The Chrono Med-Diet Score (CMDS) project was born after careful consideration
of the beneficial role of the Mediterranean Diet, which is inscribed on the representative list of
the Intangible Cultural Heritage of Humanity from the UNESCO, and the current scientific literature.
The Mediterranean Diet has been established as a significant contributor to reduce mortality from all causes,
especially cardiovascular disease, obesity, MetS, diabetes, and other chronic cardiometabolic conditions.
The original MedDiet was highly characterized by significant consumption of vegetables and fruit
associated with balance weekly intake of whole grains, legumes, nuts, seeds, aromatic herbs, and
extra-virgin olive oil (EVOO) as the most significant source of fat.
Currently, far from the original MedDiet, eating patterns have changed. Typical meals (breakfast, lunch, and dinner)
are difficult to be clearly identified during the day because skipping meals and snacking have become more frequent,
even in subjects with medical-assisted eating patterns and dietings. These eating styles can have various effects
on cardiometabolic health, particularly obesity, lipid profile, insulin resistance, and blood pressure.
There are several ways to identify adherence to MedDiet, starting from the original pyramid, then ranging from general
descriptions, a priori scoring systems, a posteriori dietary patterns or the characterizations based on food and
nutrient content. Over the last few years, a priori scores have emerged as the most popular ones, being the easiest
to correlate with primary dietary outcomes. The adherence score is consequently calculated as the sum of points awarded
for better intakes of well-being products, while negative or no points are allocated for health-harming food or habits.
These scores were mainly focused on the study of the eating patterns of subjects involved, nonetheless failed to link
these habits to clinical outcomes, especially regarding visceral adiposity.
Among the proposed scores, the MedDiet Score (MDS) developed by Trichopoulou et al. has been considered one of
the most significant scores, as well as the MEDI-LITE, proposed by Sofi et al. Both MDS and MEDI-LITE were very relatable
to the MedDiet pyramid and for the prediction of the adherence to the Mediterranean Diet Pattern.
In the CMDS project, we verified whether existing validated MedDiet scores could be associated with visceral adiposity.
Failing to find a significant association with adiposity, we proposed the validation of a new, easy-to-use adherence questionnaire,
the Chrono Med-Diet score (CMDS). The term Chrono represents the main novelty in our score: the timing of the day
in which farinaceous products are consumed, as well as the time dedicated to physical activity are the focus of our study.