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Design and development of an instrument to measure overall lifestyle habits for epidemiological research: the Mediterranean Lifestyle (MEDLIFE) index

  • Mercedes Sotos-Prieto (a1) (a2), Belén Moreno-Franco (a3), Jose M Ordovás (a1) (a4), Montse León (a5), Jose A Casasnovas (a5) and Jose L Peñalvo (a1)...
Abstract
Objective

To design and develop a questionnaire that can account for an individual’s adherence to a Mediterranean lifestyle including the assessment of diet and physical activity patterns, as well as social interaction.

Design

The Mediterranean Lifestyle (MEDLIFE) index was created based on the current Spanish Mediterranean food guide pyramid. MEDLIFE is a twenty-eight-item derived index consisting of questions about food consumption (fifteen items), traditional Mediterranean dietary habits (seven items) and physical activity, rest and social interaction habits (six items). Linear regression models and Spearman rank correlation were fitted to assess content validity and internal consistency.

Setting

A subset of participants in the Aragon Workers’ Health Study cohort (Zaragoza, Spain) provided the data for development of MEDLIFE.

Subjects

Participants (n 988) of the Aragon Workers’ Health Study cohort in Spain.

Results

Mean MEDLIFE score was 11·3 (sd 2·6; range: 0–28), and the quintile distribution of MEDLIFE score showed a significant association with each of the individual items as well as with specific nutrients and lifestyle indicators (intra-validity). We also quantified MEDLIFE correspondence with previously reported diet quality indices and found significant correlations (ρ range: 0·44–0·53; P<0·001) for the Alternate Healthy Eating Index, the Alternate Mediterranean Diet Index and Mediterranean Diet Adherence Screener.

Conclusions

MEDLIFE is the first index to include an overall assessment of lifestyle habits. It is expected to be a more holistic tool to measure adherence to the Mediterranean lifestyle in epidemiological studies.

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Corresponding author
Corresponding author: Email msotos@externo.cnic.es
References
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1. Fung, TT, McCullough, ML, Newby, PK et al. (2005) Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 82, 163173.
2. Estruch, R, Martinez-Gonzalez, MA, Corella, D et al. (2006) Effects of a Mediterranean-style diet on cardiovascular risk factors – a randomized trial. Ann Intern Med 145, 111.
3. McCullough, ML, Feskanich, D, Stampfer, MJ et al. (2002) Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am J Clin Nutr 76, 12611271.
4. Estruch, R, Ros, E, Salas-Salvado, J et al. (2013) Primary prevention of cardiovascular disease with a Mediterranean diet. New Engl J Med 368, 12791290.
5. Kennedy, ET, Ohls, J, Carlson, S et al. (1995) The Healthy Eating Index – design and applications. J Am Diet Assoc 95, 11031108.
6. Trichopoulou, A, Costacou, T, Bamia, C et al. (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 25992608.
7. Schröder, H, Fitó, M, Estruch, R et al. (2011) A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J Nutr 141, 11401145.
8. Chiuve, SE, Fung, TT, Rexrode, KM et al. (2011) Adherence to a low-risk, healthy lifestyle and risk of sudden cardiac death among women. JAMA 306, 6269.
9. Bhupathiraju, SN, Lichtenstein, AH, Dawson-Hughes, B et al. (2011) Adherence index based on the AHA 2006 diet and lifestyle recommendations is associated with select cardiovascular disease risk factors in older Puerto Ricans. J Nutr 141, 460469.
10. Behrens, G, Fischer, B, Kohler, S et al. (2013) Healthy lifestyle behaviors and decreased risk of mortality in a large prospective study of US women and men. Eur J Epidemiol 28, 361372.
11. Laugero, KD, Falcon, LM & Tucker, KL (2011) Relationship between perceived stress and dietary and activity patterns in older adults participating in the Boston Puerto Rican Health Study. Appetite 56, 194204.
12. Cappuccio, FP, D’Elia, L, Strazzullo, P et al. (2010) Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep 33, 585592.
13. Burazeri, G, Gofin, J & Kark, JD (2003) Siesta and mortality in a Mediterranean population: a community study in Jerusalem. Sleep 26, 578584.
14. Bach-Faig, A, Berry, EM, Lairon, D et al. (2011) Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr 14, 22742284.
15. Fundación Dieta Mediterránea (2010) Mediterranean Diet Pyramid: a lifestyle for today. http://dietamediterranea.com/dietamed/piramide_INGLES.pdf (accessed July 2014).
16. Casasnovas, JA, Alcaide, V, Civeira, F et al. (2012) Aragon workers’ health study – design and cohort description. BMC Cardiovasc Disord 12, 45.
17. de la Fuente-Arrillaga, C, Ruiz, ZV, Bes-Rastrollo, M et al. (2010) Reproducibility of an FFQ validated in Spain. Public Health Nutr 13, 13641372.
18. Martinez-Gonzalez, MA, Lopez-Fontana, C, Varo, JJ et al. (2005) Validation of the Spanish version of the physical activity questionnaire used in the Nurses’ Health Study and the Health Professionals’ Follow-up Study. Public Health Nutr 8, 920927.
19. Chasan-Taber, S, Rimm, EB, Stampfer, MJ et al. (1996) Reproducibility and validity of a self-administered physical activity questionnaire for male health professionals. Epidemiology 7, 8186.
20. Wolf, AM, Hunter, DJ, Colditz, GA et al. (1994) Reproducibility and validity of a self-administered physical activity questionnaire. Int J Epidemiol 23, 991999.
21. Haskell, WL, Lee, IM, Pate, RR et al. (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116, 10811093.
22. Sofi, F, Cesari, F, Abbate, R et al. (2008) Adherence to Mediterranean diet and health status: meta-analysis. BMJ 337, a1344.
23. Burazeri, G, Gofin, J & Kark, JD (2003) Over 8 hours of sleep – marker of increased mortality in Mediterranean population: follow-up population study. Croat Med J 44, 193198.
24. Keys, A, Menotti, A, Karvonen, MJ et al. (1986) The diet and 15-year death rate in the seven countries study. Am J Epidemiol 124, 903915.
25. de Koning, L, Chiuve, SE, Fung, TT et al. (2011) Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care 34, 11501156.
26. Fung, TT, Rexrode, KM, Mantzoros, CS et al. (2009) Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 119, 10931100.
27. Heidemann, C, Hoffmann, K, Spranger, J et al. (2005) A dietary pattern protective against type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC) – Potsdam Study cohort. Diabetologia 48, 11261134.
28. Martinez-Gonzalez, MA, Garcia-Arellano, A, Toledo, E et al. (2012) A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial. PLOS One 7, e43134.
29. Jurado, D, Burgos-Garrido, E, Diaz, FJ et al. (2012) Adherence to the Mediterranean dietary pattern and personality in patients attending a primary health center. J Acad Nutr Diet 112, 887891.
30. Sotos-Prieto, M, Angeles Zulet, M & Corella, D (2010) Scientific evidence of the Mediterranean diet effects in determining intermediate and final cardiovascular disease phenotypes. Med Clin (Barc) 134, 2229.
31. Willett, W (editor) 1998) Food frequency methods. In Nutritional Epidemiology, 2nd ed., pp 7494. New York: Oxford University Press.
32. Mattei, J, Bhupathiraju, S & Tucker, KL (2013) Higher adherence to a diet score based on American Heart Association recommendations is associated with lower odds of allostatic load and metabolic syndrome in Puerto Rican adults. J Nutr 143, 17531759.
33. Akbaraly, TN, Sabia, S, Shipley, MJ et al. (2013) Adherence to healthy dietary guidelines and future depressive symptoms: evidence for sex differentials in the Whitehall II study. Am J Clin Nutr 97, 419427.
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