The Development of the Mediterranean-Style Dietary Pattern Score and Its Application to the American Diet in the Framingham Offspring Cohort
Open accessAbstract
Previous Mediterranean diet scores were simple to apply but may not be appropriate for non-Mediterranean populations. We developed a Mediterranean-Style Dietary Pattern Score (MSDPS) to assess the conformity of an individual's diet to a traditional Mediterranean-style diet. The MSDPS is based on the recommended intakes of 13 food groups in the Mediterranean diet pyramid. Each food group is scored from 0 to 10 depending on the degree of correspondence with recommendations. Exceeding the recommendations results in a lower score proportional to the degree of overconsumption. The sum of the component scores is standardized to a 0-100 scale and weighted by the proportion of energy consumed from Mediterranean diet foods. We applied the MSDPS to dietary data collected at the 7th examination of the Framingham Offspring Cohort and tested the content validity of the score against selected nutrients known to be associated with the Mediterranean-style dietary pattern. The mean MSDPS was 24.8 (range, 3.1-60.7). Participants with a higher MSDPS were more likely to be women, older, multivitamin users, to have lower BMI and waist circumferences, and less likely to be current smokers. The MSDPS demonstrated content validity through expected positive associations with intakes of dietary fiber, (n-3) fatty acids, antioxidant vitamins, calcium, magnesium, and potassium, and inverse associations with those of added sugar, glycemic index, saturated fat, and trans-fat, and the (n-6):(n-3) fatty acid ratio. The MSDPS is a useful instrument to measure overall diet quality according to the principles of a Mediterranean-style dietary pattern.
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Mediterranean-style diets tend to be relatively high in unsaturated fat, particularly from extra-virgin olive oil.
“They tend to be relatively high in unsaturated fat, particularly from extravirgin olive oil.”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [24]
In Esposito et al, subjects on the intervention diet decreased body weight by 6.2 lb or 2.8 kg (P<0.001) and waist circumference by 0.8 inches or 2 cm (P=0.01) compared with the control group.
“In addition, subjects on the intervention diet decreased body weight by 6.2 lb or 2.8 kg (PϽ0.001) and waist circumference by 0.8 inches or 2 cm (Pϭ0.01)compared with the control group.”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [400]
In Esposito et al, after 2 years, triglyceride levels decreased 12% in the Mediterranean-style diet intervention group compared with the control diet (P=0.001).
“After 2 years, triglyceride levels decreased 12% in the intervention group (Pϭ0.001versus the control diet).”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [400]
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“Similarly, in the Framingham Offspring Cohort, which included 1918 participants without T2DM at baseline and followed for 7 y, participants in the highest quintile of adherence to a Mediterranean-style dietary pattern score had a 30% lower risk of incident MetS than did those in the lowest quintile, together with bett…”
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Kesse‐Guyot, E., Ahluwalia, N., Lassale, C. M., Herçberg, S., Fezeu, L., & Lairon, D. (2012) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2012.02.005 · Cited by 216 · see citing works
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“A higher adherence to the last 2 scores [the diet score proposed by Panagiotakos et al (22) and the Mediterranean-style dietary pattern score proposed by Rumawas et al (23)] was also associated with lower weight gain, but the 95% CIs were wide, and the inverse linear trend was not significant.”
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“In addition, most published MDSs did not take into account the current recommendations for adopting the Mediterranean diet [22].”
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“Concurrent validity was reported in 10 of the 28 scores; adherence to MD was associated inversely with clinical and biological markers of cardiovascular disease risk,(6) 33 34 52 56 body mass index, waist-hip and weight.(28) 31 32 50 53 56 Finally, for the analysis of construct validity, the authors linked scores with…”
BackgroundReview of a priori dietary quality indices in relation to their construction criteria
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“(77) Rappel indices 48-item (cued recall), verbal fluency tests of lexical/semantic memory Episodic memory, working memory, verbal fluency, phonometric fluency MedDiet adherence was not associated with cognitive performance overall”
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Milte, C. M., & McNaughton, S. A. (2015) · European Journal of Nutrition · doi:10.1007/s00394-015-1123-7 · Cited by 174 · see citing works
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“In addition, we computed the Mediterranean-Style Dietary Pattern Score (MSDPS), which was recently developed in the United States (22).”
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“2009 [34] EEUU Men and women Mean 54 7 2730 Score created based on MSDPS [60]: whole-grain cereals, fruit, vegetables, dairy, wine, fish, poultry, olives/legumes/nuts, potatoes, eggs, sweets, meat, and olive oil MetS Q5 MSDPS ↓ incidence MetS (38.”
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“Mediterranean-Style Dietary Pattern Score (MSDPS) [63] 13 (13 food groups/foods) 0–10 0–100”
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“82); MAI and MSDPS (0 ?”
InfluentialLaffond, A. E., Picón, C. R., Rodríguez-Muñoz, P. M., Juárez‐Vela, R., de Viñaspre‐Hernández, R. R., Navas-Echazarreta, N., & González, J. L. S. (2023) · Nutrients · doi:10.3390/nu15153356 · Cited by 127 · see citing works
“Alternative scoring systems included the alternate MDS (aMDS) [49], which includes laver and kelp/sea mustard as vegetables and multigrain rice as a whole-grain product and excludes the ratio of monounsaturated fatty acid to saturated fatty acid and nuts, and the total and maximum score is seven components, with a hig…”
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Garcı́a-Meseguer, M. J., Burriel, F. C., García, C. V., & Serrano-Urrea, R. (2014) · Appetite · doi:10.1016/j.appet.2014.03.020 · Cited by 114 · see citing works
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Lassale, C. M., Gunter, M. J., Romaguera, D., Peelen, L. M., van der Schouw, Y. T., Beulens, J. W. J., Freisling, H., Muller, D. C., Ferrari, P., Huybrechts, I., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0159025 · Cited by 108 · see citing works
“Abbreviations: MDS, Mediterranean Diet Scale; rMED, relative Mediterranean diet score; MSDPS, Mediterranean Style Dietary Pattern Score; DQI-I, Diet Quality Index–International; HNFI, Healthy Nordic Food Index; HEI-2010, Healthy Eating Index 2010; WHO HDI, World Health Organization Healthy Diet Index; DASH, Dietary Ap…”
MethodInfluentialD'Alessandro, A., & Pergola, G. D. (2018) · International Journal of Food Sciences and Nutrition · doi:10.1080/09637486.2017.1417978 · Cited by 104 · see citing works
“The score established a penalty in case of over-consumption of the component and a weighting factor from 0 to 1 which depended on the consumption of food that was not included in the food pyramid (Rumawas et al. 2009).”
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“[36], the MD quality index [37], the relative MD system [38], and modified versions of MDSs [39–49], were used in our included studies.”
BackgroundMethodCade, J. E., Taylor, E. F., Burley, V. J., & Greenwood, D. C. (2011) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2011.69 · Cited by 92 · see citing works
“Rumawas et al. (2009) have recently described an alternative approach for the derivation of a Mediterranean pattern score for use in non-Mediterranean populations.”
Mediterranean Diet in Predementia and Dementia Syndromes
Solfrizzi, V., Frisardi, V., Seripa, D., Logroscino, G., Imbimbo, B. P., D’Onofrio, G., Addante, F., Sancarlo, D., Cascavilla, L., Pilotto, A., et al. (2011) · Current Alzheimer Research · doi:10.2174/156720511796391809 · Cited by 91 · see citing works
“The evaluation of the adherence to a Mediterranean-style diet was conducted to develop scores or indexes called ‘Mediterranean Diet Scale’ or ‘Mediterranean Diet Score’ or ‘Mediterranean Adequacy Index’ or even ‘Mediterranean–Style Dietary Pattern Score’ based on a priori hypotheses and intended to be close to the tra…”
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“Nuts have also been groupedwith olives(30), with legumes(47), or all three combined(93).”
BackgroundMethodInfluentialPapadopoulou, S. Κ., Detopoulou, P., Voulgaridou, G., Tsoumana, D., Spanoudaki, M., Sadikou, F., Papadopoulou, V. G., Zidrou, C., Chatziprodromidou, I. P., Giaginis, C., et al. (2023) · Nutrients · doi:10.3390/nu15051104 · Cited by 78 · see citing works
“The adherence to the Mediterranean diet was assessed with aMED [54], MEDAS [48], PREDIMED questionnaire [56], MSDPS [55], MEDI-LITE score [49], MED score [60,61] and DQI-I [57–60].”
MethodWhat can we learn from dietary pattern analysis?
Hodge, A. M., & Bassett, J. K. (2016) · Public Health Nutrition · doi:10.1017/s1368980015003730 · Cited by 75 · see citing works
“Among the many different methods to score adherence to a Mediterranean diet((4)), some score according to dietary guidelines independent of the population in which they are being applied rather than using population-specific values((2,5,6)).”
MethodDESCRIPTION OF INDEXES BASED ON THE ADHERENCE TO THE MEDITERRANEAN DIETARY PATTERN: A REVIEW.
Ruiz, Á. H., García‐Villanova, B., Hernández, E. J. G., Amiano, P., Azpiri, M., & Molina‐Montes, E. (2015) · PubMed · doi:10.3305/nh.2015.32.5.9629 · Cited by 70 · see citing works
“Rumawas et al. (2009), developed the Mediterranean-Style Dietary Pattern Score within 3,021 participants (mean age = 60 years) of the Framingham Offspring Cohort22.”
BackgroundMethodThe Mediterranean Lifestyle as a Non-Pharmacological and Natural Antioxidant for Healthy Aging
Chatzianagnostou, K., Turco, S. D., Pingitore, A., Sabatino, L., & Vassalle, C. (2015) · Antioxidants · doi:10.3390/antiox4040719 · Cited by 65 · see citing works
“The positive effect of the MeD has been shown also in the prevention of metabolic syndrome, as described in three prospective studies in which higher adherence to the MeD was associated with a reduced risk, from 15% to 18%, of developing metabolic syndrome [49–51].”
BackgroundMediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes
D'Alessandro, A., & Pergola, G. D. (2015) · Nutrients · doi:10.3390/nu7095367 · Cited by 65 · see citing works
“[9] using the Greek Mediterranean Diet pyramid for adults as a reference [39] and was based on 13 components corresponding to 13 food groups of the pyramid: whole grains; fruit; vegetables; milk and dairy products; wine; fish; poultry; olives, legumes, nuts; potatoes; eggs; sweets; meat; and olive oil.”
MethodInfluentialLimongi, F., Siviero, P., Bozanic, A., Noale, M., Veronese, N., & Maggi, S. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.08.020 · Cited by 62 · see citing works
Funtikova, A. N., Benitez-Arciniega, A. D., Gómez, S. F., Fitó, M., Elosúa, R., & Schröder, H. (2014) · British Journal Of Nutrition · doi:10.1017/s0007114513003966 · Cited by 61 · see citing works
“A Mediterranean diet score has also been created a priori by a few studies((12)), using food intake recommendations.”
MethodA Critical Review of the Study of Neuroprotective Diets to Reduce Cognitive Decline
Duplantier, S. C., & Gardner, C. D. (2021) · Nutrients · doi:10.3390/nu13072264 · Cited by 55 · see citing works
“For example, in Greece, the median intake of vegetables is six servings a day, and the median intake of fruits is three servings [55,91].”
BackgroundGnagnarella, P., Dragà, D., Misotti, A. M., Sieri, S., Spaggiari, L., Cassano, E., Baldini, F., Soldati, L., & Maisonneuve, P. (2018) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2018.06.006 · Cited by 57 · see citing works
DASH and Mediterranean-Type Dietary Patterns to Maintain Cognitive Health
Tangney, C. (2014) · Current Nutrition Reports · doi:10.1007/s13668-013-0070-2 · Cited by 55 · see citing works
Adherence to Mediterranean Diet among Lebanese University Students
Karam, J., Bibiloni, M. D. M., Serhan, M., & Tur, J. A. (2021) · Nutrients · doi:10.3390/nu13041264 · Cited by 54 · see citing works
“It is important to assess the degree of adherence to the MedDiet through accurate measurement tools such as dietary scores [4].”
BackgroundBlack, L. J., Baker, K., Ponsonby, A., van der Mei, I. A. F., Lucas, R. M., Pereira, G. F., Chapman, C., Coulthard, A., Dear, K. B. G., Dwyer, T., et al. (2019) · Journal of Nutrition · doi:10.1093/jn/nxz089 · Cited by 51 · see citing works
“60 61 A number of approaches have been proposed to define and measure adherence to a 62 Mediterranean diet (19-24), all of which consider low intakes of red meat as beneficial.”
BackgroundSotos‐Prieto, M., Santos-Beneit, G., Bodega, P., Pocock, S., Mattei, J., & Peñalvo, J. L. (2015) · PubMed · doi:10.3305/nh.2015.32.3.9387 · Cited by 51 · see citing works
Wirth, J., di Giuseppe, R., Boeing, H., & Weikert, C. (2016) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2016.140 · Cited by 49 · see citing works
Adaptation and predictive utility of a Mediterranean diet screener score
Abu-Saad, K., Endevelt, R., Goldsmith, R., Shimony, T., Nitsan, L., Shahar, D. R., Keinan‐Boker, L., Ziv, A., & Kalter‐Leibovici, O. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.12.034 · Cited by 49 · see citing works
Fougère, B., Mazzuco, S., Spagnolo, P., Guyonnet, S., Vellas, B. J., Cesari, M., & Gallucci, M. (2015) · The journal of nutrition health & aging · doi:10.1007/s12603-015-0588-7 · Cited by 45 · see citing works
“Rumawas also took into account the negative implications of overconsumption, defined as exceeding the recommended intake of foods in the Mediterranean diet pyramid.”
Alkerwi, A., Sauvageot, N., Nau, A., Lair, M., Donneau, A., Albert, A., & Guillaume, M. (2012) · British Journal Of Nutrition · doi:10.1017/s0007114512000232 · Cited by 42 · see citing works
“salt intake), and a reward for beneficial overconsumption (for example, fruit and vegetable consumption)((18,20)) (Table 1).”
BackgroundMethodMathew, A. V., Li, L., Byun, J., Guo, Y., Michailidis, G. C., Jaiswal, M., Chen, Y., Pop‐Busui, R., & Pennathur, S. (2018) · Diabetes Care · doi:10.2337/dc18-0049 · Cited by 39 · see citing works
“We performed subgroup analysis by splitting the cohort into two groups: those above and below themean change in exercise duration (2.3 h/week) and MDS (0.44).”
MethodInfluentialMediterranean food pattern vs. Mediterranean diet: a necessary approach?
Real, H., Queiroz, J. D. S., & Graça, P. (2019) · International Journal of Food Sciences and Nutrition · doi:10.1080/09637486.2019.1617838 · Cited by 39 · see citing works
“Pattern Score(MSDPS) 13 components (13 foods groups/foods) Adults Rumawas et al. (2009) 2009 Mediterranean Adequacy Index (MAI) 16 components (16 foods groups/foods) Adults Alberti et al. (2009) 2009 Relative Mediterranean Diet Score (rMED) 9 components (8 foods groups/foods, 1 nutrient) Adults,…”
BackgroundMediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review
Camprodon‐Boadas, P., Gil-Dominguez, A., de la Serna, E., Sugranyes, G., Lázaro, I., & Baeza, I. (2024) · Nutrition Reviews · doi:10.1093/nutrit/nuae053 · Cited by 33 · see citing works
Knight, A., Bryan, J., & Murphy, K. J. (2016) · Nutritional Neuroscience · doi:10.1080/1028415x.2016.1183341 · Cited by 33 · see citing works
Ortega, E., Franch, J., Castell, C., Goday, A., Ribas-Barba, L., Soriguer, F., Vendrell, J., Casamitjana, R., Bosch-Comas, A., Bordiú, E., et al. (2013) · Annals of Nutrition and Metabolism · doi:10.1159/000346553 · Cited by 31 · see citing works
Lindström, J., Aittola, K., Pölönen, A., Hemiö, K., Ahonen, K., Karhunen, L. J., Männikkö, R., Siljamäki-Ojansuu, U., Tilles‐Tirkkonen, T., Virtanen, E., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18052362 · Cited by 31 · see citing works
“The scores measuring the adherence to the Mediterranean diet typically grade moderate daily consumption of wine as beneficial [33,51].”
BackgroundMediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions
McClure, R., & Villani, A. M. (2017) · JCSM Clinical Reports · doi:10.17987/jcsm-cr.v2i2.45 · Cited by 29 · see citing works
Millar, C. L., Costa, E., Jacques, P. F., Dufour, A. B., Kiel, D. P., Hannan, M. T., & Sahni, S. (2022) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqac130 · Cited by 29 · see citing works
Self-citationCurrent Evidence on Dietary Pattern and Cognitive Function
Cheung, B., Ho, I., Chan, R., Sea, M. M.-M., & Woo, J. (2014) · Advances in food and nutrition research · doi:10.1016/b978-0-12-800270-4.00004-3 · Cited by 28 · see citing works
Opie, R., Ralston, R. A., & Walker, K. Z. (2013) · Nutrition & Dietetics · doi:10.1111/1747-0080.12016 · Cited by 28 · see citing works
Ruffman, T., Zhang, J., Taumoepeau, M., & Skeaff, S. A. (2016) · Experimental Aging Research · doi:10.1080/0361073x.2016.1156974 · Cited by 26 · see citing works
“We used a 98-item food frequency questionnaire to assess food intake and then applied the Mediterranean Style Dietary Pattern Score (MSDPS) to summarize dietary habits as suggested by Rumawas et al. (2009) .”
MethodResultInfluentialNasab, S. J., Bahrami, A., Rafiee, P., Hekmatdoost, A., Ghanavati, M., Rashidkhani, B., Sadeghi, A., Aghdaei, H. A., Naja, F., & Hejazi, E. (2019) · Nutrition and Cancer · doi:10.1080/01635581.2019.1683212 · Cited by 26 · see citing works
Chiriacò, M., Tubili, C., Bo, S., Parillo, M., Vetrani, C., Mazzotti, A., Pistis, D., Marelli, G., Grandone, I., & Natali, A. (2023) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2023.01.024 · Cited by 26 · see citing works
Tehrani, A. N., Salehpour, A., Beyzai, B., Farhadnejad, H., Moloodi, R., Hekmatdoost, A., & Rashidkhani, B. (2018) · Mediterranean Journal of Nutrition and Metabolism · doi:10.3233/mnm-17192 · Cited by 25 · see citing works
“Exerting the penalty can prevent obtaining higher scores merely by food overconsumption [28].”
Jessri, M., Rashidkhani, B., Hajizadeh, B., & Jacques, P. F. (2012) · Journal of the American College of Nutrition · doi:10.1080/07315724.2012.10720437 · Cited by 25 · see citing works
“MSDPS was developed in 2009 to assess the conformity of an individual’s diet to the traditional Mediterranean dietary recommendations [43].”
BackgroundMethodInfluentialSelf-citationAdherence to dietary guidelines and cognitive decline from middle age: the Doetinchem Cohort Study
Nooyens, A. C. J., Yildiz, B., Hendriks, L. G., Bas, S., van Boxtel, M. P. J., Picavet, H. S. J., Boer, J. M. A., & Verschuren, W. M. M. (2021) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqab109 · Cited by 24 · see citing works
“It can be argued that the Mediterranean dietary pattern defined in our study is not truly Mediterranean (62).”
BackgroundA New Carbohydrate Food Quality Scoring System to Reflect Dietary Guidelines: An Expert Panel Report
Drewnowski, A., Maillot, M., Papanikolaou, Y., Jones, J. M., Rodriguez, J. C., Slavin, J. L., Angadi, S. S., & Comerford, K. B. (2022) · Nutrients · doi:10.3390/nu14071485 · Cited by 26 · see citing works
“Whole grain content is calculated per dry weight, following prior studies [20,21].”
MethodThe Association of Healthful Diets and Cognitive Function: A Review
Kuczmarski, M. F., Allegro, D., & Shupe, E. S. (2014) · Journal of Nutrition in Gerontology and Geriatrics · doi:10.1080/21551197.2014.907101 · Cited by 23 · see citing works
“These records were used to calculate the Mediterranean Diet Score (MDS) using the algorithm by Trichopoulou and colleagues (37) and the Mediterranean-style dietary pattern score developed by Rumawas and associates (38).”
MethodDiet quality assessment indexes
de Carvalho, K. M. B., Dutra, E. S., Pizato, N., Gruezo, N. D., & Ito, M. (2014) · Revista de Nutrição · doi:10.1590/1415-52732014000500009 · Cited by 23 · see citing works
Comparison of the Dietary Antioxidant Profiles of 21 a priori Defined Mediterranean Diet Indexes
Ruiz, Á. H., García‐Villanova, B., Guerra-Hernández, E. J., Amiano, P., Sánchez, M., Dorronsoro, M., & Molina‐Montes, E. (2018) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2018.01.006 · Cited by 23 · see citing works
Salvo, D., Frediani, J. K., Ziegler, T. R., & Cole, C. R. (2012) · Nutrition Journal · doi:10.1186/1475-2891-11-62 · Cited by 22 · see citing works
“Previous studies have used methodologies such as dietary scoring to analyze food patterns among large population groups [2,21,22].”
MethodAssessing Mediterranean Diet Adherence with the Smartphone: The Medipiatto Project
Vasiloglou, M. F., Lu, Y. L., Stathopoulou, T., Papathanail, I., Faeh, D., Ghosh, A., Baumann, M., & Mougiakakou, S. G. (2020) · Nutrients · doi:10.3390/nu12123763 · Cited by 21 · see citing works
“It is essential to determine the MD adherence level using accurate measurement tools and it has been shown that dietary scores are useful since they depict the consistency of food consumption to a pattern and in compliance to the recommended intake [29].”
MethodFrumuzachi, O., Kieserling, H., Rohn, S., & Mocan, A. (2025) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2025.2453090 · Cited by 19 · see citing works
“…dietary patterns in non-Mediterranean regions may lack the synergistic effects of other components found in the Mediterranean diet, such as fruits, vegetables, and whole grains, which could amplify the need for targeted interventions (Martínez-González et al. 2017; Rumawas et al. 2009).”
A feasibility study to assess Mediterranean Diet adherence using an AI-powered system
Papathanail, I., Vasiloglou, M. F., Stathopoulou, T., Ghosh, A., Baumann, M., Faeh, D., & Mougiakakou, S. G. (2022) · Scientific Reports · doi:10.1038/s41598-022-21421-y · Cited by 19 · see citing works
Adherence to a Mediterranean-Style Dietary Pattern and Cancer Risk in a Prospective Cohort Study
Yiannakou, I., Singer, M. R., Jacques, P. F., Xanthakis, V., Ellison, R. C., & Moore, L. L. (2021) · Nutrients · doi:10.3390/nu13114064 · Cited by 19 · see citing works
“The scoring methods for the MSDP score were based on adherence to a traditional Mediterranean diet [19] and have been previously described [17].”
BackgroundMethodInfluentialSelf-citationBernal-Orozco, M. F., Badillo-Camacho, N., Ojeda, G. M., González-Gómez, M., Orozco-Gutiérrez, J. F., Prado-Arriaga, R. J., Márquez‐Sandoval, F., Martínez, M. B. A., & Vizmanos-Lamotte, B. (2018) · Nutrients · doi:10.3390/nu10040524 · Cited by 19 · see citing works
“Among them are the MEDI-LITE Score [14], the Chilean Index of the Mediterranean Diet (Índice Chileno de la Dieta Mediterránea, IDM-Chile) [39], the Mediterranean Dietary Serving Score (MDSS) [13], the Mediterranean Diet Assessment Tool [12], the Mediterranean Diet Adherence Screener (MIDAS) [11], the Mediterranean Die…”
MethodRadd‐Vagenas, S., Singh, M. A. F., Daniel, K., Noble, Y., Jain, N., O’Leary, F., Mavros, Y., Heffernan, M., Meiklejohn, J., Guerrero, Y., et al. (2018) · Nutrients · doi:10.3390/nu10121913 · Cited by 18 · see citing works
“Most Mediterranean diet adherence scores, including multiple variants of the MDS, the MedDietScore [26] and Mediterranean Style Dietary Pattern Score (MSDPS) [27], require derivation from a food frequency questionnaire (FFQ) rather than being calculated directly from responses to an administered index tool.”
BackgroundIncrement in Dietary Potassium Predicts Weight Loss in the Treatment of the Metabolic Syndrome
Tal, B., Sack, J., Yaron, M., Shefer, G., Buch, A., Ben Haim, L., Marcus, Y., Shenkerman, G., Sofer, Y., Shefer, L., et al. (2019) · Nutrients · doi:10.3390/nu11061256 · Cited by 17 · see citing works
“In one study of the Mediterranean diet, better compliance with the diet was linked to higher consumption of dietary potassium as well as calcium and magnesium [5].”
BackgroundBakaloudi, D. R., Chrysoula, L., Leonida, I., Kotzakioulafi, E., Theodoridis, X., & Chourdakis, M. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.10.002 · Cited by 17 · see citing works
Nasab, S. J., Ghanavati, M., Rafiee, P., Bahrami, A., Majidi, N., Clark, C. C. T., Sadeghi, A., Houshyari, M., & Hejazi, E. (2021) · BMC Cancer · doi:10.1186/s12885-021-08786-5 · Cited by 17 · see citing works
Karam, J., Ghach, W., Bouteen, C., Makary, M.-J., Riman, M., & Serhan, M. (2022) · Nutrition & Food Science · doi:10.1108/nfs-10-2021-0325 · Cited by 17 · see citing works
Tehrani, A. N., Farhadnejad, H., Salehpour, A., Beyzai, B., Hekmatdoost, A., & Rashidkhani, B. (2019) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh-2018-0188 · Cited by 17 · see citing works
Christiansen, C., Tomlinson, M., Eliot, M., Nilsson, E., Costeira, R., Xia, Y., Villicaña, S., Mompeó, O., Wells, P. M., Fernandez, J. C., et al. (2022) · Genome Medicine · doi:10.1186/s13073-022-01077-z · Cited by 16 · see citing works
“Overall diet quality measures included the Healthy Eating Index (HEI) [58], the alternate Healthy Eating Index (aHEI) [59], the Dietary Approaches to Stop Hypertension (DASH) score [60], the Alternate Mediterranean Diet Score (aMED) [61], the Dietary Quality Index International (DQI-I) [62] ], Health Eating Index (HDI…”
MethodAschemann‐Witzel, J., & Grunert, K. G. (2015) · BMC Public Health · doi:10.1186/s12889-015-1348-7 · Cited by 17 · see citing works
“, rich in whole-grain cereals, fruits, vegetables, wine, fish, legumes, nuts, and olive oil, and moderate in meat, see [24]) and might be one of the reasons for the popularity of Mediterranean cuisine.”
BackgroundDietary Influence on Systolic and Diastolic Blood Pressure in the TwinsUK Cohort
Louca, P., Mompeó, O., Leeming, E. R., Berry, S. E., Mangino, M., Spector, T. D., Padmanabhan, S., & Menni, C. (2020) · Nutrients · doi:10.3390/nu12072130 · Cited by 17 · see citing works
Mahdavi‐Roshan, M., Salari, A., & Soltanipour, S. (2018) · Mediterranean Journal of Nutrition and Metabolism · doi:10.3233/mnm-18205 · Cited by 15 · see citing works
“Also in the Framingham offspring cohort 36.9% of participants met the recommended intakes of olive oil [23] and among older Spanish men and women, according to MEDAS screener 90.9 and 70.9 percent used olive oil as the principal source of fat for cooking and consumed 15 milliliter of olive oil or…”
InfluentialQuality and validity of diet quality indices for use in Australian contexts: a systematic review
Tan, M. S., Cheung, H. C., McAuley, E., ROSS, L. J., & MacLaughlin, H. L. (2021) · British Journal Of Nutrition · doi:10.1017/s0007114521004943 · Cited by 14 · see citing works
“Adequacy and moderation were assessed in all indices (6,32,34,35,38,41,42,45) .”
InfluentialDietary Unsaturated Fatty Acids and Risk of Mild Cognitive Impairment
Panza, F., Frisardi, V., Seripa, D., Imbimbo, B. P., Pilotto, A., & Solfrizzi, V. (2010) · Journal of Alzheimer s Disease · doi:10.3233/jad-2010-100777 · Cited by 14 · see citing works
“…diet was conducted to develop scores or indexes called ‘Mediterranean Diet Scale’ or ‘Mediterranean Diet Score’ or ‘Mediter-ranean Adequacy Index’ or even ‘Mediterranean-Style Dietary PatternScore’ based on a priori hypothesesand intended to be close to the traditional one [17,18].”
Gallucci, M., Pallucca, C., Battista, M. E. D., Fougère, B., & Grossi, E. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-190609 · Cited by 14 · see citing works
Dietary modulators of statin efficacy in cardiovascular disease and cognition
Wang, H., Blumberg, J. B., Chen, C. ‐. O., Choi, S., Corcoran, M. P., Harris, S. S., Jacques, P. F., Kristo, A. S., Lai, C., Lamon‐Fava, S., et al. (2014) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2014.04.001 · Cited by 14 · see citing works
Self-citationBernal-Orozco, M. F., Salmeron-Curiel, P. B., Prado-Arriaga, R. J., Orozco-Gutiérrez, J. F., Badillo-Camacho, N., Márquez‐Sandoval, F., Martínez, M. B. A., González-Gómez, M., Gutiérrez-González, P., Vizmanos-Lamotte, B., et al. (2020) · Nutrients · doi:10.3390/nu12030809 · Cited by 14 · see citing works
Gallucci, M., Mazzarolo, A. P., Focella, L., Piovesan, C., Mazzetto, M., Ramigni, M., & Marzetti, E. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200542 · Cited by 13 · see citing works
- Authors
- Rumawas, M. E., Dwyer, J. T., Mckeown, N. M., Meigs, J. B., Rogers, G., & Jacques, P. F.
- Affiliations
- Tufts University (US)
- Harvard University (US)
- Corresponding author
- Jacques, Paul F.
- Venue
- The Journal of Nutrition
- Publisher
- Elsevier BV
- Published
- 2009-06
- Volume
- 139
- Issue
- 6
- Pages
- 1150-1156
- ISSN
- 0022-3166 (ISSN-L)
- PMC
- PMC2682986
- OpenAlex
- W2029060364
- Cited by
- 188
- References
- 37
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 8 · 2023: 12 · 2022: 14 · 2021: 16 · 2020: 11 · 2019: 13 · 2018: 17 · 2017: 8 · 2016: 16 · 2015: 12 · 2014: 13 · 2013: 6 · 2012: 12
- FWCI
- 9.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc25195-41-0-1)
- National Heart, Lung, and Blood Institute (N01‐HC25195)
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK080140)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
- Keywords
- Mediterranean diet, diet quality assessment, Mediterranean diet pyramid, content validity, Framingham Offspring cohort, dietary fiber, omega-3 fatty acids, antioxidant vitamins, saturated fat, trans fatty acids, added sugars, glycemic index, n-6/n-3 ratio, multivitamin use, body mass index
- MeSH terms
- Aging, Energy Intake, Feeding Behavior, Female, Humans, Life Style, Male, Middle Aged, Sex Characteristics, Cohort Studies, Health Behavior, Diet, Mediterranean
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