Evaluation of a dietary screener: the Mediterranean Eating Pattern for Americans tool

J Hum Nutr Diet. 2017 Oct;30(5):596-603. doi: 10.1111/jhn.12451. Epub 2017 Feb 7.


Background: Evidence exists for an association between accordance with a Mediterranean diet pattern and slower rates of cognitive decline. However, an 'Americanised' version of the Mediterranean diet screener is needed to assess accordance in the USA. Thus, the Mediterranean Eating Pattern for Americans (MEPA) tool was developed to assess accordance with a Mediterranean-like food pattern when time is limited. The present study aimed to determine whether the MEPA screener captured the key elements of the Mediterranean diet compared to the more comprehensive food frequency questionnaire (FFQ).

Methods: The study comprised a cross-sectional study in which 70 women completed both the VioScreen™ FFQ (Viocare, Princeton, NJ, USA) electronically and the 16-item MEPA screener, either electronically or by telephone, aiming to evaluate the inter-method reliability of the proposed screener. The convenience sample included patients (n = 49) and healthcare providers (n = 21) recruited from a tertiary care medical centre.

Results: The overall score from the MEPA screener correlated with corresponding overall MEPA FFQ score (ρ = 0.365, P = 0.002). Agreement between screener items and FFQ items was moderate-to-good for berries (κ = 0.47, P < 0.001), nuts (κ = 0.42, P < 0.001), fish (κ = 0.62, P < 0.001) and alcohol (κ = 0.64, P < 0.001), whereas those for olive oil (κ = 0.33, P = 0.001) and green leafy vegetables (κ = 0.36, P = 0.0021) were fair. Usual intakes of potassium, magnesium, vitamin C, saturated fat, selected carotenoids, folate and fibre derived from the FFQ varied with MEPA screener scores in the anticipated directions.

Conclusions: The MEPA screener captures several components of the Mediterranean style pattern, although further testing of the MEPA screener is indicated.

Keywords: concordance; dietary assessment; eating patterns.

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Cross-Sectional Studies
  • Diet Surveys*
  • Diet, Healthy
  • Diet, Mediterranean*
  • Diet, Western
  • Female
  • Humans
  • Middle Aged
  • Nutrition Assessment*
  • Reproducibility of Results
  • United States
  • Young Adult