<p> <b>Objectives:</b> The purpose of this study was to assess the relationship between two Mediterranean diet indices and to evaluate the proportion of participants who were ranked into identical tertiles of accordance with the Alternate Mediterranean Diet (aMed) and MedDietScore (MDS) tools when applied to an American samples.</p><p> <b>Methods:</b> In this secondary analysis, participants from four samples were pooled into two groups &ndash; one in which respondents completed the web-based VioScreen&trade; (n=200) food frequency questionnaire (FFQ) and the second, those who completed a paper-based Brief Block 2000 FFQ (n=827). Mediterranean diet scores were calculated based on the sex-specific median intakes of nine aMed components as well as meeting target frequency per week of the MDS components. Participants were categorized into a <i>priori </i> tertiles for each score.</p><p> <b>Results:</b> Scores for aMed and MDS were moderately correlated in the VioScreen&trade; (rho= 0.546, p&lt;0.001) and Brief Block (rho=0.627, p&lt;0.001) samples. The greatest proportion of participants was classified into Tertile 2 for VioScreen&trade; each scoring paradigm (40% for aMed and 71% for MDS). In the Brief Block sample, 47% of participants were assigned to Tertile 1 for aMed and for MDS 52% into Tertile 2. Only 47% of VioScreen&trade; and 60.3% of Brief Block participants were ranked into identical tertiles for aMed and MDS. Classification agreement between aMed and MDS was fair for VioScreen&trade; (weighted &kgr; = 0.223, p&lt;0.001) and Brief Block samples (weighted &kgr; = 0.384, p&lt;0.001).</p><p> <b>Conclusions:</b> Agreement between aMed and MDS was no more than fair for either FFQ, indicating that the scoring paradigms are not interchangeable in measuring accordance to the Mediterranean diet. Further investigation into the effects of FFQ selection on aMed and MDS scoring in addition to factor analysis of the variability between aMed and MDS is warranted in American samples.</p><p>

Premenstrual syndrome (PMS) is characterized by the presence of physical and psychological symptoms restricted to the late luteal phase of the menstrual cycle and associated with substantial impairment in life activities. In the U.S. about 8 to 15% of women of reproductive age suffer from PMS. Many micronutrients are potentially involved in the development of this disorder due to their role in the synthesis of neurotransmitters and hormones or in their regulation, but few previous studies have evaluated the effects of micronutrients on PMS. The first study examined the association between B vitamin intakes, and PMS development among women participating in the Nurses' Health Study 2 (NHS2). We found that high thiamin and high riboflavin intake from food sources were associated with lower risk of PMS. There were not significant associations between niacin, vitamin B6, folate, and vitamin B12 dietary intake and incident PMS. Intakes of B vitamins from supplements were not associated with lower risk of PMS. The second study evaluated the association between selected mineral intakes and PMS development in the NHS2. In this study, high iron intakes were associated with lower risk of PMS. Although there was no association between zinc and PMS risk, high intake of zinc relative to copper was associated with lower risk of PMS. There were no associations between of magnesium, copper, and manganese intakes and PMS. We observed a significantly higher risk of PMS in women with high intakes of potassium from food sources. The third study focused on the association between dietary intakes of B vitamins, zinc, magnesium, iron, potassium, and sodium and some biomarkers and PMS prevalence among younger women. In this study, we found an association between zinc intake and lower prevalence of PMS. Each 1 mg/d increase in vitamin B6 from foods was associated with a lower PMS symptom score. Blood magnesium levels were higher in women with PMS compared to women without PMS. We observed that intakes of some micronutrients were associated with lower risk of PMS, but further studies should be conducted. This dissertation contributes to the research on modifiable risk factors for PMS.