Adherence to a Mediterranean dietary pattern was assessed using the 9-Unit dietary score proposed by Trichopoulou et al (1995) (link), including fruits and nuts, vegetables, legumes, cereals, lipids, fish, dairy products, meat products, and alcohol. We used a variant of this score (Trichopoulou et al, 2005 (link)), in which lipid intake was assessed by calculating the ratio of unsaturated (the sum of monounsaturated and polyunsaturated lipids) to saturated lipids, to allow for the low consumption of olive oil-derived monounsaturated lipids in non-Mediterranean countries (Trichopoulou, 2004 (link)). A value of 0 or 1 was assigned to each component of the score as follows: for components that are more consumed in Mediterranean countries (vegetables, legumes, fruits and nuts, cereals, fish, and a high ratio of unsaturated to saturated lipids), persons whose consumption was below or equal to the country sex-specific median were assigned a value of 0, and 1 otherwise. For components traditionally less consumed in Mediterranean countries (dairy, meat, and meat products), persons whose consumption was below the country- and sex-specific median were assigned a value of 1, and 0 otherwise. A value of 1 was given to persons consuming a moderate amount of alcohol (i.e., 10 to <50 g per day of ethanol for men and 5 to <25 g per day for women). For consumption of other quantities of alcohol a value of 0 was assigned. No information on legume consumption was available for the Norwegian cohort but sensitivity analyses, excluding Norway, did not influence the overall results. High scores correspond to high adherence to the Mediterranean dietary pattern (score's range: 0–9).
The score was also calculated using an alternative, more quantitative, method described in theappendix . Obtained results were very similar (data not shown).
The score was also calculated using an alternative, more quantitative, method described in the
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