Akdeniz Diyeti Kalite İndeksinin Türkçe Versiyonu (KIDMED)

Öz

Giriş: Bu çalışmanın amacı, çocuklar ve ergenlerde Akdeniz diyetine uyumu değerlendiren KIDMED'in Türkçe versiyonunun güvenirliğini ve KIDMED puanları ile antropometrik ölçümler arasındaki ilişkiyi araştırmaktır. Yöntem: Araştırma 2018 yılında İstanbul'da bir devlet ortaokulunda yürütülmüştür. İlk aşamada KIDMED Türkçeye çevrilmiş ve test-tekrar test yöntemi ile ölçeğin güvenilirliği araştırılmış, ardından tanımlayıcı ve kesitsel olarak antropometrik ölçümlerle KIDMED arasındaki ilişki değerlendirilmiştir. KIDMED'in Türkçe versiyonunun test-tekrar test güvenilirliğini değerlendirmek için başlangıçta ve iki hafta sonra 36 öğrenciye (18 E, 18 K; 11 ± 0,69 y.) uygulanarak "intraklas korelasyon katsayısı" ve "iç tutarlılık" hesaplanmıştır. Güvenirlik belirlendikten sonra indeks 504 öğrenciye (% 49,2 E; % 50,8 K; yaş ort: 11,66 ± 0,84) uygulanmış ve KIDMED skorları ile antropometrik ölçümler (BKİ ve bel çevresi) arasındaki ilişki değerlendirilmiştir. Bulgular: İki hafta arayla uygulanan KIDMED'in test-tekrar test puanları arasında istatistiksel olarak fark bulunmamıştır (5,6 ± 2,1; 5,8 ± 2,3 p = 0,6) ve sınıf içi korelasyon katsayısı 0,750 (p <0,001); Cronbach alfa katsayısı 0.857 olarak bulunmuştur. KIDMED skorları ile BKİ ve bel çevresi değerleri arasında zayıf, ama negatif bir korelasyon saptanmıştır (sırasıyla r = -0.117; p = 0.008; r = -0.112; p = 0.012). Sonuç: Bu araştırma, Türkçe KIDMED'in test-tekrar test güvenilirliğini araştıran ilk çalışmadır. Araştırmamız Türkçe KIDMED'in ergenlerde Akdeniz tarzı beslenmeyi değerlendirmek için güvenilir olduğunu düşündürmektedir.

Anahtar Kelimeler

• Obezite
• Adolesan sağlığı
• Okul sağlığı
• diyet
• yeme
• yeme alışkanlığı

Proje Numarası

SAG-C-TUP-070617-0347

The Turkish Version of the Mediterranean Diet Quality Index (KIDMED)

Öz

Introduction: The purpose of this study was to investigate the reliability of the Turkish version of the KIDMED, which assesses adherence to the Mediterranean diet among children and adolescents, and investigate the relationship between Turkish KIDMED scores and anthropometric measurements. Methods: This research was conducted in a public secondary school in Istanbul in 2018. In the first stage of the study, KIDMED was translated into Turkish and a test-retest method was used for reliability research. Then, the relationship between the anthropometric measurements of Turkish adolescents and KIDMED scores was evaluated in a descriptive and cross-sectional manner. In order to evaluate the test-retest reliability of the Turkish version of KIDMED, it was applied to 36 students (18 M, 18 K; mean age 11 ± 0.69 y) at the beginning and two weeks after and determined the "intraclass correlation coefficient" and "internal consistency". After determining the reliability, the index was applied to 504 students (49.2% M, 50.8% F; 11.66 ± 0.84 years of age) and the relationship between the KIDMED scores and the anthropometric measurements (BMI and waist circumference) was evaluated. Results: No statistical difference was found between the test-retest scores of KIDMED applied two weeks apart (5.6±2.1; 5.8±2.3 p=0.6) and the intraclass correlation coefficient was found to be 0.750 (p<0.001). Cronbach’s alpha coefficient was found to be 0.857. A weak but negative correlation was found between the KIDMED scores and BMI and waist circumference values (r=-0.117; p=0.008; r=-0.112; p=0.012, respectively). Conclusion: This is the first study investigating the test-retest reliability of the Turkish KIDMED. Turkish KIDMED can be used in Turkish adolescents to assess the Mediterranean style of eating.

Anahtar Kelimeler

• obesity
• adolescent health
• school health
• diet
• eating
• eating behavior

Destekleyen Kurum

Research Fund of the Marmara University

Proje Numarası

SAG-C-TUP-070617-0347

Teşekkür

The authors would like to thank to Emine Mizyal for her contributions to the English editing.

Kaynakça

1. 1. Currie C, Zanotti C, Morgan A, Currie D, Looze M, Roberts C, et al. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. World Regional Office for Europe, Copenhagen, 2010. Available from: https://www.euro.who.int/__data/assets/pdf_file/0003/163857/Social-determinants-of-health-and-well-being-among-young-people. pdf Accessed 05 September, 2019.
2. 2. Alper Z, Ercan İ, Uncu Y.A Meta-Analysis and an Evaluation of Trends in Obesity Prevalence among Children and Adolescents aged 5-19 in Turkey: 1990 through 2015. J Clin Res Pediatr Endocrinol. 2018;10(1):59- 67.
3. 3. Republic of Turkey Ministry of Health Public Health Institution Turkish Healthy Nutrition and Active Life Programme 2013-2017. Ministry of Health Publish No: 773, Ankara, 2017. Available from: http://dosyaism.saglik.gov.tr/Eklenti/8861,turkiye-saglikli-beslenme-ve-hareketli-hayat-programipdf.pdf? Accessed 05 September, 2019.
4. 4. Serra-Majem L, Ribas L, Ngo Ortega RM, García A, Pérez-Rodrigo C, Aranceta J. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutrition. 2004;7(7):931-935.
5. 5. Keys A. Mediterranean diet and public health: Personal reflections. Am J Clin Nutr. 1995;61(6 Supp):1321-3.
6. 6. Fidanza F, Alberti A, Lanti M, Menotti A. Mediterranean Adequacy Index: Correlation with 25-year mortality from coronary heart disease in the Seven Countries Study. Nutr Metabol Cardiovasc Dis. 2004;14(5):254-8.
7. 7. Fung TT, Rexrode KM, Mantzoros CS, Manson JE, Willett WC, Hu FB. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation. 2009;119(8):1093-100.
8. 8. Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB. The effect of mediterranean diet on metabolic syndrome and its components a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol. 2011;57(11): 1299-1313.

9. 9. Della Corte C, Mosca A, Vania A, Alterio A, Iasevoli S, Nobili V. Good adherence to the Mediterranean diet reduces the risk for NASH and diabetes in pediatric patients with obesity: The results of an Italian Study. Nutrition. 2017;39-40:8-14.
10. 10. Galan-Lopez P, Ries F, Gisladottir T, Domínguez R, Sánchez-Oliver AJ. Healthy Lifestyle: Relationship between Mediterranean Diet, Body Composition and Physical Fitness in 13 to 16-Years Old Icelandic Students. Int J Environ Res Public Health. 2018;15(2):2632.
11. 11. Bacopoulou F, Landis G, Rentoumis A, Tsitsika A, Efthymiou V. Mediterranean diet decreases adolescent waist circumference. Eur J Clin Invest. 2017;47(6):447-455.
12. 12. Costarelli V, Koretsi E, Georgitsogianni E. Health-related quality of life of Greek adolescents: the role of the Mediterranean diet. Qual Life Res. 2013;22(5):951-956.
13. 13. Schröder, H, Mendez MA, Ribas-Barba L, Covas MI, Serra-Majem L.Mediterranean diet and waist circumference in a representative national sample of young Spaniards, Int J Pediatr Obes. 2010;5(6):516-9.
14. 14. Kabaran S, Gezer C. Determination of the Mediterranean Diet and the Obesity Status of Children and Adolescents in Turkish Republic of Northern Cyprus. Turkish J Pediatr Dis. 2013;7(1):11-20.
15. 15. Erol E, Ersoy G, Pulur A, Özdemir G, Bektaş Y. Evaluation of the Mediterranean Diet Quality Index (KIDMED) in Adolescents in Turkey. International Journal of Human Sciences. 2010;7(1):647-664.
16. 16. Sahingoz SA, Sanlier N. Compliance with Mediterranean Diet Quality Index (KIDMED) and nutrition knowledge levels in adolescents. A case study from Turkey. Appetite. 2011;57(1):272-7.
17. 17. Cömert TK, Çerkez M, Tekin AG, Aydoğan N, Esşiz Ö. Compliance with Mediterranean Diet Quality Index (KIDMED) and Eating Patterns in School-age Children with Gaziantep, Turkey. American Journal of Food and Nutrition. 2015;3(1):28-33.
18. 18. Baydemir C, Ozgur EG, Balci S. Evaluation of adherence to Mediterranean diet in medical students at Kocaeli University, Turkey. J Int Med Res. 2018;46(4):1585-1594.
19. 19. Ercan I, Kan I. Reliability and Validity in The Scales. Journal of Uludağ University Medical Faculty. 2004;30(3):211-216.
20. 20. World Health Organisation. Waist Circumference and Waist-Hip Ratio Report of a WHO Expert Consultation, Geneva, 2008. Available from: https://www.who.int/nutrition/publications/obesity/WHO_report_waistcircumference_and_waisthip_ratio/en/Accessed 15 May, 2016.
21. 21. Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, Darendeliler F, et al. Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children. J Clin Res Pediatr Endocrinol. 2015;7(4):280–293.
22. 22. Hatipoglu N, Ozturk A, Mazicioglu MM, Kurtoglu S, Seyhan S, Lokoglu F.Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr. 2008;167(4):383–389.
23. 23. Garcia Cabrera S, Herrera Fernandez N, Rodriguez Hernandez C,N issensohn M, Román-Viñas B, Serra-Majem L. KIDMED test; prevalence of low adherence to the Mediterranean Diet in children and young; a systematic review. Nutr Hosp. 2015;32(6):2390-2399.
24. 24. Taşçı R, Karabak S, Bolat M, Acar O, Şanal T, Pehlivan A, et al. Consumer Preferences in Bread in Ankara. Journal of Field Crops Central Research Institute. 2017;26(1):75-85.
25. 25. Farajian P, Risvas G, Karasouli K, Pounis GD, Kastorini CM, Panagiotakos DB, et al. Very high childhood obesity prevalence and low adherence rates to the Mediterranean diet in Greek children: the GRECO study. Atherosclerosis. 2011;217(2):25-30.