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Quality of Internet information related to the Mediterranean diet


The present study aimed to evaluate the quality of Internet information on the Mediterranean diet and to determine the relationship between the quality of information and the website source.


Website sources were categorized as institutional, pharmaceutical, non-pharmaceutical commercial, charitable, support and alternative medicine. Content quality was evaluated using the DISCERN rating instrument, the Health On the Net Foundation's (HON) code principles, and Journal of the American Medical Association (JAMA) benchmarks. Readability was graded by the Flesch Reading Ease score and Flesch–Kincaid Grade Level score.


The phrase ‘Mediterranean diet’ was entered as a search term into the six most commonly used English-language search engines.


The first thirty websites forthcoming by each engine were examined.


Of the 180 websites identified, thirty-two met our inclusion criteria. Distribution of the website sources was: institutional, n 8 (25 %); non-pharmaceutical commercial, n 12 (38 %); and support, n 12 (38 %). As evaluated by the DISCERN, thirty-one of the thirty-two websites were rated as fair to very poor. Non-pharmaceutical commercial sites scored significantly lower than institutional and support sites (P = 0·002). The mean Flesch Reading Ease score and mean Flesch–Kincaid Grade Level were 55·9 (fairly difficult) and 7·2, respectively. The Flesch–Kincaid Grade Level score determines the difficulty of material by measuring the length of words and sentences and converting the results into a grade level ranging from 0 to 12 (US grade level).


Due to the poor quality of website information on the Mediterranean diet, patients or consumers who are interested in the Mediterranean diet should get advice from physicians or dietitians.

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2.FB Hu (2003) The Mediterranean diet and mortality – olive oil and beyond. N Engl J Med 348, 25952596.

3.A Mente , L de Koning , HS Shannon (2009) A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 169, 659669.

4.G Eysenbach , J Powell , O Kuss (2002) Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. JAMA 287, 26912700.

5.D Charnock , S Shepperd , G Needham (1999) DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 53, 105111.

6.WM Silberg , GD Lundberg & RA Musacchio (1997) Assessing, controlling, and assuring the quality of medical information on the Internet: Caveant lector et viewor – Let the reader and viewer beware. JAMA 277, 12441245.

9.DR Hargrave , UA Hargrave & E Bouffet (2006) Quality of health information on the Internet in pediatric neuro-oncology. Neuro Oncol 8, 175182.

10.S van der Marel , M Duijvestein , JC Hardwick (2009) Quality of web-based information on inflammatory bowel diseases. Inflamm Bowel Dis 15, 18911896.

11.AM Whelan , TM Jurgens , SK Bowles (2009) Efficacy of natural health products in treating osteoporosis: what is the quality of internet patient advice? Ann Pharmacother 43, 899907.

12.J Kaicker , VB Debono , W Dang (2010) Assessment of the quality and variability of health information on chronic pain websites using the DISCERN instrument. BMC Med 8, 59.

13.P Lopez-Jornet & F Camacho-Alonso (2009) The quality of internet sites providing information relating to oral cancer. Oral Oncol 45, e95e98.

14.F Meric , EV Bernstam , NQ Mirza (2002) Breast cancer on the world wide web: cross sectional survey of quality of information and popularity of websites. BMJ 324, 577581.

15.Y Khazaal , A Chatton , S Cochand (2008) Quality of Web-based information on cocaine addiction. Patient Educ Couns 72, 336341.

16.V Morel , A Chatton , S Cochand (2008) Quality of web-based information on bipolar disorder. J Affect Disord 110, 265269.

17.Y Khazaal , S Fernandez , S Cochand (2008) Quality of web-based information on social phobia: a cross-sectional study. Depress Anxiety 25, 461465.

18.SE Bedell , A Agrawal & LE Petersen (2004) A systematic critique of diabetes on the world wide web for patients and their physicians. Int J Med Inform 73, 687694.

21.Y Khazaal , A Chatton , S Cochand (2009) Brief DISCERN, six questions for the evaluation of evidence-based content of health-related websites. Patient Educ Couns 77, 3337.

22.D Fallis & M Fricke (2002) Indicators of accuracy of consumer health information on the Internet: a study of indicators relating to information for managing fever in children in the home. J Am Med Inform Assoc 9, 7379.

23.DM D'Alessandro , P Kingsley & J Johnson-West (2001) The readability of pediatric patient education materials on the World Wide Web. Arch Pediatr Adolesc Med 155, 807812.

24.A Trichopoulou , T Costacou , C Bamia (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 25992608.

25.N Scarmeas , Y Stern , R Mayeux (2006) Mediterranean diet, Alzheimer disease, and vascular mediation. Arch Neurol 63, 17091717.

26.N Scarmeas , Y Stern , MX Tang (2006) Mediterranean diet and risk for Alzheimer's disease. Ann Neurol 59, 912921.

27.C Feart , C Samieri , V Rondeau (2009) Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA 302, 638648.

28.TT Fung , KM Rexrode , CS Mantzoros (2009) Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 119, 10931100.

30.I Shai , D Schwarzfuchs , Y Henkin (2008) Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 359, 229241.

32.A Trichopoulou , A Kouris-Blazos , ML Wahlqvist (1995) Diet and overall survival in elderly people. BMJ 311, 14571460.

33.KM Griffiths & H Christensen (2005) Website quality indicators for consumers. J Med Internet Res 7, e55.

34.A Oenema , J Brug , A Dijkstra (2008) Efficacy and use of an internet-delivered computer-tailored lifestyle intervention, targeting saturated fat intake, physical activity and smoking cessation: a randomized controlled trial. Ann Behav Med 35, 125135.

35.W Kroeze , A Oenema , M Campbell (2008) The efficacy of Web-based and print-delivered computer-tailored interventions to reduce fat intake: results of a randomized, controlled trial. J Nutr Educ Behav 40, 226236.

36.A Park , S Nitzke , K Kritsch (2008) Internet-based interventions have potential to affect short-term mediators and indicators of dietary behavior of young adults. J Nutr Educ Behav 40, 288297.

37.TJ Moore , N Alsabeeh , CM Apovian (2008) Weight, blood pressure, and dietary benefits after 12 months of a Web-based Nutrition Education Program (DASH for health): longitudinal observational study. J Med Internet Res 10, e52.

38.A Papadaki & JA Scott (2006) Process evaluation of an innovative healthy eating website promoting the Mediterranean diet. Health Educ Res 21, 206218.

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