Value of precision nutrition in the inflammatory control of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of autoantibodies directed against endogenous antigens causing various clinical manifestations, chronic inflammation and tissue damage. Although the pathophysiology of SLE remains unknown, it is recognized that genetic, epigenetic, environmental and neuroendocrine factors are involved in the development of the disease and its complications. A notable proportion of patients with SLE also present obesity, and this dysmetabolic profile can cause renal, musculoskeletal and/or respiratory deterioration, fatigue, various pathophysiological alterations and functional deterioration. In this context, precision nutrition emerges as a promising tool in the inflammatory control of SLE, especially in patients with associated obesity. Various studies demonstrate the beneficial influence of balanced dietary patterns in macronutrients with foods rich in fiber, vitamins, minerals, antioxidants and polyphenols on the inflammatory control of SLE and the most diverse pathologies, highlighting the Mediterranean diet and plant-based diets. Finally, the intestinal microbiota may play a relevant role in this clinical scenario, since dysbiosis is associated with inflammatory processes and immune deregulation. It is believed that precision nutrition can modulate inflammatory profiles and immune dysfunctions to ensure better quality of life and metabolic well-being of SLE patients with the support of precision omics technologies.

El lupus eritematoso sistémico (LES) es una enfermedad autoinmune caracterizada por la producción de autoanticuerpos dirigidos contra antígenos endógenos causando diversas manifestaciones clínicas, inflamación crónica y daño tisular. Aunque la fisiopatología del LES sigue siendo desconocida, se reconoce que factores genéticos, epigenéticos, ambientales y neuroendocrinos están implicados en el desarrollo de la enfermedad y sus complicaciones. Una proporción notable de pacientes con LES presenta también obesidad, y este perfil dismetabólico puede producir deterioro renal, musculoesquelético y/o respiratorio, fatiga, diversas alteraciones fisiopatológicas y deterioro funcional. En este contexto, la nutrición de precisión emerge como una herramienta prometedora en el control inflamatorio del LES, especialmente en pacientes con obesidad asociada. Diversos estudios demuestran la influencia beneficiosa de patrones dietéticos equilibrados en macronutrientes con alimentos ricos en fibra, vitaminas, minerales, antioxidantes y polifenoles en el control inflamatorio del LES y de las más diversas patologías, destacando la dieta Mediterránea y las dietas basadas en plantas/vegetales. Por último, la microbiota intestinal puede tener un papel relevante en este escenario clínico, ya que la disbiosis se asocia con procesos inflamatorios y desregulación inmune. Se cree que con la nutrición de precisión se pueden modular los perfiles inflamatorios y las disfunciones inmunitarias para garantizar una mejor calidad de vida y el bienestar metabólico de los pacientes con LES con el apoyo de las tecnologías de precisión ómicas.

Effect of food literacy on adherence to mediterranean diet and anthropometric measurements in adults / Efeito da alfabetização alimentar na adesão à dieta mediterrânea e nas medidas antropométricas em adultos

ABSTRACT Objective This study aimed to evaluate the relationship between food literacy, adherence to the Mediterranean diet (MetDiet), and anthropometric measurements. Method In this study, 551 adults were evaluated. The defining features were questioned with the questionnaire form, Short Food Literacy Questionnaire (SFLQ), and Mediterranean Diet Adherence Screener (MEDAS). Neck circumference, waist circumference (WC) measurements, waist to height ratio (WHtR), waist to hip ratio (WHR), and body mass index (BMI) were evaluated. The effect of the SFLQ scores on the anthropometric measurements and MEDAS scores was evaluated with linear and binary logistic regression analysis. Results The food literacy scores were low in individuals with overweight and obesity and have risk according to the waist circumference and waist to height ratio. Individuals with high adherence to the MetDiet had high food literacy. The food literacy had the most effect on waist circumference. There was a positive relationship between the food literacy and MetDiet scores when the crude and adjusted models were compared according to age, gender, education level, marital status, and BMI. According to crude and adjusted models, food literacy was effective on strict adherence to the diet (Wald=13.446), and a 1-unit increase in the food literacy increased strict adherence to MetDiet by 1.05 times (95% CI=1.03-1.09). Conclusion The results showed positive effect of food literacy on obesity-related anthropometric measurements and MetDiet.

RESUMO Objetivo Este estudo teve como objetivo avaliar a relação entre alfabetização alimentar, adesão à dieta mediterrânea (MetDiet) e medidas antropométricas. Método Neste estudo foram avaliados 551 adultos. As características definidoras foram questionadas com o formulário do questionário Short Food Literacy Questionnaire (SFLQ) e Mediterranean Diet Adherence Screener (MEDAS). Medidas de circunferência do pescoço, circunferência da cintura (CC), relação cintura/altura (RCEst), relação cintura/quadril (RCQ) e índice de massa corporal (IMC) foram avaliados. O efeito dos escores SFLQ nas medidas antropométricas e escores MEDAS foi avaliado com análise de regressão logística linear e binária. Resultados Os escores de alfabetização alimentar foram baixos em pacientes com sobrepeso e obesidade e apresentam risco de acordo com a circunferência da cintura e relação cintura/altura. Indivíduos com alta adesão ao MetDiet tiveram alta alfabetização alimentar. A alfabetização alimentar teve o maior efeito sobre a circunferência da cintura. Houve uma relação positiva entre a alfabetização alimentar e os escores do MetDiet quando os modelos brutos e ajustados foram comparados de acordo com idade, sexo, escolaridade, estado civil e IMC. De acordo com modelos brutos e ajustados, a alfabetização alimentar foi eficaz na adesão estrita à dieta (Wald=13,446), e um aumento de 1 unidade na alfabetização alimentar aumentou a adesão estrita à MetDiet em 1,05 vezes (95% CI=1,03-1,09). Conclusão Os resultados mostraram efeito positivo da alfabetização alimentar sobre medidas antropométricas relacionadas à obesidade e MetDiet.

Beneficios del consumo de dieta mediterránea en individuos con elevado riesgo cardiovascular: un patrón que debe convertirse en el común denominador

Las enfermedades cardiovasculares siguen siendo la principal causa de morbilidad y mortalidad en el mundo. Y aunque existen herramientas terapéuticas y farmacológicas que ayudan a controlar la incidencia de desenlaces cardiovasculares con la reducción del riesgo cardiovascular, las inequidades en el acceso oportuno a servicios de salud y de determinantes sociales de la salud impiden que toda la población con esta necesidad pueda recibir esta ayuda terapéutica. Es así, como se da prioridad a las intervenciones no farmacológicas, dentro de las que se destaca, la dieta, la cual ha demostrado influir significativamente en la salud cardiovascular y en la expectativa de vida del ser humano. Particularmente, la dieta mediterránea, basada esencialmente en el consumo de frutas, vegetales, granos, legumbres, aceite de oliva, especias, seguido de proteína derivada de pescado y comida de mar, ha demostrado proveer cierto grado de protección frente a enfermedades cardiometabólicas. Sin embargo, se desconoce con certeza cuál es el impacto en la población con elevado riesgo cardiovascular y, por ende, enfermedad cardiovascular establecida. Considerando la evolución de la evidencia en los patrones dietarios, así como la necesidad de conocer qué tanto impactan las dietas viables en nuestro medio, sobre todo en aquellos con mayor riesgo de morbilidad y mortalidad por enfermedad cardiovascular, el objetivo de esta revisión consiste en exponer evidencia actualizada sobre los beneficios de la dieta mediterránea en individuos con elevado riesgo cardiovascular. Para esto, se realizó una búsqueda bibliográfica en las bases de datos PubMed, Science Direct y Scielo.

Cardiovascular diseases continue to be the leading cause of morbidity and mortality worldwide. Although there are therapeutic and pharmacological tools that help control the incidence of cardiovascular outcomes by reducing cardiovascular risk, inequities in timely access to healthcare services and social determinants of health prevent the entire population in need from receiving this therapeutic assistance. Thus, non-pharmacological interventions are prioritized, among which the diet stands out, as it has been shown to significantly influence cardiovascular health and life expectancy. Particularly, the Mediterranean diet, primarily based on the consumption of fruits, vegetables, grains, legumes, olive oil, spices, followed by fish and seafood-derived protein, has demonstrated a certain degree of protection against cardiometabolic diseases. However, the impact on a population with high cardiovascular risk and established cardiovascular disease remains uncertain. Considering the evolving evidence on dietary patterns and the need to understand how viable diets in our context affect individuals with a higher risk of morbidity and mortality from cardiovascular disease, the objective of this review is to present updated evidence on the benefits of the Mediterranean diet in individuals with high cardiovascular risk. For this purpose, a literature search was performed in the PubMed, Science Direct, and Scielo databases.

The Traditional Indian Ocean Diet

Dietary advice forms the cornerstone in the management of cardiometabolic disease. Though various national and international guidelines suggest different macronutrient proportions, locally framed person-centric diet prescriptions are likely to have a better compliance. In this article, we propose an indigenous traditional Indian Ocean (TRIO) diet, which constitutes a similar pattern of the dietary practices followed by inhabitants of the Indian Ocean littoral region. The TRIO diet highlights on concepts of procurement, preparation, presentation, prioritization, preservation and partaking and may be a good alternative to the Mediterranean diet followed in western countries.

Guía de alimentación de la Dieta Mediterránea Mexicanizada / Food guide of the Mexicanized Mediterranean Diet

Resumen Objetivo: Crear la infografía de la guía de alimentación de Dieta Mediterránea Mexicanizada (DMM) y evaluar su comprensión. Material y Métodos: Estudio de tipo descriptivo, el cual constó de dos fases la 1ra. Se creó la infografía de la guía de alimentación de Dieta Mediterránea Mexicanizada. 2da. Se evaluó la apreciación y comprensión de la infografía de la guía de alimentación, en línea a población universitaria, incluidos familiares y conocidos. Resultados: 273 participantes de 42 años promedio, 74% mujeres y 26% varones, más del 94% de los participantes respondió comprender en su totalidad la infografía. DMM es práctica, aplicable, asequible, entendible, buena para el ser humano y ambiente. Conclusión: La Dieta Mediterránea puede prevenir parcial o totalmente el síndrome metabólico, la guía de alimentación de Dieta Mediterránea Mexicanizada promueve una vida sana y bienestar para todas las edades, respalda los objetivos de desarrollo sostenible, será una herramienta de salud pública, práctica, aplicable, asequible, entendible, apta para promoverse en la población mexicana.

Abstract Objective: To create the infographic of the Mexicanized Mediterranean Diet food guide and evaluate its understanding. Material and Methods: Descriptive type study, which consisted of two phases, the 1st. The infographic of the Mexicanized Mediterranean Diet food guide was created. 2nd Appreciation and comprehension of the food guide infographic was evaluated online for the university population, including relatives and acquaintances. Results: 273 participants with an average age of 42, 74% women and 26% men, more than 94% of the participants responded that they understood the infographic in its entirety. DMM is practical, applicable, affordable, understandable, good for humans and the environment. Conclusion: The Mediterranean Diet can partially or totally prevent metabolic syndrome, the Mexicanized Mediterranean Diet food guide promotes a healthy life and well-being for all ages, supports the objectives of sustainable development, will be a practical, applicable public health tool, affordable, understandable, suitable for promotion in the Mexican population.

Association between the Mediterranean Diet Index and self-reported Gingival Health Status Indicators in a population of Chilean adults: a cross-sectional study

Abstract Despite the recognized impact of diet on non-communicable diseases, the association between the Mediterranean diet and periodontal diseases is still uncertain. This study aimed to determine the association between adherence to the Mediterranean Diet Index (MDI) and self-reported gingival health status in Chilean adults, exploring the feasibility of using validated web-based survey questionnaires. Methodology Cross-sectional data were collected from a representative sample of a population of Chilean adults (18-60 years old) using a low-cost and time-saving methodology. By the PsyToolkit platform, anonymous survey data were downloaded and analyzed in bivariate (crude) and backward stepwise selection multivariate logistic regression models adjusted for sociodemographic determinants, smoking, and dental attendance using STATA 17. Odds ratios (OR) [95% confidence intervals] were estimated. Results In total, 351 complete statistical data were mostly obtained from female university students who had never smoked and reported having visited a dentist in the previous year. Multivariate regression models showed an association between MDI and very good/good gingival health status (OR 1.18 [95% CI 1.04-1.34], p=0.013), absence of bleeding on toothbrushing (OR 1.12 [95% CI 1.01-1.25], p=0.035), and absence of clinical signs of gingival inflammation (OR 1.24 [95% CI 1.10-1.40], p<0.001), after controlling for age, sex, educational level, smoking, and dental attendance. Conclusions We associated adherence to the Mediterranean diet with better self-reported gingival health status in a population of Chilean adults in an entirely web-based research environment. Longitudinal studies with random sampling are required to establish the effect of diet on gingival and periodontal health. Nevertheless, this evidence could contribute to the design of low-cost surveillance programs to reduce the burden of periodontal disease and related "common risk factors".

Adherence to the Mediterranean diet and depression, anxiety, and stress symptoms in Chilean university students: a cross-sectional study / Adesão à dieta mediterrânea e sintomas de depressão, ansiedade e estresse em universitários chilenos: um estudo transversal / Adherencia a la dieta mediterránea y síntomas de depresión, ansiedad y estrés en universitarios chilenos: un estudio transversal

Abstract: This study aims to determine the association of adherence to the Mediterranean diet and its food groups with depressive symptoms in Chilean university students. The study design was cross-sectional. A total of 934 first-year students at a Chilean public university completed a self-report questionnaire. To assess adherence to Mediterranean diet, an index validated in Chile (Chilean-MDI) was used, and depression, anxiety, and stress symptoms were assessed using the Depression Anxiety and Stress Scale (DASS-21). Logistic regression models were used to analyze the association of adherence to Mediterranean diet and its food groups with depression, anxiety, and stress symptoms adjusted for the main confounders. Students with moderate and high adherence to Mediterranean diet showed lower odds of depression [DASS-21 > 5, odds ratio (OR) = 0.64; 95% confidence interval (95%CI): 0.47-0.88] than those with low adherence to Mediterranean diet. The consumption of 1-2 servings/day of vegetables (OR = 0.63; 95%CI: 0.43-0.92), > 2 servings/week of nuts (OR = 0.41; 95%CI: 0.21-0.80), 1-2 servings/day of fruits (OR = 0.60; 95%CI: 0.42-0.85), 1-2 servings/week of fish and seafood (OR = 0.67; 95%CI: 0.48-0.94), and 1/2-3 units/week of avocado (OR = 0.67; 95%CI: 0.48-0.93) showed low odds of depressive symptoms. The consumption of whole grains and cereals (> 2 servings/day) (OR = 1.63; 95%CI: 1.02-2.61) showed the opposite association. Adherence to Mediterranean diet and consumption of fruits, vegetables, nuts, avocado, fish, and seafood are associated with a lower likelihood of depression in Chilean university students. New policies and educational strategies are recommended to improve diet quality and the mental health of the entire university community.

Resumen: El objetivo de este estudio fue determinar la asociación entre la adherencia a la dieta mediterránea y sus grupos de alimentos y los síntomas depresivos en estudiantes universitarios chilenos. El diseño del estudio fue el transversal. Un total de 934 estudiantes de primer año de una universidad pública chilena completaron una encuesta de autoevaluación sobre la adherencia a la DM -utilizando un índice validado en Chile (IDM chileno)- y los síntomas de depresión, ansiedad y estrés, mediante el uso de la Escala de Depresión, Ansiedad y Estrés (DASS-21). Se utilizaron los modelos de regresión logística para analizar la asociación entre la adherencia a la dieta mediterránea y sus grupos alimenticios y los síntomas de depresión, ansiedad y estrés, ajustados por los principales factores de confusión. Los estudiantes con moderada o alta adherencia a la dieta mediterránea tenían menos probabilidades de presentar depresión [DASS-21 > 5, odds ratio (OR) = 0,64; intervalo de 95% de confianza (IC95%): 0,47-0,88] que aquellos con baja adherencia a la dieta mediterránea. Un consumo de 1-2 porciones por día de verduras (OR = 0,63; IC95%: 0,43-0,92), > 2 porciones por semana de nueces (OR = 0,41; IC95%: 0,21-0,80), 1-2 porciones por día de frutas (OR = 0,60; IC95%: 0,42-0,85), 1-2 porciones por semana de pescado y marisco (OR = 0,67; IC95%: 0,48-0,94) y 1/2-3 unidades por semana de aguacate (OR = 0,67; IC95%: 0,48-0,93) resultó en bajas probabilidades de síntomas depresivos. El consumo de cereales integrales (> 2 porciones por día) (OR = 1,63; IC95%: 1,02-2,61) tuvo una asociación opuesta. La adhesión a la dieta mediterránea y el consumo de frutas, verduras, nueces, aguacate, pescados y mariscos se asocian con una menor probabilidad de depresión en los estudiantes universitarios chilenos. Se sugiere la adopción de nuevas políticas y estrategias educativas para mejorar la calidad de la alimentación y promover la salud mental de toda la comunidad universitaria.

Resumo: O objetivo do estudo foi determinar a associação da adesão à dieta mediterrânea e seus grupos alimentares com sintomas depressivos em estudantes universitários chilenos. O desenho do estudo foi transversal. Um total de 934 estudantes do primeiro ano de uma universidade pública chilena responderam a uma pesquisa de autoavaliação para analisar a adesão à dieta mediterrânea - por meio de um índice validado no Chile (IDM-chileno) - e sintomas de depressão, ansiedade e estresse, utilizando a Escala de Depressão, Ansiedade e Estresse (DASS-21). Modelos de regressão logística foram utilizados para examinar a associação entre a adesão à dieta mediterrânea e seus grupos alimentares com sintomas de depressão, ansiedade e estresse, ajustados para os principais fatores de confusão. Estudantes com adesão moderada ou alta à dieta mediterrânea apresentaram chances menores de ter depressão [DASS-21 > 5, odds ratio (OR) = 0,64; intervalo de 95% de confiança (IC95%): 0,47-0,88] do que aqueles com baixa adesão à dieta mediterrânea. Um consumo de 1-2 porções por dia de verduras (OR = 0,63; IC95%: 0,43-0,92), > 2 porções por semana de nozes (OR = 0,41; IC95%: 0,21-0,80), 1-2 porções por dia de frutas (OR = 0,60; IC95%: 0,42-0,85), 1-2 porções por semana de peixes e frutos do mar (OR = 0,67; IC95%: 0,48-0,94) e 1/2-3 unidades por semana de abacate (OR = 0,67; IC95%: 0,48-0,93) resultou em chances baixas de sintomas depressivos. O consumo de cereais integrais (> 2 porções por dia) (OR = 1,63; IC95%: 1,02-2,61) resultou na associação oposta. A adesão à dieta mediterrânea e o consumo de frutas, verduras, nozes, abacate, peixes e frutos do mar estão associados a uma menor probabilidade de depressão em estudantes universitários chilenos. Recomendamos a adoção de novas políticas e estratégias educacionais para melhorar a qualidade da alimentação e promover a saúde mental de toda a comunidade universitária.

Different levels of adherence to the Mediterranean diet that do not change the risk of breast cancer in western women

Breast cancer (BC) is the most common neoplasm in women globally. Healthy eating, a characteristic of the Mediterranean diet (MD), has been associated with a lower risk of developing BC, although this relationship remains inconclusive. This study aimed to analyse the relationship between MD adherence and the risk of BC development. A case-control study was carried out with 181 women divided into two groups: with BC (n= 90) and without breast cancer (WBC) (n= 91). Clinical and reproductive aspects were investigated through interviews, and food consumption was assessed through a food frequency questionnaire (FFQ). Adherence to the MD was evaluated using the MD score. Statistical analysis was performed using SPSS® software, with p<0.05. The results showed that the main type of breast carcinoma was invasive ductal carcinoma, positive for oestrogen or progesterone receptors. The mean MD score was 4.08 ± 1.61 and 4.22 ± 1.69 among women with BC and without BC, respectively, with no difference between the groups. The risk assessment of BC with respect to adherence to MD showed no significant difference after adjustments were made in the logistic regression models. In conclusion, this study showed that women with and without breast cancer had "medium adherence" to MD, with no difference between the groups. In the group of women investigated, adherence to MD did not affect the risk of developing the disease.

El cáncer de mama (CM) es la neoplasia más frecuente entre las mujeres del mundo, y la alimentación saludable, característica del patrón de la dieta mediterránea (DM), se ha asociado con un menor riesgo de desarrollar CM, aunque esta relación sigue sin ser concluyente. El objetivo del estudio fue analizar la relación entre la adherencia a la DM y el riesgo para el desarrollo de CM. Estudio de casos y controles realizados con 181 mujeres divididas en dos grupos: con cáncer de mama (n=90) y sin cáncer de mama (SCM; n= 91). Los aspectos clínicos y reproductivos se evaluaron a través de una entrevista; consumo de alimentos a través del cuestionario de frecuencia alimentaria (FFQ) y adherencia a la dieta mediterránea evaluada según la puntuación de DM. El análisis estadístico se realizó mediante el software SPSS®, considerando valores significativos de p<0,05. Los resultados mostraron que el principal tipo de carcinoma de mama fue el carcinoma ductal invasivo, positivo para el receptor de estrógenos y progesterona. La puntuación media de DM fue de 4,08 ± 1,61 entre las mujeres con CM y de 4,22 ± 1,69 entre las que no tenían la enfermedad, sin diferencia entre los grupos. La evaluación del riesgo de CM en relación con la adherencia a la DM mostró que, después de ajustes en los modelos de regresión logística, no hubo diferencia significativa. En conclusión, el estudio muestra que las mujeres con y sin CM tuvieron "adherencia media" a la DM, sin diferencia entre los grupos. También mostró que, en el grupo de mujeres investigadas, la adherencia a la DM no influyó en el riesgo para el desarrollo de la enfermedad.

Effectiveness of Mediterranean Diet on Diabetic Control and Cardiovascular Risk Modification Among Patients With Type 2 Diabetes Mellitus in Oman: A Study Protocol

@#Introduction: In the recent years, there is remarkable increased in the prevalence of Type 2 Diabetes Mellitus (T2DM) in Middle East countries including Oman. There is good evidence that Mediterranean Diet (MedDiet) is effective over diabetes control and several cardiovascular risk factors in different populations, with little compelling evidence among Omanis. This paper describes the protocol of a wait-list, open labelled, randomized control trial, with its main objective aimed to determine the effectiveness of Mediterranean Diet intervention on glycaemic control and cardiovascular risks among T2DM patients in Oman. Methods: A total of 140 eligible T2DM patients will be recruited. Participants in the intervention group will undergo a six-month MedDiet program comprising of different activities (individual dietary counseling, cooking classes, phone calls and social media messages) while the control group will continue with standard diabetes care. Data collection will be conducted at baseline, after three and six months. The 2 x 3 mixed-design ANOVA will be used to determine the mean changes in outcome variables over the full study period between the two groups. Discussion: Epidemiology studies on nutrition and health had focused on dietary pattern, which provides an opportunity to account for nutrient-nutrient interactions lately. Mediterranean Diet has produced consistent findings on its protective role in diabetes management, with little information on its effectiveness in population outside of Mediterranean basin, including Oman. The outcomes of current study will be used to inform community and health care professionals on the effectiveness and practically of MedDiet on diabetes management.

The effects of Mediterranean diet on cardiovascular risk factors in patients with type 2 diabetes: a Meta-analysis / 中国实用护理杂志

Objective:To investigate the effect of Mediterranean diet on blood glucose control and cardiovascular risk factors in patients with type 2 diabetes.Methods:As to December 2021, the PubMed, Cochrance Central Register of Controlled Trials and Cochrance Database, Cochranc Library, Embase, China National Knowledge Infrastructure and Wanfang Medical Network system were searched for clinical randomized controlled trials(RCTs) of Mediterranean diet in patients with type 2 diabetes to conduct Meta-analysis The main observation index were cardiovascular risk factors, and the mean difference and its 95% confidence interval were used to estimate the effect size.Results:There were six RCTs, and 1181 patients met the inclusion criteria and entered the Meta-analysis. Compared with the control group, the intervention group can significantly reduce the level of systolic blood pressure ( MD=-1.20, 95% CI-2.21 to -0.19) and diastolic blood pressure ( MD=-4.17, 95% CI-7.12 to -1.22) in patients with type 2 diabetes mellitus, but there were no significant difference in the level of TC ( MD=2.92, 95% CI-0.84 to-6.67), HDL ( MD=2.33, 95% CI-0.27 to -4.92) and LDL ( MD=-2.34, 95% CI-5.67 to -0.99) between the two groups (all P>0.05). Conclusions:The meta-analysis provided evidence the Mediterranean diet showed the beneficial improvements in blood pressure glycemic control, but the effect of Mediterranean diet on lipid profile was not significant, which needed further verification.

Modification of Mediterranean Diet Pyramid from an Island's perspective / Alteração da Pirâmide Alimentar Mediterrânea na perspectiva de uma Ilha

ABSTRACT Objective The present study aimed to determine traditional and local food consumption and adherence to the Mediterranean diet in Cyprus. And also, aimed to improve their adherence to the Mediterranean diet and traditional and local food consumption. From this point, this current study aimed to revise the Cyprus Mediterranean Diet Pyramid, based on the Current Mediterranean Diet Pyramid. Methods The sample size was calculated as a minimum of 386 according to a 95.0% confidence interval, and a 5.0% error. This study was conducted online between November 2020-April 2021 in Cyprus. All volunteers were invited to this study on the national public internet platforms. Participant´s adherence to the Mediterranean diet was determined by the Mediterranean Diet Adherence Screener. Traditional and local food consumption frequencies were determined by a Food Frequency Questionnaire. A novel Cyprus Mediterranean Diet Pyramid was developed with traditional and local food items for Cyprus. The modification was also aimed to safeguard planet health, to increase traditional food consumption and adherence to the Mediterranean diet. Results 1,007 adults (78.0% native islanders/Cypriots) participated voluntarily in the current study. The mean Mediterranean Diet Adherence Screener score was 7.55±2.30 points and only 34.4% had high adherence to the Mediterranean diet. According to their responses, there was a need to increase use of olive oil, vegetables, fruits, fish, and red wine consumption and to decrease red meat and dessert consumption. According to responses to the Mediterranean Diet Adherence Screener and their traditional/local food consumption frequencies an up-to-date Cyprus Mediterranean Diet Pyramid was done hence a national food pyramid for Cyprus. Commonly consumed traditional and local foods were added to the pyramid to facilitate increased adaptation of the Mediterranean diet in the general population. Adequately consumed foods were added to make it more region-specific and rarely consumed foods were added to help to increase consumption. Conclusion This modification is believed to be instrumental to increase Mediterranean diet adaptation, traditional/local food consumption and decrease the impact of nutrition on the planet´s health. And also, this modification can shed light on the development of the other traditional food pyramids.

RESUMO Objetivo Este estudo teve como objetivo determinar o consumo alimentar tradicional e local, bem como a adesão à dieta mediterrânea no Chipre. Também teve como objetivo melhorar a adesão à dieta mediterrânea e ao consumo de alimentos tradicionais e locais. A partir desse ponto, este trabalho atual teve como objetivo revisar a Pirâmide da Dieta Mediterrânea do Chipre, que é baseada na Pirâmide da Dieta Mediterrânea Atual. Métodos O tamanho da amostra foi calculado com um mínimo de 386 de acordo com intervalo de confiança de 95,0% e erro de 5,0%. Este estudo foi realizado online entre novembro de 2020 e abril de 2021 em Chipre. Todos os voluntários foram convidados para esta análise nas plataformas públicas nacionais de internet. A adesão dos participantes à dieta mediterrânea foi avaliada pelo Medidor de Adesão à Dieta Mediterrânea. As frequências de consumo alimentar tradicional e local foram determinadas pelo Questionário de Frequência Alimentar. Foi desenvolvida uma nova Pirâmide da Dieta Mediterrânica de e para o Chipre, com alimentos tradicionais e locais. A modificação teve também como objetivo salvaguardar a saúde do planeta, aumentar o consumo de alimentos tradicionais e a adesão à dieta mediterrânea. Resultados No total de 1.007 adultos (78,0% naturais da ilha/cipriotas) participaram voluntariamente no estudo. A pontuação média obtida no Medidor de Adesão à Dieta Mediterrânea foi de 7,55±2,30 pontos, com apenas 34,4% aderindo fortemente à dieta mediterrânea. De acordo com as suas respostas, houve necessidade de aumentar a utilização de azeite, vegetais, frutas, peixe e vinho tinto, bem como de diminuir o consumo de carnes vermelhas e sobremesas. Com base nas suas respostas ao Medidor de Adesão à Dieta Mediterrânea e as suas frequências de consumo alimentar tradicional/local, foi feita uma pirâmide da Dieta Mediterrânea do Chipre atualizada, ou seja, uma pirâmide alimentar nacional para o Chipre. Alimentos locais e regionais comumente consumidos foram adicionados à pirâmide para aumentar a adesão à dieta mediterrânea. Alimentos consumidos de acordo com as recomendações foram adicionados para torná-los específico da região, e alimentos pouco consumidos foram adicionados para ajudar a aumentar o consumo. Conclusão Acredita-se que esta modificação seja determinante para aumentar a adaptação da dieta mediterrânea e o consumo de alimentos tradicionais e locais, além de diminuir o impacto da nutrição na saúde do planeta. Ainda, essa modificação pode lançar luz sobre o desenvolvimento das outras pirâmides alimentares tradicionais.

Cardiometabolic risk profile in relation to the practice of healthy habits in a sample of Spanish workers

Insulin resistance is a pathological entity that can lead to alterations in lipid metabolism and can increase cardiovascular risk. Objective. The aim of this study was to assess the influence of different sociodemographic variables such as age, sex and social class and healthy habits such as smoking, physical activity and adherence to the Mediterranean diet on the cardiometabolic profile of Spanish workers. Material and methods. A descriptive, cross-sectional study was carried out in 1457 Spanish workers in an attempt to evaluate the effect of healthy habits (physical exercise determined with the IPAQ questionnaire, Mediterranean diet and tobacco consumption) and sociodemographic variables (age, sex and social class) on the values of different insulin resistance scales. Results. The progressive increase in the level of physical activity and high adherence to the Mediterranean diet achieved an improvement in the mean values and in the prevalence of elevated values in all the insulin resistance scales analyzed in this study. Age over 50 years and belonging to the least favored social classes (social classes II-III) were the variables that increased the risk of presenting insulin resistance. Male sex also increased the risk of presenting insulin resistance. Conclusions. The different healthy habits such as vigorous physical exercise and high adherence to the Mediterranean diet improve the values of the different scales that assess insulin resistance(AU)

La resistencia a la insulina es una entidad patológica que puede provocar alteraciones en el metabolismo de los lípidos y puede aumentar el riesgo cardiovascular. Objetivo. En este trabajo se pretende valorar la influencia de diferentes variables sociodemográficas como la edad, el sexo y la clase social y hábitos saludables como el consumo de tabaco, la actividad física y la adherencia a la dieta mediterránea en el perfil cardiometabólico de trabajadores españoles. Material y métodos. Se realizó un estudio descriptivo y transversal en 1457 trabajadores españoles intentando evaluar el efecto de los hábitos saludables (ejercicio físico determinado con el cuestionario IPAQ, dieta mediterránea y consumo de tabaco) y las variables sociodemográficas (edad, sexo y clase social) sobre los valores de diferentes escalas de resistencia a la insulina. Resultados. El aumento progresivo del nivel de actividad física y la alta adherencia a la dieta mediterránea consiguieron una mejoría en los valores medios y en la prevalencia de los valores elevados en todas las escalas de resistencia a la insulina analizadas en este estudio. La edad por encima de los 50 años y la pertenencia a las clases sociales menos favorecidas (clases sociales II-III) fueron las variables que aumentaron el riesgo de presentar resistencia a la insulina. El sexo masculino también incrementó el riesgo de presentar resistencia a la insulina. Conclusiones. Los diferentes hábitos saludables como el ejercicio físico vigoroso y la alta adherencia a la dieta mediterránea mejoran los valores de las diferentes escalas que valoran resistencia a la insulina(AU)

O papel dos padrões alimentares na prevenção de demência: revisão da literatura / The role of dietary patterns in preventing dementia: Literature Review

Com o envelhecimento da população, a demência tornou-se um grande problema de saúde pública, sendo a doença de Alzheimer (DA) a mais comum. Sabe-se que a velhice e a genética são fatores de risco não modificáveis, porém estudos mostram que o desenvolvimento da DA possui forte relação com os fatores de risco modificáveis, dentre eles a nutrição, que tem chamado bastante atenção com a grande quantidade de evidências, mostrando forte relação entre a alimentação dos indivíduos com a neurodegeneração. É extremamente necessário investigar estratégias nutricionais de modo que se possa adiar ou até mesmo impedir o início da demência, dada a escassez de tratamentos farmacológicos eficazes na prevenção do declínio cognitivo. O objetivo da revisão foi analisar a influência dos padrões alimentares na prevenção do declínio cognitivo e da DA. Como metodologia, oram incluídos estudos do tipo observacionais e ensaios clínicos controlados feitos em humanos, adultos e idosos, publicados nos últimos 5 anos e que analisaram o componente alimentar. Dos 118 artigos encontrados apenas 8 atenderam os critérios e foram incluídos que dentre estes apenas 2 não apresentaram associação positiva entre dieta e prevenção do declínio cognitivo. Os demais estudos mostraram de alguma forma que dieta dentre outras covariáveis, possuem impacto consideravelmente positivo no envelhecimento do cérebro durante a meia idade. Concluiu-se que não há apenas um padrão alimentar capaz de retardar o surgimento de doenças neurodegenerativas, mas sim que diversos padrões alimentares com características em comum, possuem capacidade neuroprotetora

As the population ages, dementia has become a major public health problem, with Alzheimer's disease (AD) being the most common. It is known that old age and genetics are non-modifiable risk factors, but studies show that the development of AD has a strong relationship with modifiable risk factors, among them nutrition, which has drawn a lot of attention with the large amount of evidence, showing a strong relationship between the diet of individuals and neurodegeneration. It is extremely necessary to investigate nutritional strategies so that dementia can be postponed or even prevented, given the scarcity of effective pharmacological treatments to prevent cognitive decline. The purpose of the review was to analyze the influence of dietary patterns on the prevention of cognitive decline and AD. As a methodology, observational-type studies and controlled clinical trials carried out on humans, adults and the elderly, published in the last 5 years and that analyzed the food component, were included. Of the 118 articles found, only 8 met the criteria and it was included that among these, only 2 did not show a positive association between diet and prevention of cognitive decline. The other studies have somehow shown that diet, among other covariates, have a considerably positive impact on brain aging during middle age. It was concluded that there is not only a dietary pattern capable of delaying the emergence of neurodegenerative diseases, but that different dietary patterns with common characteristics, have neuroprotective capacity

Factores bioquímicos asociados a la adherencia a la dieta mediterránea / Biochemical factors associated with adherence to a Mediterranean Diet

Introducción: Existen evidencias respecto a la relación inversa, entre la adherencia a la dieta mediterránea y el desarrollo de padecimientos crónicos como enfermedad coronaria, síndrome metabólico y diabetes. Objetivo: Determinar los factores bioquímicos asociados a la adherencia a la dieta mediterránea, en pacientes atendidos en un centro médico peruano. Métodos: Estudio transversal en 209 pacientes atendidos en un centro médico de Lima, Perú. Se utilizó el cuestionario PREDIMED para medir la adherencia a la dieta mediterránea. Se indagó la correlación entre el puntaje de adherencia a la dieta mediterránea y las covariables, edad, sexo, hipertrigliceridemia, hipercolesterolemia, hiperglicemia en ayunas y diagnóstico nutricional. Se utilizaron modelos lineales generales. Resultados: De 209 participantes, la mayoría fueron hombres (79,9 por ciento) y la mediana de edad fue de 31 años. El 20,2 por ciento tenía obesidad, quienes presentaron alteraciones en triglicéridos, fueron el 29,1 por ciento, colesterol (21,7 por ciento) y glicemia en ayunas (26,8 por ciento). En cuanto al puntaje del PREDIMED, la media fue de 4,6 puntos. Se encontró que la hiperglicemia en ayunas (Coef. = -2,08) tuvo asociación negativa con el puntaje de adherencia a la dieta mediterránea. Conclusión: La adherencia al patrón de dieta mediterránea es baja, y se correlaciona de forma negativa con hallazgos de hiperglicemia en los participantes evaluados (AU)

Introduction: There is evidence regarding the inverse relationship between adherence to the Mediterranean diet and the development of chronic conditions such as coronary heart disease, metabolic syndrome and diabetes. Objective: To determine the factors associated with adherence to the Mediterranean diet in patients attended in a Peruvian medical center. Methods: Cross-sectional analytical study in 209 patients attended at a medical center in Lima, Peru. The PREDIMED questionnaire was used to measure adherence to Mediterranean diet. Correlation between the Mediterranean diet adherence score and the covariates, age, sex, hypertriglyceridemia, hypercholesterolemia, fasting hyperglycemia and nutritional diagnosis was investigated. General linear models were used. Results: Of 209 participants, the majority were male (79.9 %) and the median age was 31 years. The 20.2 percent had obesity, those who presented alterations in triglycerides were 29.1 percent, cholesterol (21.7 percent) and fasting glycemia (26.8 percent). As for the PREDIMED score, the mean was 4.6 points. It was found that fasting hyperglycemia (Coef. = -2.08) had a negative association with the Mediterranean diet adherence score. Conclusion: Adherence to the Mediterranean diet pattern is low, and is negatively correlated with hyperglycemia findings in the participants evaluated(AU)

Patrones de desayuno en estudiantes universitarios de España, Túnez y Estados Unidos. Factores antropométricos, sociodemográficos y de estilo de vida / Breakfast patterns in university students of Spain, Tunisia, and The United States of America. Anthropometric, sociodemographic and lifestyle factors

La mayoría de los estudios apoyan la tesis de que el desayuno es la comida más importante del día. Un desayuno adecuado contribuye a lograr un patrón dietético global saludable y a mejorar la calidad de la dieta. El objetivo de este estudio fue determinar los principales patrones de desayuno en tres poblaciones universitarias de España, Túnez y Estados Unidos, analizar sus semejanzas y diferencias y estudiar la influencia de factores antropométricos, sociodemográficos y de estilo de vida en la adherencia a cada patrón. Se realizó un estudio transversal con datos de 730 estudiantes matriculados en las Universidades de Castilla-La Mancha, Cartago e Internacional de Florida en 2013. El consumo de alimentos se obtuvo mediante dos recordatorios de 24 horas, no consecutivos, uno de ellos en fin de semana. Los patrones se identificaron mediante análisis factorial exploratorio. La adherencia de los estudiantes a cada patrón se evaluó usando las puntuaciones factoriales. Se obtuvieron cuatro patrones para cada país. El principal patrón de los universitarios españoles incluyó pan, tomate, sal y aceite de oliva (varianza explicada: 20,85%); el principal de los tunecinos contenía pan, mermelada, nata y mantequilla (varianza explicada: 12,73%) y el principal de los americanos incluyó huevos, leche entera y azúcares (varianza explicada: 10,77%). Género, peso, IMC o comer fuera de casa fueron factores que influyeron en la adherencia a diferentes patrones. El estudio mostró la coexistencia de patrones tradicionales con otros occidentalizados y modelos transicionales intermedios. No se determinó un patrón generalizable asociado a mejores resultados del IMC(AU)

Most studies support the conclusion that breakfast is the most important meal of the day. An adequate breakfast contributes to achieving a healthy global dietary pattern and improving quality of diet. The objective of this study was to determine the main breakfast patterns of three university populations from Spain, Tunisia, and The United States of America, analyze their similarities and differences, and study the impact of anthropometric, sociodemographic and lifestyle factors on the adherence to each pattern. A cross-sectional study was developed with data from 730 students enrolled at the University of Castilla-La Mancha, University of Carthage, and Florida International University, during 2013. Food consumption data were obtained by means of two non-consecutive 24-hour recalls including one weekend day. Exploratory factor analysis was conducted to identify breakfast patterns. Factor scores were used to assess students' adherence to each pattern. Four breakfast patterns were obtained for each country. The main pattern of the Spanish students included bread, tomato, salt, and olive oil (explained variance: 20.85%); the main model of the Tunisians included bread, jam, cream and butter (explained variance: 12.73%); and the first pattern of the Americans was characterized by eggs, whole milk and sugars (explained variance: 10.77%). Gender, weight, BMI or eating out of home were factors that influenced the adherence to different patterns. Breakfast patterns obtained in this work showed the coexistence of traditional models with westernized and transitional ones. It was not determined a generalizable pattern associated with better BMI results(AU)

Variedad en la calidad de la dieta en adultos españoles y mexicanos / Diet quality variety in Spanish and Mexican adults

La pérdida de patrones de alimentación tradicionales a favor de otros más occidentales redunda en un descenso de calidad de la dieta alrededor del mundo. Muchos aspectos determinan la calidad dietética, aunque en general pueden resumirse en una dieta moderada, variada, equilibrada y adecuada para cada individuo. Estos aspectos son evaluados por el Diet Quality Index-International (DQI-I). Objetivo: Comparar la calidad de la dieta de población mexicana y española mediante un índice de calidad internacional de la dieta, determinando que factores son en mayor medida responsables de la pérdida de calidad. Material y métodos: Estudio observacional transversal sobre una muestra representativa de sujetos adultos residentes en Querétaro (México) y de sujetos de la misma franja de edad procedentes de la Región de Murcia, en la cuenca mediterránea española. Se recogieron datos sociodemográficos, antropométricos, de frecuencia de consumo de alimentos y de ingesta con 3 recuerdos de 24 horas y se valoró el DQI-I en la población. Resultados: Se encontraron diferencias para el gasto energético y el DQI-I en todos sus aspectos con valores de calidad superiores para la población mexicana. La variedad fue la dimensión más castigada para todos los sujetos, presentando los mexicanos mejores cifras de consumo de vegetales pero peores para las fuentes proteicas. Conclusiones: La muestra mexicana mejoró las cifras de calidad de la española, tal vez por una mayor influencia de conocimientos en nutrición. El 86% de la población podría mejorar sus puntajes de calidad en el DQI-I ajustando sus frecuencias de consumo de alimentos(AU)

The loss of traditional eating patterns in favour of more Western ones results in a decline in dietary quality around the world. Many aspects determine dietary quality, but in general they can be summarised as a moderate, varied, balanced diet suitable for each individual. These aspects are assessed by the Diet Quality Index-International (DQI-I). Objective: To compare the quality of the diet of the Mexican and Spanish populations using an international diet quality index, determining which factors are most responsible for the loss of quality. Material and methods: Cross-sectional observational study on a representative sample of adult subjects living in Querétaro (Mexico) and subjects of the same age group from the Region of Murcia, in the Spanish Mediterranean basin. Sociodemographic, anthropometric, food frequency consumption and intake data were collected with 3 24-hour recall and the DQI-I was assessed in the population. Results: Differences were found for energy expenditure and DQI-I in all aspects with higher quality values for the Mexican population. Variety was the most punished dimension for all subjects, with Mexicans presenting better figures for vegetable intake but worse for protein sources. Conclusions: The Mexican sample improved the quality figures of the Spanish sample, perhaps due to a greater influence of nutritional knowledge. Eighty-six percent of the population could improve their DQI-I quality scores by adjusting their food consumption frequencies(AU)

Adherencia a la dieta mediterránea en niños y adolescentes deportistas: revisión sistemática / Adherence to the mediterranean diet in child and adolescent athletes: a systematic review

Resumen Peláez Barrios, E.M. y Vernetta Santana M. (2021). Adherencia a la dieta mediterránea en niños y adolescentes deportistas: revisión sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(1), 1-19. El objetivo de esta revisión fue analizar los estudios realizados en niños y adolescentes deportistas que utilizaban el índice KIDMED para conocer la adherencia a la dieta mediterránea (ADM). Se realizó una búsqueda en diferentes bases de datos: WOS, Scopus, Google Scholar, Pubmed y Sport Discuss, entre el 1 de enero de 2010 y el 1 de junio de 2020, siguiendo la guía PRISMA. De los 82 estudios identificados, 10 analizaron la ADM y cumplieron con todos los criterios de inclusión. Los resultados obtenidos indicaron que los mayores porcentajes de ADM óptima se evidencian en piragüistas masculinos, seguidos de futbolistas masculinos, gimnastas de rítmica y kayakistas femeninas (66%, 54.8%, 52.2% y 51%, respectivamente). En todos los deportistas analizados, los resultados son mejorables, principalmente en el caso de las jugadoras de futbol sala. En la mayoría de los estudios no existe una relación entre ADM y las medidas antropométricas. Como conclusión, se destaca que la mayoría de los deportistas se encuentran entre una mejorable y óptima adherencia a la dieta mediterránea y son pocos los que obtienen porcentajes bajos de adherencia a la dieta mediterránea; destaca un patrón de adherencia a la dieta mediterránea aceptable casi en su totalidad, pero no óptimo. Además, la mayoría de los estudios incluidos en la revisión sistemática obtienen una alta calidad según las directrices STROBE.

Abstract Peláez Barrios, E.M. & Vernetta Santana M. (2021). Adherence to the mediterranean diet in child and adolescent athletes: a systematic review. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(1), 1-19. The objective of this review was to analyze studies conducted in child and adolescent athletes using the KIDMED index to study their adherence to the Mediterranean diet (ADM). A search was conducted in different databases including WOS, Scopus, Google Scholar, PubMed, and Sport Discuss between January 1st and June 1st, 2020, following the PRISMA guide. Of the 82 studies identified, 10 articles analyzed ADM and met all the inclusion criteria. Results indicated that the highest percentages of optimal ADM are evident in male canoeists, followed by male soccer players, rhythmic gymnasts, and female kayakers (66%, 54.8%, 52.2%, and 51%, respectively). Results are improvable in all the athletes analyzed, mainly in female futsal players. Most studies do not show a relationship between ADM and anthropometric measurements. In conclusion, most athletes show between improvable and optimal adherence to the Mediterranean diet, and only a few obtain low adherence percentages. Therefore, the pattern of adherence to the Mediterranean diet is mostly acceptable but not optimal. In addition, the quality of most of the studies included in the systematic review are rated high based on the STROBE guidelines.

Resumo Peláez Barrios, E.M. e Vernetta Santana M. (2021). A adesão à dieta mediterrânea em crianças e adolescentes esportistas: revisão sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(1), 1-19. Esta revisão teve como objetivo analisar os estudos realizados em crianças e adolescentes esportistas que utilizavam o índice KIDMED para entender a adesão à dieta mediterrânea (ADM). Foi realizada uma busca em diferentes bases de dados: WOS, Scopus, Google Scholar, Pubmed e Sport Discuss, entre 1º de janeiro de 2010 e 1º de junho de 2020, seguindo a recomendação PRISMA. Dos 82 estudos identificados, 10 analisaram a ADM e cumpriram todos os critérios de adesão. Os resultados obtidos indicaram que as maiores porcentagens de ADM ideal se evidenciaram em canoístas masculinos, seguidos de futebolistas masculinos, ginastas rítmicas masculinos e canoístas femininas (66%, 54,8%, 52,2% e 51%, respectivamente). Em todos os esportistas analisados, os resultados são aperfeiçoáveis, principalmente no caso das jogadoras de futebol de salão. Na maioria dos estudos não existe uma relação entre ADM e as medidas antropométricas. Em conclusão, destaca-se que a maioria dos esportistas estão entre uma aperfeiçoável e ótima adesão à dieta mediterrânea e são poucos os que obtém baixas porcentagens de adesão a ela; destaca-se um padrão de adesão à dieta mediterrânea aceitável praticamente total, mas não ótimo. Além disso, a maioria dos estudos incluídos na revisão sistemática obtém uma alta qualidade de acordo com as diretrizes STROBE.

Progress on prevention of osteoporosis with Mediterranean diet / 中华内分泌代谢杂志

The Mediterranean diet refers to the dietary pattern derived from eating habits of the southern European countries along the Mediterranean coast. It is a healthy diet pattern with essential nutrients. It was reported that the incidence of osteoporosis in the Mediterranean countries is lower, so it is of particular interest to explore the effect and potential mechanism of the diet on bone health. Applying research results of the Mediterranean diet to the prevention of osteoporosis in other countries is a feasible way to reduce the incidence of osteoporosis in the future.

Nutritional genomics, inflammation and obesity

ABSTRACT The Human Genome Project has significantly broadened our understanding of the molecular aspects regulating the homeostasis and the pathophysiology of different clinical conditions. Consequently, the field of nutrition has been strongly influenced by such improvements in knowledge - especially for determining how nutrients act at the molecular level in different conditions, such as obesity, type 2 diabetes, cardiovascular disease, and cancer. In this manner, characterizing how the genome influences the diet and vice-versa provides insights about the molecular mechanisms involved in chronic inflammation-related diseases. Therefore, the present review aims to discuss the potential application of Nutritional Genomics to modulate obesity-related inflammatory responses. Arch Endocrinol Metab. 2020;64(3):205-22

Translation and cultural adaptation of the mediterranean diet quality index in children and adolescents / Tradução e adaptação cultural do mediterranean diet quality index in children and adolescents

ABSTRACT Objective: To translate and culturally adapt the Mediterranean Diet Quality Index in Children and Adolescent (KIDMED) for the Brazilian population. Methods: The processes of translation and cultural adaptation followed internationally standardized methodological norms. We used the intraclass correlation coefficient and the Bland-Altman dispersion analysis to assess the reproducibility and calculated the internal consistency with Cronbach's alpha coefficient. Results: A total of 102 children and adolescents participated in the cross-cultural adaptation, of whom 58 (56.9%) were females, with a mean age of 9.8±4.9 years. The mean overall scores of adherence to the Mediterranean diet in the test and retest were similar (8.00 and 3.80 versus 8.01 and 3.84) for children and adolescents, respectively. The intraclass correlation coefficient for children and adolescents was 0.893 and 0.998, respectively. The internal consistency was 0.72. The Bland-Altman plot analysis showed good agreement between the final scores of the test and retest questionnaires, with no statistically significant difference. Conclusions: The KIDMED questionnaire was translated into Brazilian Portuguese and culturally adapted, presenting high reproducibility. This questionnaire can, therefore, be included and used in Brazilian studies that aim at evaluating the adherence to the Mediterranean diet among children and adolescents.

RESUMO Objetivo: Traduzir e adaptar culturalmente a escala do Mediterranean Diet Quality Index in Children and Adolescent (KIDMED) para a população brasileira. Métodos: Os processos de tradução e adaptação cultural seguiram normas metodológicas padronizadas internacionalmente. A reprodutibilidade foi avaliada pelo coeficiente de correlação intraclasse e pela análise de dispersão de Bland-Altman, e a consistência interna foi calculada pelo coeficiente de Cronbach. Resultados: Participaram da etapa de adaptação transcultural 102 crianças e adolescentes, sendo 58 (56,9%) meninas com idade média de 9,8±4,9 anos. Os escores totais médio de aderência à dieta mediterrânea no teste e no reteste foram semelhantes (8,00 e 3,80 versus 8,01 e 3,84) para as crianças e os adolescentes, respectivamente. O coeficiente de correlação intraclasse para as crianças e os adolescentes foi de 0,893 e 0,998, respectivamente. A consistência interna obtida foi de 0,72. A análise do gráfico de Bland-Altman demonstrou boa concordância entre os escores finais dos questionários de teste e de reteste, sem diferença estatisticamente significativa. Conclusões: O questionário KIDMED foi traduzido e adaptado culturalmente para a língua portuguesa do Brasil, apresentando alta reprodutibilidade. Esse questionário pode ser, portanto, incluído e utilizado em estudos brasileiros que visem avaliar a aderência à dieta mediterrânea de crianças e adolescentes.