title: Proposal of a Mediterranean Diet Serving Score.
abstract: OBJECTIVE
  Numerous studies have demonstrated a relationship between Mediterranean Diet (MD) adherence and the prevention of cardiovascular diseases, cancer, and diabetes, etc. The study aim was to validate a novel instrument to measure MD adherence based on the consumption of food servings and food groups, and apply it in a female population from southern Spain and determining influential factors.
  
  
  RESULTS
  The study included 1,155 women aged 12-83 yrs, classified as adolescents, adults, and over-60-yr-olds. All completed a validated semi-quantitative food frequency questionnaire (FFQ). The Mediterranean Dietary Serving Score (MDSS) is based on the latest update of the Mediterranean Diet Pyramid, using the recommended consumption frequency of foods and food groups; the MDSS ranges from 0 to 24. The discriminative power or correct subject classification capacity of the MDSS was analyzed with the Receiver Operating Characteristic (ROC) curve, using the MDS as reference method. Predictive factors for higher MDSS adherence were determined with a logistic regression model, adjusting for age. According to ROC curve analysis, MDSS evidenced a significant discriminative capacity between adherents and non-adherents to the MD pattern (optimal cutoff point=13.50; sensitivity=74%; specificity=48%). The mean MDSS was 12.45 (2.69) and was significantly higher with older age (p<0.001). Logistic regression analysis showed highest MD adherence by over 60-year-olds with low BMI and no habit of eating between meals.
  
  
  CONCLUSIONS
  The MDSS is an updated, easy, valid, and accurate instrument to assess MD adherence based on the consumption of foods and food groups per meal, day, and week. It may be useful in future nutritional education programs to prevent the early onset of chronic non-transmittable diseases in younger populations.
authors.affiliation: Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain.
authors.forename: Celia
authors.initials: C
authors.lastname: Monteagudo
authors.affiliation: Department of Food Technology, Nutrition and Food Science, University of Murcia, Campus de Lorca, 30800, Lorca, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Mariscal-Arcas
authors.affiliation: Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Rivas
authors.affiliation: Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Lorenzo-Tovar
authors.affiliation: Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & CIBEROBN (Physiopathology of Obesity and Nutrition), E-07122, Palma de Mallorca, Spain.
authors.forename: Josep A
authors.initials: JA
authors.lastname: Tur
authors.affiliation: Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain.
authors.forename: Fátima
authors.initials: F
authors.lastname: Olea-Serrano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002648:Child; D004034:Diet Surveys / Q000706:statistics & numerical data*; D038441:Diet, Mediterranean; D004435:Eating; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult