Yetişkinlerde Akdeniz Diyeti Bağlılık Ölçeği ve Sağlıklı Yeme İndeksi-2015’in Obezite ile İlişkisi: Kesitsel Çalışma

Yıl 2024, Cilt: 9 Sayı: 2, 130 - 135, 16.06.2024

Yasemin Ertaş Öztürk , Zeynep Uzdil , Sedanur Macit , Pınar Kaya

https://doi.org/10.26453/otjhs.1364936

Öz

Amaç: Çalışmada Sağlıklı Yeme İndeksi (HEI)-2015 ile Akdeniz Diyeti Bağlılık Ölçeği (MEDAS) arasındaki uyum ve obezite ile ilişkilerinin değerlendirilmesi amaçlanmıştır.
Materyal ve Metot: Bu çalışmaya 19-65 yaş arası 404 yetişkin (134 erkek, 270 kadın) katılmıştır. HEI-2015 bileşenleri 24-saatlik geriye-dönük besin tüketim kaydı verilerinden hesaplanmıştır. Akdeniz diyetine bağlılık MEDAS aracı kullanılarak değerlendirilmiştir. Beden kütle indeksi (BKİ), bel-boy, bel-kalça oranı, vücut şekli indeksi (VŞİ) ve vücut yuvarlaklık indeksi (VYİ) hesaplanmıştır. Diyet kalitesi ile obezite arasındaki ilişkiler Pearson korelasyon katsayıları sunularak verilmiştir. HEI-2015 ve MEDAS arasındaki uyumu göstermek için Cohen Kappa testi uygulanmıştır.
Bulgular: Ortalama BKİ, HEI-2015 ve MEDAS skorları sırasıyla 25.35±5.21 kg/m2, 49.34±12.96 ve 7.45±2.17 idi. MEDAS, yaş, cinsiyet, eğitim düzeyi, medeni durum ve sigara içme durumuna gore düzenlendikten sonra BKİ (r=-0.120, p<0.05), bel-boy oranı (r=-0.137, p<0.01) ve VYİ (p=-0.130, p<0.05) ile negatif ilişkiliydi. HEI-2015 skorları ile obezite indeksleri arasında bir ilişki bulunmamıştır (p>0.05). Cohen Kappa testi, MEDAS skoru ile HEI-2015 skorları arasında hafif bir uyum olduğunu göstermiştir (κ=0.126, p<0.05).
Sonuç: Bu çalışmada HEI-2015 ve MEDAS arasında hafif bir uyum gösterilmiştir. Yalnızca MEDAS’ın obezite ile ilişkili olduğu bulunmuştur. Bu bulguların kontrollü çalışmalarla desteklenmesi gerekmektedir.

Anahtar Kelimeler

Akdeniz diyeti, diyet kalitesi, sağlıklı yeme indeksi-2015, obezite

Proje Numarası

N/A

Associations between Mediterranean Diet Adherence Screener and Healthy Eating Index-2015 with Obesity in Adults: A Cross-sectional Study

Öz

Objective: Evaluating the agreement between the Healthy Eating Index (HEI)-2015 with the Mediterranean Diet Assessment Screener (MEDAS) and the associations with obesity were aimed.
Materials and Methods: Four-hundred-and-four adults (134 men, 270 women) aged 19-65 participated in this study. HEI-2015 components were calculated from 24-hour dietary recall data. Mediterranean diet adherence was assessed using the MEDAS tool. Body mass index (BMI), waist-to-height, waist-to-hip ratio, body shape index (ABSI), and body roundness index (BRI) were calculated. Pearson correlation coefficients between diet quality and obesity were given. Cohen Kappa test was applied to show agreement between HEI-2015 and MEDAS.
Results: Mean BMI, HEI-2015, and MEDAS scores were 25.35±5.21 kg/m2, 49.34±12.96, and 7.45±2.17, respectively. MEDAS were negatively related to BMI (r=-0.120, p<0.05), waist-to-height ratio (r=-0.137, p<0.01), and BRI (p=-0.130, p<0.05) after adjusting for age, gender, education level, marital status, and smoking status. There was no association between HEI-2015 scores and obesity indices (p>0.05). Cohen Kappa test showed a slight agreement between the binarized MEDAS score and HEI-2015 scores (κ=0.126, p<0.05).
Conclusions: A slight agreement was found between HEI-2015 and MEDAS. Only MEDAS was related to obesity in this study. Future research should aim to replicate these findings in well-controlled studies.

Anahtar Kelimeler

Diet quality, healthy eating index 2015, Mediterranean diet, obesity

Proje Numarası

N/A

Kaynakça

• Afshin A, Sur PJ, Fay KA, et al. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2019;393(10184):1958-1972.
• Cowan AE, Jun S, Tooze JA, et al. A narrative review of nutrient based indexes to assess diet quality and the proposed total nutrient index that reflects total dietary exposures. Crit Rev Food Sci Nutr. 2023;63(12):1722-1732
• Jannasch F, Nickel D, Schulze MB. The reliability and relative validity of predefined dietary patterns were higher than that of exploratory dietary patterns in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam population. Br J Nutr. 2021;125(11):1270-1280.
• Marendic M, Polic N, Matek H, Orsulic L, Polasek O, Kolcic I. Mediterranean diet assessment challenges: Validation of the Croatian Version of the 14-item Mediterranean Diet Serving Score (MDSS) Questionnaire. PLoS One. 2021;16(3):e0247269. doi:10.1371/journal.pone.0247269
• Petersen KS, Kris-Etherton PM. Diet Quality Assessment and the Relationship between Diet Quality and Cardiovascular Disease Risk. Nutrients. 2021;13(12):4305. doi:10.3390/nu13124305
• Patel YR, Robbins JM, Gaziano JM, Djousse L. Mediterranean, DASH, and Alternate Healthy Eating Index Dietary Patterns and Risk of Death in the Physicians' Health Study. Nutrients. 2021;13(6):1893. doi:10.3390/nu13061893
• Sanchez-Sanchez ML, Garcia-Vigara A, Hidalgo-Mora JJ, Garcia-Perez MA, Tarin J, Cano A. Mediterranean diet and health: A systematic review of epidemiological studies and intervention trials. Maturitas. 2020;136:25-37.
• Morze J, Danielewicz A, Hoffmann G, Schwingshackl L. Diet Quality as Assessed by the Healthy Eating Index, Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension Score, and Health Outcomes: A Second Update of a Systematic Review and Meta-Analysis of Cohort Studies. J Acad Nutr Diet. 2020;120(12):1998-2031.
• Zappala G, Buscemi S, Mule S, et al. High adherence to Mediterranean diet, but not individual foods or nutrients, is associated with lower likelihood of being obese in a Mediterranean cohort. Eat Weight Disord. 2018;23(5):605-614.
• Koksal E, Karacil Ermumcu MS, Mortas H. Description of the healthy eating indices-based diet quality in Turkish adults: a cross-sectional study. Environ Health Prev Med. 2017;22(1):12. doi:10.1186/s12199-017-0613-z
• Helvaci G, Kartal FT, Ayhan NY. Healthy Eating Index (HEI-2015) of Female College Students According to Obesity and Exercise Participation. J Obes Metab Syndr. 2021;30(3):296-303.
• Alkerwi A. Diet quality concept. Nutrition. 2014;30(6):613-618. Krebs-Smith SM, Pannucci TE, Subar AF, et al. Update of the Healthy Eating Index: HEI-2015. J Acad Nutr Diet. 2018;118(9):1591-1602.
• Krebs-Smith SM, Pannucci TE, Subar AF, et al. Update of the Healthy Eating Index: HEI-2015. J Acad Nutr Diet. 2018;118(9):1591-1602.
• Martinez-Gonzalez MA, Garcia-Arellano A, Toledo E, et al. A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial. PLoS One. 2012;7(8):e43134. doi:10.1371/journal.pone.0043134
• Schröder H, Fitó M, Estruch R, et al. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. The Journal of nutrition. 2011;141(6):1140-1145.
• Pehlivanoğlu EFÖ, Balcıoğlu H, Ünlüoğlu İ. Turkish Validation and Reliability of Mediterranean Diet Adherence Screener. Osmangazi Journal of Medicine. 2020;42(2):160-164.
• Krakauer NY, Krakauer JC. A new body shape index predicts mortality hazard independently of body mass index. PLoS One. 2012;7(7):e39504. doi:10.1371/journal.pone.0039504
• Thomas DM, Bredlau C, Bosy-Westphal A, et al. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity (Silver Spring). 2013;21(11):2264-2271.
• Zagarins SE, Ronnenberg AG, Bertone-Johnson ER. Established diet quality indices are not universally associated with body composition in young adult women. Public Health Nutr. 2021;24(9):2465-2472.
• Kadam I, Neupane S, Wei J, et al. A Systematic Review of Diet Quality Index and Obesity among Chinese Adults. Nutrients. 2021;13(10). doi: 10.3390/nu13103555
• Dinu M, Pagliai G, Lotti S, Giangrandi I, Colombini B, Sofi F. Adherence to Mediterranean Diet Measured through Medi-Lite Score and Obesity: A Retrospective Study. Nutrients. 2021;13(6):2007. doi:10.3390/nu13062007
• Seifu CN, Fahey PP, Hailemariam TG, Frost SA, Atlantis E. Dietary patterns associated with obesity outcomes in adults: an umbrella review of systematic reviews. Public Health Nutr. 2021;24(18):6390-6414.
• Asghari G, Mirmiran P, Yuzbashian E, Azizi F. A systematic review of diet quality indices in relation to obesity. Br J Nutr. 2017;117(8):1055-1065.
• Warensjo Lemming E, Byberg L, Wolk A, Michaelsson K. A comparison between two healthy diet scores, the modified Mediterranean diet score and the Healthy Nordic Food Index, in relation to all-cause and cause-specific mortality. Br J Nutr. 2018;119(7):836-846.
• Murakami K, Livingstone MBE, Fujiwara A, Sasaki S. Application of the Healthy Eating Index-2015 and the Nutrient-Rich Food Index 9.3 for assessing overall diet quality in the Japanese context: Different nutritional concerns from the US. PLoS One. 2020;15(1):e0228318. . doi: 10.1371/journal.pone.0228318
• Garcia-Conesa MT, Philippou E, Pafilas C, et al. Exploring the Validity of the 14-Item Mediterranean Diet Adherence Screener (MEDAS): A Cross-National Study in Seven European Countries around the Mediterranean Region. Nutrients. 2020;12(10):2960. doi: 10.3390/nu12102960
• Santos L. The impact of nutrition and lifestyle modification on health. Eur J Intern Med. 2022;97:18-25.
• Hutchins-Wiese HL, Bales CW, Porter Starr KN. Mediterranean diet scoring systems: understanding the evolution and applications for Mediterranean and non-Mediterranean countries. Br J Nutr. 2022;128(7):1371-1392.
• Kirkpatrick SI, Dodd KW, Potischman N, et al. Healthy Eating Index-2015 Scores Among Adults Based on Observed vs Recalled Dietary Intake. J Acad Nutr Diet. 2021;121(11):2233-2241.