Abstract:
The accurate assessment of dietary intake is a critical step in addressing the rising burden
of non-communicable diseases (NCDs), particularly in middle-income countries like
Lebanon undergoing rapid nutritional transition. This study aimed to evaluate the validity
and reproducibility of the culturally adapted Modified Mediterranean Prime Screen
(MMPS) tool in estimating macronutrient intake among adults in Lebanon.
Adults aged 18 to 64 years were recruited from two hospital sites in Beirut and Mount
Lebanon following a quota mimicking the characteristics of the Lebanese population.
Dietary intake was assessed through two administrations of the MMPS and the FFQ.
Reproducibility was tested using intraclass correlation coefficients (ICC) between
repeated administrations, while validity was assessed by comparing MMPS to FFQ using
ICCs and visual inspection of Bland-Altman plots. A total of 214 participants were recruited (mean age: 38.9 years; 65.4% female). The
MMPS demonstrated high reproducibility across most macronutrients, with adjusted
ICCs ranging from 0.306 for carbohydrates to 0.909 for polyunsaturated fatty acids
(PUFAs). Validity analysis showed moderate agreement with the reference FFQ, with the
highest adjusted ICCs observed for protein (0.512), total sugar (0.508), and energy
(0.487). However, the agreement for fatty acids was not statistically significant. Bland-
Altman analyses revealed modest mean differences but wide limits of agreement.
MMPS demonstrated strong reproducibility and acceptable validity for assessing
macronutrient intake in adults living in Lebanon. Its brevity and cultural specificity make it a promising tool for use in clinical and public health settings where time and resources
are limited.
