Nutr Res Pract.  2019 Aug;13(4):333-343. 10.4162/nrp.2019.13.4.333.

Comparison of five international indices of adherence to the Mediterranean diet among healthy adults: similarities and differences

  • 1Laboratoire de pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, 1107 2180, Lebanon.
  • 2Department of nutrition, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, 1107 2180, Lebanon.
  • 3Department of Public Health, Faculty of Medicine, Saint-Joseph University, Beirut, 1107 2180, Lebanon.
  • 4Department of Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University, 1107 2180, Beirut, Lebanon.
  • 5Centre de Recherche en Odontologie Clinique, EA 4847, University of Clermont Auvergne, Clermont-Ferrand, France.


To compare five indices of adherence to the Mediterranean Diet (MD) among adults living in the Mediterranean region.
A total of 100 healthy Lebanese adults aged between 18 and 65 years. Face-to-face interviews to collect sociodemographic and medical information, to take anthropometric measurements, and to fill a validated, culturally adapted, food frequency questionnaire (FFQ). The score for each item was calculated following the recommendations for each corresponding index. The five MD indices were Mediterranean Diet Scale (MDScale), Mediterranean Food Pattern (MFP), MD Score (MDS), Short Mediterranean Diet Questionnaire (SMDQ), and the MedDiet score.
Significant correlations were detected between items with P-values < 0.001. Minimal agreement was seen between MDScale and MedDiet score and maximal agreement between MDS and MedDiet score. Univariate and multivariate analyses showed that MDS and MedDiet scores had significant correlations with fiber and olive oil intake, main components of the MD. MDScale showed a significant correlation with waist-to-hip ratio and with total energy intake but none of the five indices was correlated to body mass index (BMI).
The indices that showed the highest correlation with variables related to the MD are the MDScale and the MedDiet score; therefore, they can be used to assess our future study populations. Based on the current results, more than half of the study population was non-adherent to the MD and adherence to this diet did not appear to protect against being overweight (BMI ≥ 30).


Mediterranean diet; score; adherence; Mediterranean country
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