Response to: Measuring adherence to the Mediterranean diet (Kleiman SC); Median-centered dietary indices do not accurately classify exposure to the Mediterranean diet (Smith LP); Adherence to the Mediterranean diet and quality of life in the SUN Project (Kepler S)

摘要

We send one common response letter to the three authors because the contents of the comments are similar and all of them come from the Department of Nutrition, Gillings School of Global Public Health.We agree with the letters of the three authors in the possibility of misclassification due to the fact that most people consume very near to the median for each of the Mediterranean diet food group. It is something very well described in the field of Nutrition Epidemiology.1 We have to assume this fact that it is common to every method of classification. However, the aim of the study was to analyze the role of an overall dietary pattern and not of a specific food item. Hence, it is necessary to calculate a score (with its specific limitations) that measures the adherence. To solve this problem, we used categories of adherence as the main exposure (categories of Mediterranean dietary score).