Objective of the Questionnaire

The primary aim of the questionnaire is to assess individuals’ current dietary habits and estimate the likelihood of experiencing an acute coronary event. Additionally, it is used to evaluate the degree to which the Mediterranean diet is being followed.

Questionnaire Analysis

The Frequency Questionnaire (The Mediterranean Diet Score) is a tool designed to estimate adherence to the traditional Mediterranean diet. It was initially developed by Trichopoulou and colleagues in 1995, including 8 criteria. Later, in 2006, Panagiotakos and colleagues developed an updated index to better reflect the Mediterranean dietary pattern, incorporating 11 different components (food groups), where participants are asked about their weekly consumption frequency.

Question Scoring and Statistical Analysis

The MedDietScore, which includes 11 different components (unprocessed cereals, fruits, vegetables, potatoes, legumes, olive oil, fish, red meat, poultry, full-fat dairy products, alcohol), is scored using functions ranging from 0 to 5. The total score ranges from 0 to 55.
Foods recommended by the Mediterranean Diet are scored as follows:
0 = Never, 1 = Rarely, 2 = Often, 3 = Very often, 4 = Weekly, 5 = Daily
For non-Mediterranean foods, the scoring is inverted.
Alcohol consumption:
Less than 300ml/day = 5 points
More than 700ml/day = 0 points
Scores from 1–4 are assigned to intermediate consumption levels
Higher total scores reflect greater adherence to the Mediterranean Diet, while lower scores reflect lesser adherence.

Validity and Reliability

The index demonstrates high diagnostic accuracy and reproducibility, particularly across food groups included in the Mediterranean Food Pyramid. It serves as a valuable tool for assessing dietary habits and the potential risk of acute coronary events, making it especially useful in clinical practice.
In terms of internal consistency, the Cronbach’s alpha for the MedDietScore is 0.75, indicating acceptable reliability.

References

Antonopoulou, M., Mantzorou, M., Serdari, A., Bonotis, K., Vasios, G., Pavlidou, E., … & Giaginis, C. (2020). Evaluating Mediterranean diet adherence in university student populations: Does this dietary pattern affect students’ academic performance and mental health? The International Journal of Health Planning and Management, 35(1), 5–21.
Arvaniti, F., & Panagiotakos, D. B. (2008). Healthy indexes in public health practice and research: a review. Critical Reviews in Food Science and Nutrition, 48(4), 317–332.
Panagiotakos, D. B., Pitsavos, C., & Stefanadis, C. (2006). Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutrition, Metabolism and Cardiovascular Diseases, 16(8), 559–568.
Panagiotakos, D., Kalogeropoulos, N., Pitsavos, C., Roussinou, G., Palliou, K., Chrysohoou, C., & Stefanadis, C. (2009). Validation of the MedDietScore via the determination of plasma fatty acids. International Journal of Food Sciences and Nutrition, 60(sup5), 168–180.