Understanding the Mediterranean Diet Score (MEDAS)
The Mediterranean diet is a heart-healthy eating pattern emphasizing plant-based foods, healthy fats, and moderate consumption of fish and poultry. A Mediterranean Diet Score, such as the MEDAS, provides a quantitative way to assess how well an individual's diet aligns with this pattern. The score is based on a 14-item questionnaire that covers both positive and negative food habits characteristic of the diet. A higher score on the MEDAS indicates a greater adherence to the Mediterranean diet, which is consistently linked with better health outcomes in numerous studies.
The 14 Items of the MEDAS Questionnaire
The MEDAS questionnaire is structured with a mix of questions about food frequency and specific habits. For each item, you receive 1 point for meeting the Mediterranean diet guideline and 0 points otherwise. The total score, ranging from 0 to 14, provides a comprehensive overview of your dietary pattern.
Here are the 14 questions used in the MEDAS assessment, along with the scoring criteria for each:
- Olive Oil Use: Do you use olive oil as your primary cooking fat? (+1 point for yes).
- Olive Oil Quantity: Do you consume at least 4 tablespoons of olive oil daily? (+1 point for yes).
- Vegetable Servings: Do you consume at least 2 servings of vegetables daily, with at least one serving being raw or salad? (+1 point for yes).
- Fruit Servings: Do you consume at least 3 servings of fruit daily? (+1 point for yes).
- Red or Processed Meat: Do you consume less than 1 serving of red meat or processed meat per day? (+1 point for yes).
- Butter, Margarine, or Cream: Do you consume less than 1 serving of butter, margarine, or cream per day? (+1 point for yes).
- Sugar-Sweetened Beverages: Do you consume fewer than 1 sugar-sweetened beverage daily? (+1 point for yes).
- Legumes: Do you consume at least 3 servings of beans, peas, or lentils per week? (+1 point for yes).
- Fish or Seafood: Do you consume at least 3 servings of fish or seafood per week? (+1 point for yes).
- Sweets or Pastries: Do you consume commercial sweets or pastries fewer than 3 times per week? (+1 point for yes).
- Nuts: Do you consume at least 3 servings of nuts per week? (+1 point for yes).
- Sofrito: Do you consume dishes with sofrito (a tomato-based sauce with onion, leek, or garlic simmered in olive oil) at least twice per week? (+1 point for yes).
- Wine Consumption: Do you consume at least three glasses of wine per week? (+1 point for yes). Note: This item is often excluded or modified in populations where alcohol consumption is not part of the cultural norm, or for those who abstain from alcohol.
- Poultry over Red Meat: Do you prefer consuming poultry over red meat? (+1 point for yes).
Step-by-Step Guide to Calculating Your MEDAS Score
- Obtain the Questionnaire: Use a version of the MEDAS questionnaire, which can often be found through health clinics or online resources.
- Honestly Answer Each Item: Go through the 14 questions and honestly assess your typical intake and habits over a representative period, such as the past year.
- Assign Points: Award yourself one point for every question where your habits align with the Mediterranean diet recommendation. For example, if you use olive oil as your primary cooking fat, you get 1 point. If you use butter instead, you get 0 points.
- Sum Your Total Score: Add up all the points from the 14 questions to get your final MEDAS score, which will be between 0 and 14.
- Interpret Your Score: Use the standard ranges to understand your level of adherence:
- High Adherence: 9 or more points
- Moderate Adherence: 6-9 points (some studies use 7-8 points)
- Low Adherence: 5 or fewer points (some studies use 0-5 points)
How Different Scoring Methods Compare
While the MEDAS is a popular and straightforward method, other more complex scoring systems exist for research purposes. These different indices highlight variations in what researchers emphasize when assessing Mediterranean diet adherence.
| Scoring System | Number of Items | Scoring Range | Scoring Method | Key Differences |
|---|---|---|---|---|
| MEDAS | 14 | 0–14 | Binary (0 or 1 point) based on intake frequency/habits. | Simple, practical, based on specific food frequency and habits. |
| MedDietScore (Panagiotakos) | 11 | 0–55 | 0–5 points per item based on consumption frequency (e.g., monthly servings). | More nuanced, considers a wider range of consumption frequency. |
| Alternate Mediterranean Diet (aMED) | 9 | 0–9 | Binary (0 or 1 point) based on sex-specific median intakes. | Scoring is population-dependent, making cross-study comparisons challenging. |
| Mediterranean-Style Dietary Pattern Score (MSDPS) | 13 | 0–100 | Continuously scaled, with penalties for overconsumption; weighted for non-Mediterranean foods. | Highly complex, detailed, and accounts for overconsumption and overall dietary pattern. |
Conclusion
Calculating your Mediterranean Diet score using a tool like the MEDAS provides valuable insight into your dietary habits and adherence to this beneficial eating pattern. Although various scoring systems exist, the MEDAS is a practical and easy-to-use tool for both individuals and healthcare professionals. By understanding your score, you can identify areas for improvement and take actionable steps to move toward a more heart-healthy, balanced diet. Even small changes, such as increasing your intake of vegetables, legumes, or nuts, can positively impact your overall adherence and well-being. Regularly assessing your score can help track your progress toward a healthier lifestyle, aligning your food choices with the robust evidence supporting the Mediterranean diet's long-term health benefits. For individuals living in non-Mediterranean regions, the MEDAS tool can effectively measure adherence to the core principles of the diet regardless of typical local consumption patterns.
