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Mediterranean Diet Adherence Test (PREDIMED MEDAS)

Score your Mediterranean diet adherence with this fast PREDIMED MEDAS-based test. Answer 4 key habits, get a 0–4 score, and see the full 14-item MEDAS cutoffs.

🗓️ Updated June 2026 Reviewed by
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The Mediterranean diet is one of the most evidence-backed eating patterns for heart health. The PREDIMED trial used a validated 14-item screener (MEDAS) to measure how closely people follow it. This is a fast, 4-question version built from four of the highest-yield MEDAS habits — olive oil as your main fat, fish a few times a week, daily fruit, and moderate red wine with meals. It scores you from 0 to 4 and shows where the easy gains are. It is a quick orientation, not the full 14-item questionnaire (see below for how the complete MEDAS works).

When to use this calculator

  • Quickly gauge whether your current eating habits line up with the Mediterranean pattern before deciding what to change first
  • Spot the single highest-impact habit you're missing (e.g., switching to olive oil, or adding fish) instead of overhauling everything at once
  • Re-check yourself every few weeks to see whether a change you made (like daily fruit) is actually sticking
  • Use as a classroom or coaching warm-up to introduce the PREDIMED MEDAS screener and what dietary 'adherence' means

Full 14-Item MEDAS — Items, Criteria & Scoring (PREDIMED)

#Dietary habit / criterionPoint awarded if…
1Olive oil as the principal fat for cookingYes
2Olive oil consumption≥ 4 tablespoons per day
3Vegetables≥ 2 servings per day
4Fruit≥ 3 servings per day
5Red or processed meat< 1 serving per day
6Butter, margarine or cream< 1 serving per day
7Sugar-sweetened or carbonated drinks< 1 serving per day
8Wine (with meals)≥ 7 glasses per week
9Legumes≥ 3 servings per week
10Fish or seafood≥ 3 servings per week
11Commercial sweets or pastries< 3 servings per week
12Nuts≥ 3 servings per week
13Meat preferenceWhite meat (poultry) over red meat
14Sofrito (tomato/garlic/onion sauce in olive oil)≥ 2 times per week

Fuente: Schröder H, Martínez-González MA, et al. J Nutr 2011 (MEDAS validation); Estruch R, et al. N Engl J Med 2018 (PREDIMED). Total score 0–14; cutoff for high adherence: ≥ 10 points (> 9).

How it works

How it works

This tool is a 4-question shortcut derived from the MEDAS (Mediterranean Diet Adherence Screener), the 14-item questionnaire validated and used in the Spanish PREDIMED trial. It asks about four high-yield Mediterranean habits, gives 1 point for each one you hit, and adds them up to a score from 0 to 4:

Item asked herePoint if you answer "Yes"
Olive oil as your main cooking/dressing fat1
Fish or seafood ≥ 3 times per week1
Red wine ≈ 1 small glass/day with meals (if you drink)1
Fruit ≥ 3 servings per day1

Your adherence band (this 4-item version):

  • 3–4 points → High adherence

  • 2 points → Medium adherence

  • 0–1 points → Low adherence
  • The full 14-item MEDAS (the validated instrument)

    The complete MEDAS scores 14 yes/no items, each worth 1 point, for a total of 0 to 14. In PREDIMED and its validation studies, a score of 10 or higher (>9) is the cutoff for high adherence. The 14 items cover, broadly:

    1. Olive oil as the principal fat for cooking
    2. ≥ 4 tablespoons of olive oil per day
    3. ≥ 2 servings of vegetables per day
    4. ≥ 3 servings of fruit per day
    5. < 1 serving of red/processed meat per day
    6. < 1 serving of butter, margarine or cream per day
    7. < 1 sugar-sweetened or carbonated drink per day
    8. ≥ 7 glasses of wine per week (with meals)
    9. ≥ 3 servings of legumes per week
    10. ≥ 3 servings of fish/seafood per week
    11. < 3 commercial sweets/pastries per week
    12. ≥ 3 servings of nuts per week
    13. Preferring white meat (poultry) over red meat
    14. ≥ 2 times/week of "sofrito" (tomato/garlic/onion sauce cooked in olive oil)

    This 4-question screener covers items 1, 4, 8 and 10. It's meant for a fast read on the biggest levers — it is not a substitute for the full questionnaire, and a high score here does not guarantee a high score on all 14 items (you could still be heavy on red meat, sweets or sugary drinks).

    What the evidence actually shows

    In the PREDIMED trial (≈7,400 adults at high cardiovascular risk), a Mediterranean diet supplemented with extra-virgin olive oil or mixed nuts was associated with roughly a 30% lower risk of major cardiovascular events (heart attack, stroke, cardiovascular death) versus a control low-fat diet. The original 2013 paper was retracted and republished in 2018 after randomization issues were corrected; the reanalysis reached the same conclusion. The benefit is tied to the overall pattern — olive oil, nuts, vegetables, legumes, fish, whole grains and limited red/processed meat — not to any single food.

    Health disclaimer

    This calculator is for general information and education only and is not medical or nutritional advice, diagnosis, or treatment. It does not replace assessment by a physician or registered dietitian. If you have a medical condition (e.g., diabetes, heart disease, kidney disease), are pregnant, take medications, or are considering significant diet or alcohol changes, talk to a qualified healthcare professional first. Reviewed periodically; current as of 2026.

    Worked example

    Maria cooks with olive oil (Yes = 1), eats fish 3–4 times a week (Yes = 1), drinks wine only on weekends rather than daily (No = 0), and has 3 pieces of fruit most days (Yes = 1).
    Points: 1 + 1 + 0 + 1 = 3 out of 4.
    A score of 3 lands in the High band (3 or 4 = High adherence on this 4-item check).
    Score 3/4 → High adherence. Recommendation: good foundation — optimize the details (legumes, nuts, fewer ultra-processed foods). On the full 14-item MEDAS she would still want to confirm vegetables, legumes and a low intake of red/processed meat and sweets.

    Frequently asked questions

    What does the Mediterranean Diet Adherence Screener (MEDAS) actually measure?
    MEDAS measures how closely your usual eating habits match the traditional Mediterranean pattern — not your weight or calories. The full version asks 14 yes/no questions about specific habits (olive oil, vegetables, fruit, legumes, nuts, fish, wine with meals, and limits on red/processed meat, sweets and sugary drinks). This page uses a 4-question subset to give you a fast read on the biggest levers.
    What is a good MEDAS score?
    On the full 14-item MEDAS, a score of 10 or higher (technically greater than 9) is the cutoff used in PREDIMED to indicate high adherence; lower scores indicate moderate or low adherence. On this 4-item shortcut the score runs 0–4, where 3–4 is High, 2 is Medium and 0–1 is Low. The 0–4 and 0–14 scales are not interchangeable.
    Why does this calculator only ask 4 questions instead of 14?
    To give a quick orientation. The four items here — olive oil as your main fat, fish 3+ times a week, daily fruit, and moderate red wine with meals — are high-yield habits from the validated MEDAS. It's a screener-of-a-screener: useful for spotting where to start, but not a clinical-grade assessment. For a complete picture you'd answer all 14 MEDAS items, which also check vegetables, legumes, nuts, sofrito, and your intake of red meat, butter, sweets and sugary drinks.
    What did the PREDIMED study find about cardiovascular benefit?
    PREDIMED followed about 7,400 adults at high cardiovascular risk. Those assigned a Mediterranean diet supplemented with extra-virgin olive oil or mixed nuts had roughly a 30% lower risk of major cardiovascular events (heart attack, stroke, or cardiovascular death) than the low-fat control group. The original 2013 paper was retracted and republished in 2018 after randomization errors were corrected, and the reanalysis reached the same conclusion.
    Why are olive oil and nuts singled out?
    They were the two specific supplements PREDIMED added on top of Mediterranean-diet advice, and both intervention arms beat the control diet. Extra-virgin olive oil supplies monounsaturated fat and polyphenols; nuts add unsaturated fats, fiber and plant protein. In MEDAS, using olive oil as your principal fat (and ≥4 tablespoons/day) plus eating nuts ≥3 times a week each earn points.
    How is this different from just 'eating healthy'?
    It's specific and measurable. 'Eating healthy' is vague; MEDAS pins down concrete, countable habits (e.g., fish ≥3×/week, <1 sugary drink/day, olive oil as your main fat) tied to a pattern that's been tested in a randomized trial. That makes it possible to score yourself and target the exact habit that moves the needle, rather than guessing.
    Do I have to drink wine to score well?
    No. Wine is one optional item among many. If you don't drink, simply skip that habit and focus on the others — there's no health reason to start drinking for a diet score, and major guidelines do not recommend taking up alcohol for cardiovascular benefit. On this 4-item check you can still reach the High band by hitting the olive oil, fish and fruit items, and on the full MEDAS there are 13 other ways to earn points.
    How much fish counts, and does the type matter?
    MEDAS credits 3 or more servings of fish or seafood per week (a serving is roughly 100–150 g). Oily fish such as sardines, salmon, mackerel and anchovies are emphasized because they're rich in omega-3 fatty acids, but white fish and shellfish also count toward the habit.
    Does a high score here mean my whole diet is Mediterranean?
    Not necessarily. Because this version only checks 4 of the 14 items, you could score High here and still eat a lot of red meat, pastries or sugary drinks — things the full MEDAS penalizes. Treat a high score as a good sign on key habits, then verify the rest (vegetables, legumes, nuts, and limiting processed meat and sweets) against the 14-item list above.
    Can the Mediterranean diet help with anything besides the heart?
    Observational and trial evidence links higher Mediterranean-diet adherence with benefits for type 2 diabetes risk, blood pressure, and some markers of cognitive and metabolic health. The strongest randomized evidence (PREDIMED) is for cardiovascular events. As always, individual results vary — use this as general information and discuss your own situation with a healthcare professional.
    Is this calculator medical advice?
    No. It's an educational tool. It doesn't diagnose, treat, or replace a physician or registered dietitian. If you have a health condition, are pregnant, take medication, or plan major changes to your diet or alcohol intake, check with a qualified professional first.

    Methodology & trust

    Editorial

    Calculadora de salud revisada por el equipo editorial de Hacé Cuentas, contrastada con Estruch R, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med 2018 (PREDIMED, retraction & republication), según nuestra política editorial y metodología.

    Updates

    Última revisión: June 20, 2026. Los parámetros se verifican periódicamente con las fuentes citadas.

    Privacy

    Calculations run 100% in your browser. We do not store or transmit your data.

    Limitations

    Indicative results. For critical decisions, consult a professional.

    📌 How to cite this calculator

    Rodríguez, M. (2026). Mediterranean Diet Adherence Test (PREDIMED MEDAS). Hacé Cuentas. https://hacecuentas.com/dieta-mediterranea-adherencia-score-test

    Contenido bajo licencia CC-BY 4.0 — reutilizable citando la fuente con enlace a Hacé Cuentas.

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