MedDietScore [MDS-11]

Description

The MedDietScore (MDS-11) is a dietary assessment tool designed to evaluate the degree of adherence to key characteristics of the Mediterranean dietary pattern. The assessment is based on the frequency of consumption of specific food and beverage categories and converts these dietary habits into a numerical score.

In the available questionnaire, the MedDietScore includes 11 main categories: whole-grain cereals, potatoes, fruits and juices, vegetables and salads, legumes, fish and soups, red meat and meat products, poultry, full-fat dairy products, olive oil used in daily cooking, and alcoholic beverages.

The scoring approach differs across food groups depending on the direction of consumption represented in the questionnaire. For some categories, greater consumption receives a higher score, whereas for others, lower consumption receives a higher score.

Objective

The main objective of the MedDietScore is to provide a quantitative assessment of dietary behavior through an overall score.

It allows researchers to compare individuals or population groups according to their food consumption patterns and to examine the relationship between dietary habits and health-related, lifestyle, or demographic variables.

The instrument can be used in nutritional and epidemiological research, as well as in studies investigating dietary patterns and their association with broader health outcomes.

Questionnaire Analysis

For each of the 11 categories, participants report their frequency of consumption, generally expressed as servings per week or, in the case of alcoholic beverages, as daily intake.

For food categories such as whole-grain cereals, fruits, vegetables, legumes, and fish, higher consumption frequencies are assigned progressively higher scores. For example, whole-grain cereal consumption ranges from 0 points for no consumption to 5 points for more than 32 servings per week.

A similar progressive scoring approach is used for fruits and juices, vegetables and salads, legumes, and fish.

In contrast, categories such as red meat and meat products, poultry, and full-fat dairy products are reverse scored, meaning that lower consumption frequencies receive higher scores.

Olive oil is scored from 0 to 5, with daily use receiving the highest score.

Scoring

Each MedDietScore category is assigned a score ranging from 0 to 5 points.

For food groups in which higher intake is represented as more favorable within the scoring system, higher consumption frequencies receive higher scores. For categories in which lower consumption is represented more favorably, the scoring direction is reversed.

Indicatively:

Whole-grain cereals: 0–5 points according to weekly consumption frequency.

Potatoes: from 0 points for no consumption to 5 points for more than 18 servings per week.

Fruits and juices: from 0 to 5 points, with the highest score corresponding to more than 22 servings per week.

Vegetables and salads: from 0 to 5 points, with the highest score corresponding to more than 33 servings per week.

Legumes and fish: scores increase progressively up to 5 points at the highest consumption categories.

Red meat and meat products: consumption of up to 1 serving per week receives 5 points, whereas consumption of more than 10 servings receives 0 points.

Poultry: lower consumption receives a higher score, ranging from 5 to 0 points.

Full-fat dairy products: the score decreases as consumption increases, ranging from 5 to 0 points.

Olive oil: daily use is scored with 5 points.

For alcoholic beverages, the questionnaire applies a separate scoring system according to the reported daily quantity.

Interpretation

The total MedDietScore is obtained by summing the individual scores across the 11 food and beverage categories.

Since each category can receive between 0 and 5 points, the overall score can theoretically range from 0 to 55 points.

A higher total score indicates a dietary pattern that more closely corresponds to the scoring profile represented by the MedDietScore, whereas a lower score indicates lower adherence to that pattern.

Depending on the research design, the total score may be analyzed as a continuous variable or used to compare different participant groups.

Additional Dietary Information

The source document also includes a more extensive food-frequency section assessing how often participants consumed various foods during the previous month, using predefined serving sizes and response categories ranging from “Never/Rarely” to “≥2 times per day.”

In addition, a separate section evaluates fluid intake, including daily water consumption through glasses or bottles and the frequency of consumption of different beverages, including juices, soft drinks, milk, tea, coffee, and alcoholic beverages.

These additional data can be used alongside the MedDietScore to provide a broader assessment of participants’ dietary habits and fluid consumption.