Madeleine Hull
The Mediterranean diet score (MDS) is a scoring system that quantifies adherence to the Mediterranean diet, which is characterised by a high intake of vegetables, legumes, fruits, nuts, cereals, fish, and olive oil, and a low intake of saturated lipids, dairy products, and meat. The MDS has been studied in relation to various health outcomes, including total mortality, cardiovascular mortality, and the risk of sudden cardiac death. The scoring system uses absolute cut-off values to overcome the limitations of previous versions of MDS, which used relative cut-off points that did not allow for comparisons between populations. The Mediterranean diet scoring systems aim to encapsulate the synergistic effect of the diet's components and their unique health benefits.
| Characteristics | Values |
|---|---|
| Scoring System | Trichopoulou-Mediterranean Diet Scale (T-MDS) |
| modified T-MDS (mT-MDS) | |
| revised T-MDS (rMED) | |
| Panagiotakos Mediterranean Diet Score (MedDietScore) | |
| Mediterranean Diet Serving Score (MDSS) | |
| MEDLIFE tool | |
| Dietary Characteristics | High intake of vegetables, legumes, fruits, nuts, and cereals |
| High intake of olive oil | |
| Low intake of saturated lipids | |
| Moderately high intake of fish | |
| Low-to-moderate intake of dairy products | |
| Low intake of meat and poultry | |
| Regular but moderate intake of ethanol, primarily in the form of wine |
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What You'll Learn
Mediterranean diet scoring systems
The Mediterranean diet has been associated with a lower risk of cardiovascular disease and other chronic diseases. The Mediterranean diet scoring system (MedD) encapsulates the dietary pattern into a numeric score for assessment with health outcomes.
There are several MedD scoring systems, including the Trichopoulou-Mediterranean Diet Scale (T-MDS), the revised T-MDS (rMED), the modified T-MDS (mT-MDS), the Panagiotakos Mediterranean Diet Score (MedDietScore), the Mediterranean Diet Serving Score (MDSS), and the MEDLIFE tool. These scoring systems vary in the specific foods and food groups included, the weighting of different components, and the methods used to assess dietary intake.
The T-MDS, developed by Trichopoulou and colleagues, has been widely used and modified over time. In 2005, Trichopoulou modified the T-MDS's lipid ratio to include PUFA in the MUFA:SFA ratio and included only fruits rather than "fruits and nuts" together. The T-MDS has been applied in various ways depending on the study population and has been used in several European countries in the EPIC study.
The MedDietScore, developed in 2006, is based on the MedD pyramid recommendations and includes eleven food/food group questions on a 0-5 scale, resulting in a score ranging from 0 to 55. This system includes potatoes and olive oil as positive factors but does not include nuts, and considers white meat/poultry as a negative factor.
The MDSS uses a weighted scoring system and includes upper and lower limits for food group intake on a meal, day, or week frequency. The MEDLIFE tool is the only assessment tool that incorporates dietary behaviours and lifestyle factors, including physical activity, rest, and social habits, along with food intake questions.
These MedD scoring systems have been used in various studies to investigate the associations between adherence to a Mediterranean diet and health outcomes, such as sudden cardiac death, total mortality, and cardiovascular mortality. The scoring systems allow for a quantitative assessment of dietary patterns and their potential impact on health.
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The Panagiotakos Mediterranean Diet Score
The Mediterranean diet has long been associated with a lower risk of cardiovascular disease and cancer. The Panagiotakos Mediterranean Diet Score (MedDietScore) is a scoring system that helps to assess an individual's nutritional status and the potential impact on their health. It was developed in 2006 by Panagiotakos, Pitsavos, and Stefanadis and is based on the MedD pyramid recommendations.
The MedDietScore includes eleven food groups: non-refined cereals, fruits, vegetables, potatoes, legumes, olive oil, fish, red meat, poultry, full-fat dairy products, and alcohol. Participants are given a score of 0 to 5 for each food group, with 0 representing no consumption and 5 representing daily consumption. The total score ranges from 0 to 55.
This scoring system has been applied in various studies to investigate the relationship between diet and health. For example, in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study, participants who closely adhered to a traditional Mediterranean diet showed a lower risk of sudden cardiac death (SCD) than those with lower adherence. Similarly, an analysis from the Women's Health Initiative found that a higher Mediterranean diet score was associated with a reduced risk of SCD in women.
The MedDietScore has also been used to study the relationship between diet and the risk of developing breast cancer. In a case-control study, it was found that healthy eating, a characteristic of the Mediterranean diet, was associated with a lower risk of breast cancer, although the relationship was inconclusive.
Overall, the Panagiotakos Mediterranean Diet Score is a valuable tool for assessing adherence to the Mediterranean diet and its potential health benefits, particularly in relation to cardiovascular health and cancer risk.
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Mediterranean Diet Serving Score
The Mediterranean Diet Serving Score (MDSS) is a scoring system that assesses an individual's adherence to a traditional Mediterranean diet. The Mediterranean diet has been associated with various health benefits, including reduced risk of cardiovascular disease, coronary heart disease, stroke, and total mortality. The MDSS uses a weighted scoring system and considers both the amount and frequency of consumption of specific food groups.
The MDSS includes upper and lower limits for food group intake, which can be measured per meal, day, or week. It takes into account a variety of dietary habits and behaviours, such as specific physical activity levels, rest patterns, and social habits. The scoring is typically done using a simple yes/no (1/0 points) format for each component. This scoring system allows for a more nuanced understanding of an individual's dietary patterns and can provide insights into their overall health and well-being.
The Mediterranean diet is characterised by a high intake of vegetables, legumes, fruits, nuts, and cereals, as well as a high consumption of olive oil. It also includes a moderately high intake of fish, depending on proximity to the sea, and a low-to-moderate intake of dairy products, mostly in the form of cheese or yogurt. The diet recommends a low intake of meat and poultry and encourages a regular but moderate intake of ethanol, primarily in the form of wine during meals.
The MDSS is one of several Mediterranean diet scoring systems. Another commonly applied scoring system is the Panagiotakos Mediterranean Diet Score (MedDietScore), which includes eleven food/food group questions on a 0–5 scale, resulting in a wider-ranging score (0–55). The MedDietScore includes potatoes and olive oil as positive factors but does not include nuts, and considers white meat/poultry as a negative factor.
These scoring systems are valuable tools for understanding the relationship between dietary patterns and health outcomes. They allow researchers and healthcare professionals to assess an individual's adherence to the Mediterranean diet and provide insights into the potential health benefits or risks associated with their dietary choices.
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Mediterranean diet and survival in a Greek population
The Mediterranean diet is associated with a range of health benefits. Mediterranean diet scoring systems quantify adherence to the diet and are used to assess health outcomes. The Trichopoulou-Mediterranean Diet Scale (T-MDS), the Panagiotakos Mediterranean Diet Score (MedDietScore), and the Mediterranean Diet Serving Score (MDSS) are examples of scoring systems that have been applied in various countries.
A study involving 22,043 adults in Greece investigated the relationship between adherence to the Mediterranean diet and survival. The participants completed an extensive, validated food-frequency questionnaire, and their adherence to the Mediterranean diet was assessed using a 10-point scale. The results showed that a higher score, indicating greater adherence to the Mediterranean diet, was associated with a significant reduction in overall mortality, mortality due to coronary heart disease, and mortality due to cancer.
The study found that during a median follow-up period of 44 months, there were 275 deaths. The risk of death associated with a two-point increment in the Mediterranean-diet score was 0.75, with a 95% confidence interval of 0.64 to 0.87. This suggests that the Mediterranean diet may improve longevity, although more data is needed to confirm this relationship.
The Mediterranean diet is characterized by a high consumption of vegetables, fruits and nuts, legumes, and olive oil. This dietary pattern has been associated with a lower risk of sudden cardiac death in studies such as REGARDS (Reasons for Geographic and Racial Differences in Stroke) and the Women's Health Initiative.
In summary, the Mediterranean diet has been linked to improved survival in a Greek population, with a higher degree of adherence resulting in a significant reduction in overall mortality and mortality due to specific causes such as coronary heart disease and cancer. Further research and larger studies are needed to strengthen the understanding of the relationship between the Mediterranean diet and survival in different populations.
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Mediterranean diet score and total and cardiovascular mortality in Eastern Europe
The Mediterranean diet score (MDS) is a scoring system based on the MedD pyramid recommendations. The MedD pyramid encompasses the unique dietary and lifestyle features of the Mediterranean diet, which has been associated with a lower risk of cardiovascular disease (CVD) and other chronic diseases. The MDS is derived from the consumption of nine groups of food using absolute cut-offs.
The Panagiotakos Mediterranean Diet Score (MedDietScore) is a commonly applied MDS that includes eleven food/food group questions on a 0–5 scale, resulting in a wide-ranging score (0–55). The Trichopoulou-Mediterranean Diet Scale (T-MDS) is another MDS that includes fruits and a specific MUFA:SFA ratio.
The Mediterranean diet score has been studied in relation to total and cardiovascular mortality in Eastern Europe through the HAPIEE
The HAPIEE study also examined the association between olive oil consumption, a key component of the Mediterranean diet, and all-cause, cardiovascular, and cancer mortality. The results showed that a higher Mediterranean diet score was associated with lower risk of sudden cardiac death (SCD) in women. Additionally, the study found inverse associations between the Mediterranean diet score and total and CVD mortality, suggesting that unhealthy diets have played a role in the high CVD mortality rates in Eastern Europe.
In conclusion, the Mediterranean diet score is a useful tool for assessing adherence to the Mediterranean diet, which has been associated with reduced risk of total and CVD mortality in Eastern European populations. The HAPIEE study provides evidence that the Mediterranean diet may be beneficial for cardiovascular health in non-Mediterranean populations as well. However, it is important to consider the limitations of the study, such as the moderate response rates and the restriction of cohorts to urban settings, when interpreting the results.
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Frequently asked questions
The Mediterranean Diet Score (MDS) is a scoring system that quantifies adherence to the Mediterranean diet in terms of a nine-point scale.
The Mediterranean diet is characterised by a high intake of vegetables, legumes, fruits and nuts, and cereals, a high intake of olive oil, a low intake of saturated lipids, a moderately high intake of fish, a low-to-moderate intake of dairy products, a low intake of meat and poultry, and a regular but moderate intake of ethanol, primarily in the form of wine and generally during meals.
The Mediterranean diet has been associated with a lower risk of cardiovascular disease and other chronic diseases, as well as a lower risk of sudden cardiac death.
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