A fascinating paper published in the Journal of the American Medical Association analyzed data collected from over 130,000 people in the UK Biobank study in terms of eight lifestyle metrics to see how they were linked to life expectancy free of chronic disease. The metrics, first evaluated in 2006, were smoking status, physical activity, weight, diet, sleep, blood pressure, blood glucose and blood cholesterol. Points were attached to each of these. For example, 150 minutes or more of moderate or greater intensity of physical activity earned 100 points, 60 to 90 minutes got 60 points, and less than 30 minutes only received 20 points. For sleep, 7 to 9 hours got 100 points, and 4 to 5 hours only 20. Blood pressure lower than 120/80 mm Hg got 100 points, and 130-139/ 80-89 was valued at 50 points. Similarly, points were also awarded for the other metrics. All the points were then added up and the total was divided by 8 to arrive at a “Life’s Essential 8 (LE8)” score that is indicative of potential health outcomes. Less than 50 was categorized as low, between 50 and 80 as moderate, and 80-100 as high.
Originally, the LE8 was designed as a measure of cardiovascular health, but the current study also evaluated diabetes, cancer and dementia in relation to LE8 levels. An association between a higher LE8 score and life expectancy free of major chronic diseases comes as no surprise. After all, these metrics have been extensively studied before and their link to health is backed by a large body of evidence. However, what is new here is the attachment of a numerical value to the disease-free years that are potentially the result of a high LE8 score. At age 50, men with a low LE8 score looked forward to 21 years of being disease-free while men with a high LE8 were rewarded with 28 years for a difference of 7 years! The corresponding numbers for women were 24 and 33.5 for 9.5 years.
What all of this means is that it is worth striving for a high LE8 score! And the quest is not futile since all of these metrics are modifiable, some more easily than others. Increasing physical activity and modifying diet is within everyone’s reach while lowering blood cholesterol and increasing hours of sleep are more challenging. But this is not an all-or-nothing type of situation Any effort to increase the LE8 score is worthwhile.
Let’s have a look at improving diet. One tool that can be used is the “Mediterranean Eating Pattern for Americans (MEPA) Questionnaire. The Mediterranean diet emphasizes fresh fruits and vegetables, fish, legumes, nuts, whole grains, olive oil, and wine, yet there is no single Mediterranean diet because eating patterns vary across the Mediterranean countries. The MEPA Questionnaire is therefore an attempt to integrate the essential features of Mediterranean diets into a general eating pattern to which people in North America can adhere. It includes sixteen questions, each of which is given a point of 0 or 1 for a maximum of 16 points. The higher the total, the better the diet. The questions are below, as well as the guide about how each question is evaluated. And we encourage you to take the questionnaire! As indicated, please assign a 0 or 1 to each question, and then add them up. The total will be between 0-16. Once you have your total, please to submit your response. Note that these results will be viewed by the OSS only and will not be made for the public. But it will be quite interesting to see the overall average score of our readership.
Mediterranean Eating Pattern for Americans (MEPA) III Questionnaire
Answer the following questions about how often you eat foods or drink beverages each day, each week, or each month. Write the number (whole numbers only) of servings in the box below that corresponds to the number of times you eat that food either in a day, a week, or a month. The amount of food for one serving is listed in parentheses after each question. If you do not eat that food, put a “0” in any box below the day, week, or month option.
For example, let’s say you eat ½ cup of blueberries twice a week. You would complete the frequency column as Day: 0, Week: 2
|1. How many servings of olive oil do you eat (including that used in salad dressings and cooking? (1 Tablespoon)||Day:___ Week:___|
|2. How many servings of green leafy vegetables do you eat such as spinach, kale, greens, romaine? (1 cup for raw leafy vegetables, 1/2 cup for cooked leafy vegetables)||Day:___ Week:___|
|3. How many servings of other types of vegetables do you eat? (1/2 cup)||Day:___ Week:___|
|4. How many servings of berries (e.g. blueberries, raspberries, strawberries) do you eat? (1/2 cup)||Day:___ Week:___|
|5. How many servings of fruit, not including berries, do you eat? (1/2 cup)||Day:___ Week:___|
|6. How many servings of red meat, hamburger, bacon or sausage do you eat? (3 ounces)||Day:___ Week:___|
|7. How many servings of fish (not fried) do you eat? (3 ounces)||Day:___ Week:___|
|8. How many servings of chicken (not fried) do you eat? (3 ounces)||Day:___ Week:___|
|9. How many servings of full fat or regular cheese or cream cheese do you eat? (1 ounce)||Day:___ Week:___|
|10. How many servings of butter or cream (whipping cream or half & half) do you eat? (1 Tablespoon)||Day:___ Week:___|
|11. How many servings of beans (pinto and black beans, lentils, soy such as edamame and tofu) do you eat?||Day:___ Week:___|
|12. How often do you eat breads, pasta, or cereals that are whole grain? (1 slice bread, 3/4 cup pasta/cereal)||Day:___ Week:___|
|13. How often do you eat commercial sweets, candy bars, pastries, cookies or cakes? (1 cookie, pastry)||Day:___ Week:___|
|14. How many servings of nuts do you eat? (1/4 cup)||Day:___ Week:___|
|15. How many times do you eat food from a fast food restaurant such as McDonald's, Burger King, Denny's, Domino's, Popeye's, or Kentucky-Fried Chicken?||Day:___ Week:___|
|16. How many servings of alcohol do you drink? (5 ounces wine, 12 ounces beer, 1 ounce hard liquor)||Day:___ Week:___|
A score of ‘0’ or ‘1’ is assigned to each item on the MEPA screener based on reported frequencies. A score of‘1’ for any given item was indicative of Mediterranean-like diet accordance.
One point is given for each of:
(i) ≥ 2 servings of olive oil per day;
(ii) ≥7 servings of green leafy vegetables per week;
(iii) ≥2 servings of other vegetables per day;
(iv) ≥2 servings of berries per week;
(v) ≥1serving of other fruit per day;
(vi) ≤3 servings of red meat, hamburger, bacon, or sausage per week;
(vii) ≥1 serving of fish per week;
(viii) ≤5 servings of chicken per week;
(ix) ≤4 servings of full fat or regular cheese or cream cheese per week;
(x) ≤5 servings of butter or cream per week;
(xi) ≥3 servings of beans per week;
(xii) ≥3servings of whole grains per day;
(xiii) ≤4 servings of commercial sweets, candy bars, pastries, cookies or cakes per week;
(xiv) ≥4 servings of nuts per week;
(xv) ≤1 meal at a fast food restaurant per week; and
(xvi) >0 or ≤2 servings of alcohol per day for men and >0 or ≤1 serving of alcohol per day for women.
If any condition was not met, a score of ‘0’ is recorded for that item. The total MEPA screener score ranges from 0 to 16