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Physical Activity and Nutrition Survey and Evaluation for Public Health

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Sports Nutrition".

Deadline for manuscript submissions: closed (15 March 2023) | Viewed by 40046

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Special Issue Editors

Dr. Roberto Pippi

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Guest Editor

Healthy Lifestyle Institute, C.U.R.I.A.Mo. (Centro Universitario Ricerca Interdipartimentale Attività Motoria), Department of Medicine and Surgery, University of Perugia, 06126 Perugia, Italy
Interests: childhood obesity; health promotion; lifestyle; Mediterranean diet; obesity and diabetes prevention; physical activity; quality of life; wellbeing

Dr. Carmine Giuseppe Fanelli

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Guest Editor

Section of Endocrinology and Metabolism, Department of Medicine and Surgery, Perugia University School of Medicine, Via Gambuli 1, 06126 Perugia, Italy
Interests: health promotion; nutrition; physical activity; diabetes; metabolic disorders

Dr. Matteo Vandoni

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Guest Editor

Facoltà di Medicina, Università di Pavia, 27100 Pavia, Italy
Interests: physical activity; exercise; obesity; diabetes; functional evaluation; motor competence
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Physical activity and nutrition are two of the most important modifiable lifestyle factors that affect health status, both in healthy people and in special populations with metabolic disorders and non-communicable diseases (e.g., obesity and type 2 diabetes (DM2)). Their assessment is mandatory to properly implement healthy lifestyle habits and modifications (i.e., suggest a nutritional medical therapy, prescribe exercise programs or simply improve state of health).

The aim of this Special Issue is to improve the knowledge regarding physical activity and human nutrition aspects, with an emphasis on (but not limited to) assessment and evaluation for public health, in healthy people, athletes and in both general and pathological populations, during the entire lifespan.

We are pleased to invite you to submit a contribution in the form of an original research article or narrative or systematic review. Research areas may include (but are not limited to) the following:

Physical activity;
Exercise testing and evaluation;
Nutrition survey;
Lifestyle assessment;
Body composition evaluation;
Health and non-communicable diseases.

We look forward to receiving your contributions.

Dr. Roberto Pippi
Dr. Carmine Giuseppe Fanelli
Dr. Matteo Vandoni
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

physical activity
exercise testing and evaluation
nutrition survey
evaluation
lifestyle assessment
body composition evaluation
health and non-communicable diseases

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Published Papers (13 papers)

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Editorial

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4 pages, 207 KiB

Open AccessEditorial

Physical Activity and Nutrition Survey and Evaluation for Public Health

by Roberto Pippi, Matteo Vandoni and Carmine Giuseppe Fanelli

Nutrients 2023, 15(19), 4139; https://doi.org/10.3390/nu15194139 - 25 Sep 2023

Viewed by 1650

Abstract

Regular physical activity (PA) and healthy nutrition are effective strategies to improve crucial modifiable lifestyle factors that affect health status, both in healthy people and in special populations suffering from metabolic disorders [...] Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

Research

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11 pages, 1099 KiB

Open AccessArticle

Physical Activity, Sun Exposure, Vitamin D Intake and Perceived Stress in Italian Adults

by Bruno Trovato, Justyna Godos, Simone Varrasi, Federico Roggio, Sabrina Castellano and Giuseppe Musumeci

Nutrients 2023, 15(10), 2301; https://doi.org/10.3390/nu15102301 - 13 May 2023

Cited by 4 | Viewed by 3414

Abstract

The last decades of global development have, due to rapid urbanization, pressuring entire populations to changes in lifestyle and dietary habits, led to an increase in the prevalence of mental disorders, including stress. This study explored how lifestyle and dietary factors, such as physical activity, sun exposure, and vitamin D intake are related to perceived stress in a Mediterranean-based population. Physical activity level was evaluated using the international physical activity questionnaires (IPAQ), sun exposure was evaluated using the sunlight exposure measurement questionnaire (SEM-Q), and validated food frequency questionnaires (FFQs) were used to assess dietary intakes. The perceived stress of the study participants was evaluated using the perceived stress scale (PSS). Multivariate logistic regression models were used to test for potential associations. In the most adjusted model, an inverse association between physical activity level, sunlight exposure, vitamin D intake, and high perceived stress was found (OR = 0.72, 95% CI: 0.51, 1.00, OR = 0.72, 95% CI: 0.52, 0.99, OR = 0.69, 95% CI: 0.53, 0.89, respectively). However, when stratifying the population by level of physical activity, the retrieved associations with sunlight exposure and dietary vitamin D intake were significant only among those individuals reporting being moderately to highly physically active (OR = 0.16, 95% CI: 0.08, 0.33 and OR = 0.46, 95% CI: 0.28, 0.76, respectively), while results on low physically active participants were null. In conclusion, this study demonstrated that higher dietary intake of vitamin D and sunlight exposure are associated with a lower likelihood of having high perceived stress among physically active individuals. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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10 pages, 672 KiB

Open AccessArticle

Bioimpedance Patterns and Bioelectrical Impedance Vector Analysis (BIVA) of Body Builders

by Cristian Petri, Matteo Levi Micheli, Pascal Izzicupo, Niccolò Timperanza, Tommaso Lastrucci, Daniele Vanni, Massimo Gulisano and Gabriele Mascherini

Nutrients 2023, 15(7), 1606; https://doi.org/10.3390/nu15071606 - 25 Mar 2023

Cited by 6 | Viewed by 2423

Abstract

Bodybuilders are athletes characterized by high muscle mass. During competitions, the evaluation is performed based on aesthetic parameters. The study aims to provide normative references of body composition with the vector bioimpedance methodology (BIVA). A second aim is to compare BIVA assessments performed on both sides and the upper and lower body. A group of 68 elite bodybuilders (41 males aged 30.1 ± 9.2 years and 27 females aged 32.1 ± 8.0 years) was enrolled. A BIVA assessment was performed the day before the 2021 World Natural Bodybuilding Federation Italian Championships. As a result, male and female bodybuilders ranked to the left in the BIVA ellipse relative to the general population. Furthermore, unlike females, males also ranked lower than the general athletic population. In addition, in the symmetry assessment, males show a significantly greater upper body than the lower, right, and left parts, while in women, this is observed for the lower part of the body. The differences in the results obtained between males and females can be attributed to the different patterns of endocrine production between the sexes and the different criteria used by the juries to attribute the final score during the competitions. Therefore, BIVA references in bodybuilders could help adjust the training and nutritional program during the peak week before a competition. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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18 pages, 1645 KiB

Open AccessArticle

Effects of Endurance Exercise Intensities on Autonomic and Metabolic Controls in Children with Obesity: A Feasibility Study Employing Online Exercise Training

by Valeria Calcaterra, Giuseppina Bernardelli, Mara Malacarne, Matteo Vandoni, Savina Mannarino, Vittoria Carnevale Pellino, Cristiana Larizza, Massimo Pagani, Gianvincenzo Zuccotti and Daniela Lucini

Nutrients 2023, 15(4), 1054; https://doi.org/10.3390/nu15041054 - 20 Feb 2023

Cited by 2 | Viewed by 2556

Abstract

Exercise is one of the major determinants of a healthy lifestyle, which is particularly important in childhood and serves as a powerful preventive tool. On the other hand, obesity and arterial hypertension rates are increasing in children, representing a huge risk for developing major cardiovascular and metabolic diseases in adult life. Of fundamental importance is the modality and volume of exercise required to obtain benefits. In this feasibility study, we considered a group of obese children, studied before and after a 12-week online exercise training program, and subdivided the participants into two groups considering the volume of exercise performed (above or below 1200 MET·min/week). This threshold level was applied in two different ways: subdivision A considered the total weekly physical activity volume (considering both time spent walking for at least 10 min consecutively and time spent performing structured exercise) and subdivision B considered only the weekly volume of structured exercise. We assessed autonomic and metabolic control and auxological and lifestyle parameters. We observed that the improved volume of structured exercise was associated with reduced arterial pressure percentile only in subdivision B and an improvement in markers of vagal and metabolic control was evident. Moreover, the 12-week online exercise training program, defined considering individual fitness level and progressively adapted as the goal was reached, proved to be sustainable from an economical and organizational point of view. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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14 pages, 784 KiB

Open AccessArticle

The Influence of Nutrition and Physical Activity on Exercise Performance after Mild COVID-19 Infection in Endurance Athletes-CESAR Study

by Daniel Śliż, Szczepan Wiecha, Jakub S. Gąsior, Przemysław Seweryn Kasiak, Katarzyna Ulaszewska, Marek Postuła, Łukasz A. Małek and Artur Mamcarz

Nutrients 2022, 14(24), 5381; https://doi.org/10.3390/nu14245381 - 18 Dec 2022

Cited by 8 | Viewed by 4241

Abstract

COVID-19 and imposed restrictions are linked with numerous health consequences, especially among endurance athletes (EA). Unfavorable changes in physical activity and nutrition may affect later sports and competition performance. The aims of this study were: (1) to assess the impact of COVID-19 infection and pandemic restrictions on the nutrition and physical activity of EAs and (2) to compare them with the results of cardiopulmonary exercise testing (CPET). In total, 49 EAs (n_male = 43, n_female = 6, mean age = 39.9 ± 7.8 year., height = 178.4 ± 6.8 cm, weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m⁻²) underwent pre- and post-COVID-19 CPET and fulfilled the dietary and physical activity survey. COVID-19 infection significantly deteriorated CPET performance. There was a reduction in oxygen uptake and in heart rate post-COVID-19 (both p < 0.001). Consuming processed meat and replacing meat with plant-based protein affected blood lactate concentration (p = 0.035). Fat-free mass was linked with consuming unsaturated fatty acids (p = 0.031). Adding salt to meals influenced maximal speed/power (p = 0.024) and breathing frequency (p = 0.033). Dietary and Fitness Practitioners and Medical Professionals should be aware of possible COVID-19 infection and pandemic consequences among EA. The results of this study are a helpful guideline to properly adjust the treatment, nutrition, and training of EA. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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10 pages, 406 KiB

Open AccessArticle

Supervised Exercise in Water: Is It a Viable Alternative in Overweight/Obese People with or without Type 2 Diabetes? A Pilot Study

by Roberto Pippi, Matteo Vandoni, Matteo Tortorella, Vittorio Bini and Carmine Giuseppe Fanelli

Nutrients 2022, 14(23), 4963; https://doi.org/10.3390/nu14234963 - 23 Nov 2022

Cited by 1 | Viewed by 2276

Abstract

The study of the effects of a water-based exercise program in overweight/obese people with or without type 2 diabetes is a topic of relatively recent interest. This type of exercise presents some advantages in reducing the risk of injury or trauma, and it can be a valuable therapeutic card to play for sedentary or physically inactive patients who have chronic metabolic diseases. This work aims to make a contribution showing the effects of a water-based exercise intervention, supervised by graduates in sports sciences, in a group of overweight/obese people with or without type 2 diabetes. In total, 93 adults (age 60.59 ± 10.44 years), including 72 women (age 60.19 ± 10.97 years) and 21 men (age 61.95 ± 8.48 years), were recruited to follow a water-based exercise program (2 sessions/week, for 12 weeks) at the C.U.R.I.A.Mo. Healthy Lifestyle Institute of Perugia University. Results showed an improvement in body mass index (−0.90 ± 1.56, p = 0.001), waist circumference (−4.32 ± 6.03, p < 0.001), and systolic (−7.78 ± 13.37, p = 0.001) and diastolic (−6.30 ± 10.91, p = 0.001) blood pressure. The supervised water-based intervention was useful in managing patients with metabolic diseases who often present with other health impairments, such as musculoskeletal problems or cardiovascular or rheumatic disease that could contraindicate gym-based exercise. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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12 pages, 759 KiB

Open AccessArticle

Physical Activity, Dietary Behavior, and Body Weight Changes during the COVID-19 Nationwide Level 3 Alert in Taiwan: Results of a Taiwanese Online Survey

by Hao-Ting Ke, Chi-Lin Hsieh and Wei-Jen Cheng

Nutrients 2022, 14(22), 4941; https://doi.org/10.3390/nu14224941 - 21 Nov 2022

Cited by 5 | Viewed by 2173

Abstract

This cross-sectional study aimed to explore the influence of the COVID-19 pandemic on physical activity (PA) and dietary habits, and their impact on body weight changes during the Level 3 alert period that resulted in the lockdown in Taiwan. The study was conducted between 1 July 2021 and 15 July 2021, using a Google Forms online survey platform. Personal data, anthropometric information, PA information, and dietary habit information were collected before and during the alert period. Exactly 374 respondents, aged between 20 and 66, were included in the study. The results indicate that the lockdown during the alert period negatively impacted all levels of PA, including vigorous and moderate activities and walking. Additionally, respondents showed a sedentary lifestyle, with an increased daily sitting time of 22%. However, body weight and dietary behavior were not significantly affected, and some dietary questions achieved significant differences, including eating three meals less regularly, among others. During the pandemic, exercise was still one of the most important ways to maintain health; therefore, we hope to bring more attention to the prevention of sedentary lifestyles and dietary abnormalities in Taiwan during a pandemic. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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10 pages, 622 KiB

Open AccessArticle

Acute Responses to Resistance Training on Body Composition, Muscular Fitness and Flexibility by Sex and Age in Healthy War Veterans Aged 50–80 Years

by Mario Kasović, Lovro Štefan and Zvonimir Kalčik

Nutrients 2022, 14(16), 3436; https://doi.org/10.3390/nu14163436 - 21 Aug 2022

Cited by 5 | Viewed by 2368

Abstract

Background: Although evidence suggests that resistance training should be prescribed as a method to enhance or maintain physical fitness, these findings are mostly based on research on younger men. Studies investigating responses by sex and age to resistance training, especially in war veterans aged ≥50 years, are lacking. Therefore, the main purpose of this study was to examine whether a 4-week resistance training program would have similar effects on body composition, muscular fitness, and flexibility in men and women aged 50–80 years. Methods: Seven-hundred and sixty-four participants were recruited and categorized into two groups each of men and women aged 50–64 and 65–80 years. The training intervention lasted 4 weeks and consisted of three 60 min sessions per week. All participants were tested for each of the following physical fitness components: body composition, push-ups in 30 s, chair-stands in 30 s, sit-ups in 30 s, and a sit-and-reach test. Results: Over the intervention period of 4 weeks, body weight (p = 0.002) and the percent of fat mass (p < 0.001) decreased, while the percent of lean mass (p < 0.001) in push-ups in 30 s (p < 0.001), chair-stands in 30 s (p < 0.001), sit-ups in 30 s (p < 0.001), and sit-and-reach (p < 0.001) increased. Significant time*age interactions were shown for push-ups in 30 s (F_1,763 = 4.348, p = 0.038) and chair-stands in 30 s (F_1,763 = 9.552, p = 0.002), where men and women aged 50–64 years exhibited larger time-induced changes compared to their older (65–80 yr) counterparts. Effect sizes were similar between sex- and age-specific groups. Conclusions: The 4-week resistance training produced similar pronounced positive effects on body composition, muscular fitness, and flexibility, while men and women aged 50–64 years displayed significantly larger improvements in upper and lower muscular fitness compared with their 65–80-year-old counterparts. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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15 pages, 1269 KiB

Open AccessArticle

Prevalence of Orthorexia in Groups of Students with Varied Diets and Physical Activity (Silesia, Poland)

by Mateusz Grajek, Karolina Krupa-Kotara, Krzysztof Sas-Nowosielski, Ewa Misterska and Joanna Kobza

Nutrients 2022, 14(14), 2816; https://doi.org/10.3390/nu14142816 - 8 Jul 2022

Cited by 8 | Viewed by 3047

Abstract

(1) Background: The literature emphasizes the role of many factors influencing the onset of eating disorders (EDs) and their mutual influence on each other. Therefore, this study aimed to evaluate and compare the prevalence of orthorexic behaviors in groups of health-related and non-health-related students in terms of their differential health behaviors—diet and physical activity levels. (2) The study included 300 individuals representing two equal groups of fields of study, which for the study were called the health-related field (HRF) and the non-health-related field (NRF). (3) Results: Based on the results of the dietary assessment, it was found that the best dietary model was characterized by the HRF group; in this group, 97.2% of students were characterized by a very good and good dietary mode. The NRF group, on the other hand, was dominated by a sufficient dietary mode for 64.4% of all cases in this group (94 people), while the dietary model marked as “good” was less popular, at 24.6% of this group (36 people). (4) Conclusions: Based on the cited self-research and information from the literature, it can be concluded that the problem of orthorexia is still a new issue at the level of social sciences, medical sciences, and health sciences. The psychometric tools used in this study allowed us to demonstrate the prevalence of the aforementioned eating disorders in the sample groups of students. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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23 pages, 995 KiB

Open AccessArticle

Weekend–Weekday Differences in Adherence to the Mediterranean Diet among Spanish University Students

by Luis M. Béjar

Nutrients 2022, 14(14), 2811; https://doi.org/10.3390/nu14142811 - 8 Jul 2022

Cited by 6 | Viewed by 2207

Abstract

Daily routines may influence eating patterns; however, differences in intake on weekdays and at weekends have rarely been explored. Furthermore, these differences have not been analyzed among university students (a particularly interesting group among the younger generations). The aim of the study was to evaluate weekend–weekday variation in the Mediterranean diet among Spanish university students, while investigating the potential influence of age, gender, studies, body mass index, smoking status and physical activity status. A repeated-measurement 28-day cross-sectional observational study with self-reported dietary intake collected using the e12HR app was conducted. There were 361 participants: average age 20.6 years; 72.9% women; 58.2% students of Pharmacy; average BMI 21.9 kg/m²; 91.4% nonsmokers; 77.6% performed ≥150 min/week of physical activity. Outcome measurements were adherence to the Mediterranean diet (AMD) index and percentage of participants meeting recommendations for each food group on weekdays and at weekends. In all subgroups, Spanish university students’ global diet was associated with low AMD, with poorer diet quality (>12% reductions in mean scores of AMD index and >26% reductions in adequate adherence scores (≥9)) at weekends. In conclusion, weekend health behaviors of Spanish university students displayed less favorable eating behavior, making the weekend an important target for public health interventions aiming to improve dietary intake. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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Review

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20 pages, 622 KiB

Open AccessEditor’s ChoiceReview

The Effectiveness of Wearable Devices in Non-Communicable Diseases to Manage Physical Activity and Nutrition: Where We Are?

by Valentina Natalucci, Federica Marmondi, Michele Biraghi and Matteo Bonato

Nutrients 2023, 15(4), 913; https://doi.org/10.3390/nu15040913 - 11 Feb 2023

Cited by 17 | Viewed by 5890

Abstract

Wearable devices are increasingly popular in clinical and non-clinical populations as a tool for exercise prescription, monitoring of daily physical activity and nutrition, and health-related parameters management. In this regard, smart devices not only assist people in pursuing a healthier lifestyle, but also provide a constant stream of physiological and metabolic data for management of non-communicable diseases (NCDs). Although the benefits of lifestyle-based interventions (exercise and nutrition) for NCDs are well known, the potential of wearable devices to promote healthy behaviors in clinical populations is still controversial. In this narrative review, we aimed to discuss the current application of wearable devices in NCDs, highlighting their role in prescribing and monitoring daily physical activity and dietary habits in the population living with chronic diseases. None of the studies considered specifically addressed the efficacy of the use of wearable devices, and limited are those that incorporate monitoring of both physical activity and nutrition for NCDs. However, there is evidence that such devices have helped improve physical activity levels, physical fitness, body composition, and metabolic and psychological parameters. Therefore, the authors believe that the benefits obtained from the use of wearable devices are likely to translate to public health and represent one of the important tools for the development of prevention plans in everyday life and clinical practice for optimal patient management. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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Other

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15 pages, 627 KiB

Open AccessSystematic Review

Unraveling Barriers to a Healthy Lifestyle: Understanding Barriers to Diet and Physical Activity in Patients with Chronic Non-Communicable Diseases

by Massimiliano Cavallo, Giovanni Morgana, Ivan Dozzani, Alessandro Gatti, Matteo Vandoni, Roberto Pippi, Giacomo Pucci, Gaetano Vaudo and Carmine Giuseppe Fanelli

Nutrients 2023, 15(15), 3473; https://doi.org/10.3390/nu15153473 - 5 Aug 2023

Cited by 5 | Viewed by 4175

Abstract

Although the important contribution of nutrition and physical activity to people’s health is known, it is equally well known that there are many barriers to adherence to healthy habits (i.e., of an organizational, economic, and/or psychological nature) experienced by the general population, as well as by people with non-communicable diseases. Knowledge of these barriers seems essential to the implementation of the activities and strategies needed to overcome them. Here, we aim to highlight the most frequent barriers to nutrition and exercise improvement that patients with chronic-degenerative diseases experience. Drawing from the Pubmed database, our analysis includes quantitative or mixed descriptive studies published within the last 10 years, involving adult participants with non-communicable diseases. Barriers of an organizational nature, as well as those of an environmental, economic, or psychological nature, are reported. The study of patients’ barriers enables healthcare and non-health professionals, stakeholders, and policymakers to propose truly effective solutions that can help both the general population and those with chronic pathologies to adhere to a healthy lifestyle. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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28 pages, 1053 KiB

Open AccessSystematic Review

Assessment Strategies to Evaluate the Mediterranean Lifestyle: A Systematic Review

by Elisabet Montero-Sandiego, Rosario Ferrer-Cascales, Nicolás Ruiz-Robledillo, Borja Costa-López, Cristian Alcocer-Bruno and Natalia Albaladejo-Blázquez

Nutrients 2022, 14(19), 4179; https://doi.org/10.3390/nu14194179 - 8 Oct 2022

Cited by 7 | Viewed by 2220

Abstract

The Mediterranean Lifestyle (MLS) has been related to better health and quality of life. However, there is no consensus on how to assess this lifestyle. The main objective of this work was to systematically review the methodology used in different studies on the evaluation of the MLS. The specific objectives were (1) to analyze the MLS components evaluated in previous studies, (2) to explore the assessment instruments available for the analysis of the MLS, and (3) to identify the psychometric properties of these instruments. The search was carried out using the PubMed, Scopus, Web of Science, and ScienceDirect databases with the purpose of identifying those published articles in which the MLS was assessed. The review included 26 studies linked to the assessment of the MLS. Of these studies, only four exclusively used a tool to analyze MLS components globally. These studies included two questionnaires and three different indexes. None of them, however, evaluated all of the recognized MLS components, and food preparation was the least frequently evaluated component. Given the clear importance of analyzing MLS adherence and the lack of consensus in previous research, an evaluation tool needs to be created to comprehensively assess all of the MLS dimensions by means of appropriate psychometric properties. Full article

(This article belongs to the Special Issue Physical Activity and Nutrition Survey and Evaluation for Public Health)

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