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MedDietCalc: multi calculator to compute scores of adherence to Mediterranean Diet

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Abstract

Mediterranean Diet (MedDiet) is broadly aknowledged as healthy. Different scoring systems of adherence to MedDiet have been developed. These indexes share components, but also disagree and don’t correlate as expected. So, methodological issues arise when comparing studies using different MedDiet adherence scores. Furthermore, scoring calculus is time consuming and prone to error. We develop this package as a reproducible and easy-to-use way of calculating different scores of adherence to MedDiet and provide a methodological improvement to nutriepidemiological studies using adherence scores. Each function in MedDietCalc package computes a single score according to its authors published scoring schema. Implementation: R package. Main feature is a group of calculators of 14 literature available MedDiet scores, with several implementations to ease their use. It also includes a sample dataset from DRECE 6 study and FRESCO cardiovascular risk score calculator. Available from the Comprehensive R Archive Network [CRAN.R-project.org] under the name “MedDietCalc”, licensed with General Public License 3. We provide the first software to compute and compare different MedDiet scores, which can also be used with datasets. Different scores to measure adherence to MedDiet exist, with no gold standard. In the provided sample just 3 score pairs were highly correlated, and most of them were moderately or poorly correlated. This disagreement limits our understanding of the effects of MedDiet on health status. Comparability of studies could be improved if adherence to MedDiet were reported with more than a single score.

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References

  1. Dinu M, Pagliai G, Casini A, Sofi F. Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. Eur J Clin Nutr. 2018;72:30–43. Available from: https://www.nature.com/articles/ejcn201758

  2. Martínez-González MA, Gea A, Ruiz-Canela M. The Mediterranean Diet and Cardiovascular Health. Circ Res. 2019;124:779–798. Available from: https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.118.313348

  3. Davis C, Bryan J, Hodgson J, Murphy K. Definition of the Mediterranean Diet; A Literature Review. Nutrients. 2015;7:9139–53.

    Article  Google Scholar 

  4. Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, Gnardellis C, Lagiou P, Polychronopoulos E, et al. Diet and overall survival in elderly people. BMJ. 1995;311:1457–60.

    Article  Google Scholar 

  5. Zaragoza-Martí A, Cabañero-Martínez MJ, Hurtado-Sánchez JA, Laguna-Pérez A, Ferrer-Cascales R. Evaluation of Mediterranean diet adherence scores: a systematic review. BMJ Open. 2018;8:e019033.

    Article  Google Scholar 

  6. Milà-Villarroel R, Bach-Faig A, Puig J, Puchal A, Farran A, Serra-Majem L, et al. Comparison and evaluation of the reliability of indexes of adherence to the Mediterranean diet. Public Health Nutr. 2011;14:2338–45.

    Article  Google Scholar 

  7. Bamia C, Martimianaki G, Kritikou M, Trichopoulou A. Indexes for Assessing Adherence to a Mediterranean Diet from Data Measured through Brief Questionnaires: Issues Raised from the Analysis of a Greek Population Study. Curr Dev Nutr. 2017;1. Available from: https://academic.oup.com/cdn/article/1/3/e000075/4555130

  8. Olmedo-Requena R, González-Donquiles C, Dávila-Batista V, Romaguera D, Castelló A, Molina de la Torre AJ, et al. Agreement among Mediterranean Diet Pattern Adherence Indexes: MCC-Spain Study. Nutrients. 2019;11:488. Available from: https://www.mdpi.com/2072-6643/11/3/488

  9. R Core Team. R: A language and environment for statistical computing [Internet]. Vienna, Austria: R Foundation for Statistical Computing; 2013. Available from: http://www.R-project.org

  10. D’Alessandro A, De Pergola G. Mediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes. Nutrients. 2015;7:7863–88.

    Article  Google Scholar 

  11. Martínez-González MA, Fernández-Jarne E, Serrano-Martínez M, Marti A, Martinez JA, Martín-Moreno JM. Mediterranean diet and reduction in the risk of a first acute myocardial infarction: an operational healthy dietary score. Eur J Nutr. 2002;41:153–60.

    Article  Google Scholar 

  12. Rumawas ME, Dwyer JT, Mckeown NM, Meigs JB, Rogers G, Jacques PF. The Development of the Mediterranean-Style Dietary Pattern Score and Its Application to the American Diet in the Framingham Offspring Cohort. J Nutr. 2009;139:1150–6.

    Article  Google Scholar 

  13. Alberti-Fidanza A, Fidanza F, Chiuchiù MP, Verducci G, Fruttini D. Dietary studies on two rural italian population groups of the Seven Countries Study. 3. Trend Of food and nutrient intake from 1960 to 1991. Eur J Clin Nutr. 1999;53:854–60.

    Article  Google Scholar 

  14. Pitsavos C, Panagiotakos DB, Tzima N, Chrysohoou C, Economou M, Zampelas A, et al. Adherence to the Mediterranean diet is associated with total antioxidant capacity in healthy adults: the ATTICA study. Am J Clin Nutr. 2005;82:694–9.

    Article  Google Scholar 

  15. Martínez-González MÁ, Corella D, Salas-Salvadó J, Ros E, Covas MI, Fiol M, et al. Cohort profile: design and methods of the PREDIMED study. Int J Epidemiol. 2012;41:377–85.

    Article  Google Scholar 

  16. Trichopoulou A, Orfanos P, Norat T, Bueno-de-Mesquita B, Ocké MC, Peeters PH, et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ. 2005;330:991.

    Article  Google Scholar 

  17. Goulet J, Lamarche B, Nadeau G, Lemieux S. Effect of a nutritional intervention promoting the Mediterranean food pattern on plasma lipids, lipoproteins and body weight in healthy French-Canadian women. Atherosclerosis. 2003;170:115–24.

    Article  Google Scholar 

  18. Scali J, Richard A, Gerber M. Diet profiles in a population sample from Mediterranean southern France. Public Health Nutr. 2001;4:173–82.

    Article  Google Scholar 

  19. Buckland G, González CA, Agudo A, Vilardell M, Berenguer A, Amiano P, et al. Adherence to the Mediterranean Diet and Risk of Coronary Heart Disease in the Spanish EPIC Cohort Study. Am J Epidemiol. 2009;kwp282. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19903723

  20. Martínez-González MA, Fernández-Jarne E, Serrano-Martínez M, Wright M, Gomez-Gracia E. Development of a short dietary intake questionnaire for the quantitative estimation of adherence to a cardioprotective Mediterranean diet. Eur J Clin Nutr. 2004;58:1550–2.

    Article  Google Scholar 

  21. Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr. 2014;17:2769–82.

    Article  Google Scholar 

  22. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean Diet and Survival in a Greek Population. N Engl J Med. 2003;348:2599–608.

    Article  Google Scholar 

  23. Sofi F, Abbate R, Gensini GF, Casini A, Trichopoulou A, Bamia C. Identification of change-points in the relationship between food groups in the Mediterranean diet and overall mortality: an ‘a posteriori’ approach. Eur J Nutr. 2012;51:167–72.

    Article  Google Scholar 

  24. Marrugat J, Subirana I, Ramos R, Vila J, Marín-Ibañez A, Guembe MJ, et al. Derivation and validation of a set of 10-year cardiovascular risk predictive functions in Spain: the FRESCO Study. Prev Med. 2014;61:66–74.

    Article  Google Scholar 

  25. Gómez Gerique JA, Herrera R, Gómez de la Cámara A, Grupo DRECE. Capítulo 2. El proyecto DRECE. Med Clínica. 2011;12:3–5. Available from: https://medes.com/publication/69829

  26. Panagiotakos DB, Milias GA, Pitsavos C, Stefanadis C. MedDietScore: a computer program that evaluates the adherence to the Mediterranean dietary pattern and its relation to cardiovascular disease risk. Comput Methods Prog Biomed. 2006;83:73–7.

    Article  Google Scholar 

  27. Waijers PMCM, Feskens EJM, Ocké MC. A critical review of predefined diet quality scores. Br J Nutr. 2007;97:219–31.

    Article  Google Scholar 

  28. Lassale C, Fezeu L, Andreeva VA, Hercberg S, Kengne A-P, Czernichow S, et al. Association between dietary scores and 13-year weight change and obesity risk in a French prospective cohort. Int J Obes 2005. 2012;36:1455–62. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22249228

  29. Galbete C, Schwingshackl L, Schwedhelm C, Boeing H, Schulze MB. Evaluating Mediterranean diet and risk of chronic disease in cohort studies: an umbrella review of meta-analyses. Eur J Epidemiol. 2018;33:909–31. https://doi.org/10.1007/s10654-018-0427-3.

    Article  Google Scholar 

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Funding

MedDietCalc is part of the DRECE project, who has received grants from Spanish Health Institute Carlos III: FIS 03/0014, 08/90643, PI10/02123 and PI14/01940; and from Research Institute Hospital 12 de Octubre (i + 12): 2019/0047.

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Correspondence to Miguel Menéndez Orenga M.D., Ph.D..

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DRECE VI project was approved by Hospital 12 de Octubre Research Institute i + 12 Institutional Review Board.

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Data from participants was provided voluntarily and freely by themselves by telephone survey and stored anonymous, according to data protection laws.

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Menéndez Orenga, M., Lora Pablos, D. & Gómez de la Cámara, A. MedDietCalc: multi calculator to compute scores of adherence to Mediterranean Diet. Health Technol. 9, 497–504 (2019). https://doi.org/10.1007/s12553-019-00341-4

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  • DOI: https://doi.org/10.1007/s12553-019-00341-4

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