Validation of a short questionnaire to record adherence to the Mediterranean diet: An Italian experience

P. Gnagnarella, D. Dragà, A.M. Misotti, S. Sieri, L. Spaggiari, E. Cassano, F. Baldini, L. Soldati, P. Maisonneuve

Research output: Contribution to journalArticlepeer-review


Background and aims: A greater adherence to the Mediterranean diet has been associated with a reduced risk of major chronic diseases and cancer. The aim of the study was to assess the validity of a new short self-administered 15-item questionnaire (QueMD) to measure adherence to the Mediterranean diet in Italy. Methods and results: Four-hundred and eighty three participants to cancer-screening programmes at the European Institute of Oncology, Milan (Italy) were invited to join this study. Those interested compiled the QueMD and a validated Food Frequency Questionnaire (FFQ) reporting their usual food consumption during the previous six months. We derived the alternate Mediterranean score (aMED) from both questionnaires with values ranging from 0 (minimal adherence) to 9 (maximal adherence). Complete dietary data were available for 343 individuals (participation rates 71.0%). Spearman correlation coefficient between the responses to the 15 questions of the QueMD and corresponding food intake derived from the FFQ ranged from 0.15 to 0.84. A moderate correlation was found between the aMED scores calculated from the QueMD and the FFQ (intraclass correlation coefficient 0.50; 95% CI, 0.42–0.58), while agreement between the two instruments was only poor to fair for 7 of the 9 single items composing the aMED score, with values ranging from 53.0% for wholegrain products to 79.5% for fruits. Conclusion: This new self-administered 15-item questionnaire could be a useful tool to assess adherence to the Mediterranean diet in the Italian population. © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University
Original languageEnglish
Pages (from-to)1140-1147
Number of pages8
JournalNutrition, Metabolism and Cardiovascular Diseases
Issue number11
Publication statusPublished - 2018


  • Mediterranean diet
  • Questionnaire
  • Validation study
  • fat
  • olive oil
  • saturated fatty acid
  • yoghurt
  • adult
  • aged
  • Article
  • beverage
  • breast cancer
  • butter
  • caloric intake
  • cancer risk
  • cancer screening
  • cereal
  • chicken
  • correlation coefficient
  • correlational study
  • dairy product
  • dietary compliance
  • dietary fiber
  • dietary intake
  • female
  • fish
  • food composition
  • food frequency questionnaire
  • food intake
  • fruit
  • grain legume
  • human
  • hypertension
  • legume
  • major clinical study
  • male
  • meat
  • milk
  • nutrient
  • nutritional assessment
  • obesity
  • observational study
  • priority journal
  • questionnaire
  • self-concept assessment
  • underweight
  • vegetable
  • whole grain
  • wine


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