Mediterranean Diet and Lifestyle Index Development for Older Adults

OBJECTIVES: The Mediterranean diet is associated with many health benefits, yet it is typically only the food pattern that is assessed without consideration for lifestyle attributes that accompany a Mediterranean way of life. The Mediterranean diet pyramid includes lifestyle activities at the base of the pyramid such as regular physical activity (PA), adequate rest, conviviality, biodiversity and seasonality, traditional local and eco-friendly products, and culinary activities. The purpose of this study was to design and pilot test a Mediterranean diet and lifestyle index for older adults in the U.S. METHODS: The Harvard Food Frequency Questionnaire was used to determine the alternative Mediterranean Diet Score (aMed). The short version of the Minnesota Leisure Time PA questionnaire and additional Mediterranean diet-related dietary habit and lifestyle questions were piloted in 75 older adults attending senior centers. RESULTS: Participants were primarily women (80.6%) and Caucasian (68%) with an average age of 71.89+/−7.60 years. A 27-item index including the aMed food groups, dietary habits, PA, culinary activities, purchasing of local and seasonal foods, and adequate rest resulted in a reliable score (α = 0.75). Individual index factors correlated with the overall Mediterranean diet and lifestyle score. CONCLUSIONS: While this Mediterranean diet and lifestyle index resulted in good internal consistency; assessment of conviviality, especially for older adults in the time of Covid-19, need be re-evaluated as a lifestyle measure that can impact dietary intake and overall health. FUNDING SOURCES: Eastern Michigan University Faculty Research Fellowship Award.