The average consumption of vegetable foods was inversely related (R= -0.59), and animal foods (R =0.68), hard fats and sweet products (sugar products and pastries) (R=0.84) were positively related to 50-year CHD mortality rates. The MAI food pattern score was strongly inversely associated with 50-year CHD mortality rates (R= -0.91). A high MAI score is an indicator of the traditional Mediterranean and Japanese dietary patterns and is associated with low CHD mortality rates. These ecological findings among populations are concordant with results from meta-analyses of individual diet-disease data from prospective studies and randomized trials.

Relationship of the Mediterranean Adequacy Index at baseline with 50-year CHD death rates.  BE Belgrade, Serbia, CO Corfu, Greece, CR Crevalcore, Italy, DA Dalmatia, Croatia, EF East Finland, KT Crete, Greece, MO Montegiorgio, Italy, RR Rome railroad, Italy, SL Slavonia, Croatia, TA Tanushimaru, Japan, UB Ushibuka, Japan, US US railroad, VK Velika Krsna, Serbia, WF West Finland, ZR Zrenjanin, Serbia, ZU Zutphen, the Netherlands

The Mediterranean Adequacy Index

The MAI is an a priori food pattern score based on 15 food groups as computed by Fidanza and colleagues. The numerator of the score includes foods typical of the traditional Mediterranean diet (bread, cereals, legumes, potatoes, vegetables, fruit, fish, vegetable oil (mainly olive oil) and wine), while the denominator includes foods not typical of the Mediterranean diet (high-fat milk, cheese, meat, eggs, hard fats, and sweet products).