by Terwee: (1) conceptual, (2) applicability and (3) psychometric properties. Three authors independently extracted information from eligible studies. Results Twenty-seven studies were identified as meeting the inclusion criteria, yielding 28 MD adherence scores. The results showed that evidence is scarce and that very few scores fulfilled the applicability parameters and psychometric quality. The scores developed by Panagiotakos et al, Buckland et al and Sotos-Prieto et al showed the highest levels of evidence. Conclusions Scores measuring adherence to MD are useful tools for identifying the dietary patterns of a given population. However, further information is required regarding existing scores. In addition, new instruments with greater conceptual and methodological rigour should be developed and evaluated for their psychometric properties.
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              Validation of the English Version of the 14-Item Mediterranean Diet Adherence Screener of the PREDIMED Study, in People at High Cardiovascular Risk in the UK

              The aim of this study was to examine the validity of the English version of the PREvencion con DIetaMEDiterranea (PREDIMED) 14-item Mediterranean Diet Adherence Screener (MEDAS), a brief questionnaire assessing adherence to the Mediterranean diet (MedDiet), which was used in the PREDIMED trial for assessment and immediate feedback. This instrument (MEDAS) was administered to 96 adults with a high cardiovascular risk (66% women, mean age 68.3 ± 6.0 years), recruited from general practices in Bristol, UK. Participants then completed a 3-day estimated food record, and the MEDAS was administered again one month later. A MedDiet score (range = 0–14) was calculated from the MEDAS’ administrations and food record to assess concurrent validity and test-retest reliability. Predictive validity was assessed by examining the association of the MEDAS-derived score with cardiometabolic risk factors and dietary intakes derived from the food records. The MEDAS-derived MedDiet score was higher by 1.47 points compared to food records (5.47 vs.4.00, p < 0.001), correlated moderately with the record-derived score (r = 0.50, p < 0.001; ICC = 0.53, p < 0.001) and there was borderline fair agreement between the two methods (κ = 0.19, 95% CI 0.07–0.31, p = 0.002; 95% limits of agreement −2.2, 5.1). Exact agreement within score categories and gross misclassificationwere 45.8% and 21.9%, respectively. The distribution of dietary intakes, reported on the food records by the MEDAS-derived total MedDiet score, was in the expected direction, but no association was observed with cardiometabolic risk factors. The two administrations of the MEDAS produced similar mean total MedDiet scores (5.5 vs. 5.4, p = 0.706), which were correlated (r and ICC = 0.69, p < 0.001) and agreed fairly (κ = 0.38, 95% CI 0.24–0.52, p < 0.001; 95% limits of agreement −3.1, 3.2). The English version of the MEDAS has acceptable accuracy and reliability for assessing MedDiet adherence among individuals with a high cardiovascular risk, in the UK, and can be used to rank individuals according to MedDiet adherence in research and practice.
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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                08 June 2020
                2020
                : 28
                : e3295
                Affiliations
                [1 ]Universidad San Jorge, Facultad de Ciencias de la Salud, Zaragoza, Esp, Espanha.
                [2 ]MAS Prevención, Servicio de Prevención, Zaragoza, Esp, Espanha.
                [3 ]Universidad de Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Esp, Espanha.
                [4 ]Grupo de Investigación Tranfercult (Exp. H27-20D), Zaragoza, Esp, Spain.
                Author notes
                Corresponding author: Enrique Ramón-Arbués E-mail: eramon@ 123456usj.es https://orcid.org/0000-0002-7911-9949

                Associate Editor: Maria Lúcia do Carmo Cruz Robazzi

                Author information
                http://orcid.org/0000-0002-7911-9949
                http://orcid.org/0000-0003-3926-441X
                http://orcid.org/0000-0003-0053-1429
                http://orcid.org/0000-0002-4753-630X
                http://orcid.org/0000-0001-7674-0150
                http://orcid.org/0000-0002-8206-4803
                Article
                00346
                10.1590/1518-8345.3904.3295
                7282722
                32520245
                3bd279ef-81b6-4a94-8833-bde082ccb921
                Copyright © 2020 Revista Latino-Americana de Enfermagem

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 September 2019
                : 12 March 2020
                Categories
                Original Article

                diet, mediterranean,cardiovascular diseases,risk factors,cross-sectional studies,workers,occupational health nursing,dieta mediterrânea,doenças cardiovasculares,fatores de risco,estudos transversais,trabalhadores,enfermagem do trabalho,dieta mediterránea,enfermedades cardiovasculares,factores de riesgo,estudios transversales,trabajadores,enfermería del trabajo

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