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However, validated tools adapted to assess adherence to the MD during pregnancy and across different cultural contexts remain limited. This study aimed to translate, cross-culturally adapt, and validate an Italian version of the pregnancy-adapted Mediterranean Diet Adherence Screener (ITpreg-MEDAS), derived from the original Spanish preg-MEDAS questionnaire. We hypothesized that the ITpreg-MEDAS would show adequate construct validity and would be associated with markers of diet quality during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The preg-MEDAS is a 17-item questionnaire designed to assess adherence to the MD among pregnant women. The Italian version was developed following a six steps process in accordance with established methodological guidelines: forward translation, synthesis I, blind-back translation, synthesis II, pre-testing, and validation. Psychometric properties were evaluated by assessing internal consistency, test-retest reliability, and construct validity, in a sample of Italian pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The preg-MEDAS was translated and cross-cultural adapted, requiring some semantic revisions. All 25 Italian pregnant women involved in the pre-testing in pre-testing found it clear and comprehensible. A total of 116 Italian pregnant women participated in the validation phase, with a mean ITpreg-MEDAS score of 7.2\u2009\u00b1\u20092.5 out of 17, indicating medium adherence to the MD. Reliability was confirmed by good test-retest correlation (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.756) and acceptable internal consistency (Cronbach\u2019s \u03b1\u2009=\u20090.623).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The ITpreg-MEDAS is a reliable and valid Italian version of the preg-MEDAS questionnaire, providing a simple tool to assess adherence to the Mediterranean Diet during pregnancy in both clinical practice and research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00394-026-04087-4","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T12:25:56Z","timestamp":1788006356000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation and cultural adaptation of the pregnancy-adapted Mediterranean Diet Adherence Screener (ITpreg-MEDAS) in Italian pregnant women"],"prefix":"10.1007","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2094-7459","authenticated-orcid":false,"given":"Silvia","family":"Callegaro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5372-8658","authenticated-orcid":false,"given":"Francesca","family":"Scazzina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2150-2977","authenticated-orcid":false,"given":"Pedro","family":"Mena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine Tita","family":"Kaihura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7201-0206","authenticated-orcid":false,"given":"Andrea","family":"Dall\u2019Asta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1260-4445","authenticated-orcid":false,"given":"Ramon","family":"Estruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Casas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8533-797X","authenticated-orcid":false,"given":"Alice","family":"Rosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,29]]},"reference":[{"issue":"12","key":"4087_CR1","doi-asserted-by":"publisher","first-page":"2891","DOI":"10.3390\/nu11122891","volume":"11","author":"K Beluska-Turkan","year":"2019","unstructured":"Beluska-Turkan K, Korczak R, Hartell B, Moskal K, Maukonen J, Alexander DE, Salem N, Harkness L, Ayad W, Szaro J, Zhang K, Siriwardhana N (2019) Nutritional gaps and supplementation in the first 1000 days. 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