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Reply

Reply to Alvarez Stehle, E. Comment on “Leone et al. Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity. Nutrients 2022, 14, 3771”

1
International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
2
Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 20145 Milan, Italy
3
Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
4
Internal Medicine Unit Addressed to Frailty and Aging, Department of Primary Health Care, S. Maria delle Croci Hospital, AUSL Romagna, 48121 Ravenna, Italy
5
Clinical Nutrition Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 20145 Milan, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2023, 15(5), 1140; https://doi.org/10.3390/nu15051140
Submission received: 6 December 2022 / Accepted: 16 February 2023 / Published: 24 February 2023
We thank Dr. Elvira Alvarez Stehle [1] for her interest in our work reporting the association between a Mediterranean diet and a fatty liver in women with overweight and obesity [2].
Although deviations from the original protocol were found in the PREDIMED trial, they do not affect the validation of the MEDAS questionnaire. Schröder et al. [3] did, in fact, validate MEDAS against a 137-item semiquantitative FFQ using baseline data from PREDIMED prior to randomization. Certainly, the validation of MEDAS against an FFQ has several limitations. As Schröder et al. stated in their work [3], the similar designs of FFQ and MEDAS may have caused an overestimation of the accuracy of MEDAS given the likely between-method correlation of the errors.
More recently, García-Conesa et al. [4] performed a validation study of MEDAS using small samples of subjects from different Mediterranean and non-Mediterranean countries. They compared the results obtained from MEDAS with those obtained from a 3 day dietary record. In addition to confirming the reliability of the MEDAS questionnaire, they found a good agreement between the two methods, with values similar to, and in some cases greater than, those reported by Schröder et al. [3]. They found low agreement between the two methods for some food items, but this could be due to the difficulty of quantifying a weekly consumption using a 3 day dietary record. This limitation can be overcome by using multiple 7 day dietary records.
We thus believe that the MEDAS questionnaire remains a useful and reliable tool for rapidly assessing adherence to the Mediterranean diet.

Author Contributions

Writing—original draft preparation, A.L., G.B. and A.B.; S.B., L.V. and M.P. agreed this reply. All authors have read and agreed to the published version of the manuscript.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Alvarez Stehle, E. Comment on Leone et al. Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity. Nutrients 2022, 14, 3771. Nutrients 2023, 15, 1139. [Google Scholar] [CrossRef]
  2. Leone, A.; Bertoli, S.; Bedogni, G.; Vignati, L.; Pellizzari, M.; Battezzati, A. Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity. Nutrients 2022, 14, 3771. [Google Scholar] [CrossRef] [PubMed]
  3. Schröder, H.; Fitó, M.; Estruch, R.; Martínez-González, M.A.; Corella, D.; Salas-Salvadó, J.; Lamuela-Raventós, R.; Ros, E.; Salaverría, I.; Fiol, M.; et al. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J. Nutr. 2011, 141, 1140–1145. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  4. García-Conesa, M.T.; Philippou, E.; Pafilas, C.; Massaro, M.; Quarta, S.; Andrade, V.; Jorge, R.; Chervenkov, M.; Ivanova, T.; Dimitrova, D.; 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, 2960. [Google Scholar] [CrossRef] [PubMed]
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MDPI and ACS Style

Leone, A.; Bertoli, S.; Bedogni, G.; Vignati, L.; Pellizzari, M.; Battezzati, A. Reply to Alvarez Stehle, E. Comment on “Leone et al. Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity. Nutrients 2022, 14, 3771”. Nutrients 2023, 15, 1140. https://doi.org/10.3390/nu15051140

AMA Style

Leone A, Bertoli S, Bedogni G, Vignati L, Pellizzari M, Battezzati A. Reply to Alvarez Stehle, E. Comment on “Leone et al. Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity. Nutrients 2022, 14, 3771”. Nutrients. 2023; 15(5):1140. https://doi.org/10.3390/nu15051140

Chicago/Turabian Style

Leone, Alessandro, Simona Bertoli, Giorgio Bedogni, Laila Vignati, Marta Pellizzari, and Alberto Battezzati. 2023. "Reply to Alvarez Stehle, E. Comment on “Leone et al. Association between Mediterranean Diet and Fatty Liver in Women with Overweight and Obesity. Nutrients 2022, 14, 3771”" Nutrients 15, no. 5: 1140. https://doi.org/10.3390/nu15051140

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