Calculate your Mediterranean Diet Adherence Score using the Trichopoulou scale. Rate your diet against the gold standard of healthy eating patterns.
The Mediterranean diet is consistently ranked the #1 overall diet by U.S. News & World Report and is the most studied dietary pattern in human nutrition research. Originating from the traditional eating habits of Greece, southern Italy, and Spain in the 1960s, this diet emphasizes olive oil, fruits, vegetables, legumes, whole grains, fish, and moderate red wine, while limiting red meat, processed foods, and added sugars.
The Trichopoulou Mediterranean Diet Score (MDS) is the most widely used research-validated scoring system. It awards points (0 or 1) for each of 9 dietary components based on whether your intake exceeds the population median for beneficial foods or falls below it for harmful foods, producing a score from 0 (no adherence) to 9 (full adherence).
This calculator uses the Trichopoulou scale with simplified serving-based thresholds to help you objectively measure how closely your diet follows Mediterranean principles. Whether you are a beginner or experienced professional, this free online tool provides instant, reliable results without manual computation.
The Mediterranean diet has the strongest evidence base of any dietary pattern, with randomized controlled trials showing it reduces cardiovascular events by 30%, type 2 diabetes risk by 52%, and cognitive decline by 35%. Scoring your adherence helps you identify specific areas for improvement rather than guessing whether your diet is “Mediterranean enough.”
Mediterranean Diet Score (0–9) = Sum of 9 component scores Beneficial components (1 point if ≥ threshold): • Vegetables: ≥ 3 servings/day • Fruits: ≥ 2 servings/day • Legumes: ≥ 0.5 servings/day • Fish: ≥ 0.4 servings/day (~3/week) • Whole Grains/Cereals: ≥ 3 servings/day • Olive Oil: ≥ 2 tbsp/day Harmful components (1 point if ≤ threshold): • Red/Processed Meat: ≤ 1 serving/day • Full-fat Dairy: ≤ 1 serving/day Moderate component: • Wine: 0.5–1.5 glasses/day (1 point if moderate)
Result: MDS: 7/9 (Good Adherence)
Vegetables 4 ≥ 3 → 1, Fruits 2 ≥ 2 → 1, Legumes 0.5 ≥ 0.5 → 1, Fish 0.5 ≥ 0.4 → 1, Cereals 3 ≥ 3 → 1, Olive Oil 2 ≥ 2 → 1, Meat 0.8 ≤ 1 → 1, Dairy 1.5 > 1 → 0, Wine 1 in 0.5–1.5 → 1. Total = 7/9. Good adherence; reducing dairy below 1 serving or switching to low-fat dairy would achieve near-perfect score.
The Mediterranean diet has been studied in over 40 randomized controlled trials and hundreds of observational studies. The landmark PREDIMED trial randomly assigned 7,447 high-risk adults to a Mediterranean diet supplemented with olive oil, a Mediterranean diet supplemented with nuts, or a control diet. After 5 years, both Mediterranean groups had approximately 30% fewer cardiovascular events.
Researchers believe the benefits come from the synergy of multiple components rather than any single food. Olive oil provides oleic acid and polyphenols. Fish provides EPA/DHA omega-3 fatty acids. Fruits and vegetables provide fiber, potassium, and thousands of phytochemicals. Moderate alcohol may increase HDL cholesterol. The overall pattern is high in fiber, healthy fats, and antioxidants while being low in refined carbohydrates, processed foods, and saturated fats.
You don't need to eat Greek or Italian food to follow this pattern. Replace olive oil with canola for cooking if needed, eat local fish varieties, use whatever whole grains are available in your region, and focus on seasonal produce. The principles are universal: whole foods, healthy fats, abundant plants, and limited processed items.
Developed by Dr. Antonia Trichopoulou and colleagues at the University of Athens, the MDS is a 0–9 point scoring system used in the landmark EPIC and HALE studies. Each of 9 dietary components is scored as 0 or 1 based on sex-specific population medians. This calculator uses simplified universal thresholds for practical use.
Research consistently shows that scores of 6–9 are associated with the greatest health benefits. Each 2-point increase in MDS was associated with a 25% reduction in all-cause mortality in the original Greek EPIC study (n=22,043). Even modest improvements from 2 to 4 provide meaningful benefit.
The Mediterranean diet is appropriate for most adults and has been studied extensively in populations worldwide, not just Mediterranean countries. It's naturally flexible and can accommodate vegetarian, pescatarian, or gluten-free modifications. Those with specific medical conditions should consult their healthcare provider.
The wine component accounts for only 1 of 9 points. Many studies show the Mediterranean diet's benefits persist without alcohol. If you don't drink, focus on maximizing the other 8 components for a top score of 8/9, which still represents excellent adherence.
In head-to-head trials, the Mediterranean diet outperforms low-fat diets for cardiovascular outcomes, matches or exceeds low-carb diets for weight management, and shows unique benefits for cognitive health. The PREDIMED trial (7,447 participants) demonstrated a 30% reduction in cardiovascular events compared to a control diet.
Vegetables: 1 cup raw or ½ cup cooked. Fruits: 1 medium piece or ½ cup. Legumes: ½ cup cooked. Fish: 3–4 oz cooked. Whole grains: 1 slice bread or ½ cup cooked grain. Olive oil: 1 tablespoon. Meat: 3–4 oz cooked. Dairy: 1 cup milk or 1.5 oz cheese. Wine: 5 oz glass.