title: Design and development of an instrument to measure overall lifestyle habits for epidemiological research: the Mediterranean Lifestyle (MEDLIFE) index.
abstract: OBJECTIVE
  To design and develop a questionnaire that can account for an individual's adherence to a Mediterranean lifestyle including the assessment of diet and physical activity patterns, as well as social interaction.
  
  
  METHODS
  The Mediterranean Lifestyle (MEDLIFE) index was created based on the current Spanish Mediterranean food guide pyramid. MEDLIFE is a twenty-eight-item derived index consisting of questions about food consumption (fifteen items), traditional Mediterranean dietary habits (seven items) and physical activity, rest and social interaction habits (six items). Linear regression models and Spearman rank correlation were fitted to assess content validity and internal consistency.
  
  
  METHODS
  A subset of participants in the Aragon Workers' Health Study cohort (Zaragoza, Spain) provided the data for development of MEDLIFE.
  
  
  METHODS
  Participants (n 988) of the Aragon Workers' Health Study cohort in Spain.
  
  
  RESULTS
  Mean MEDLIFE score was 11·3 (sd 2·6; range: 0-28), and the quintile distribution of MEDLIFE score showed a significant association with each of the individual items as well as with specific nutrients and lifestyle indicators (intra-validity). We also quantified MEDLIFE correspondence with previously reported diet quality indices and found significant correlations (ρ range: 0·44-0·53; P<0·001) for the Alternate Healthy Eating Index, the Alternate Mediterranean Diet Index and Mediterranean Diet Adherence Screener.
  
  
  CONCLUSIONS
  MEDLIFE is the first index to include an overall assessment of lifestyle habits. It is expected to be a more holistic tool to measure adherence to the Mediterranean lifestyle in epidemiological studies.
authors.affiliation: 1Department of Epidemiology,Atherothrombosis,and Imaging,Centro Nacional de Investigaciones Cardiovasculares (CNIC),28029 Madrid,Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Sotos-Prieto
authors.affiliation: 3Department of Medicine,Psychiatry and Dermatology,University of Zaragoza,Zaragoza,Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Moreno-Franco
authors.affiliation: 1Department of Epidemiology,Atherothrombosis,and Imaging,Centro Nacional de Investigaciones Cardiovasculares (CNIC),28029 Madrid,Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Ordovás
authors.affiliation: 5Cardiovascular Research Unit,Instituto Aragonés de Ciencias de la Salud (I+CS),Zaragoza,Spain.
authors.forename: Montse
authors.initials: M
authors.lastname: León
authors.affiliation: 5Cardiovascular Research Unit,Instituto Aragonés de Ciencias de la Salud (I+CS),Zaragoza,Spain.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Casasnovas
authors.affiliation: 1Department of Epidemiology,Atherothrombosis,and Imaging,Centro Nacional de Investigaciones Cardiovasculares (CNIC),28029 Madrid,Spain.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Peñalvo
mesh_terms: D000328:Adult; D015331:Cohort Studies; D038441:Diet, Mediterranean / Q000208:ethnology; D005260:Female; D006184:Habits; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007398:Interpersonal Relations; D008019:Life Style / Q000208:ethnology; D016014:Linear Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D019083:Mediterranean Region; D008875:Middle Aged; D009043:Motor Activity; D015596:Nutrition Assessment; D010349:Patient Compliance / Q000208:ethnology; D012146:Rest; D013030:Spain; D011795:Surveys and Questionnaires
keywords: Lifestyle