Abstract
The Mediterranean diet originates in the food cultures of ancient civilizations which developed around the Mediterranean Basin and is based on the regular consumption of olive oil (as the main source of added fat), plant foods (cereals, fruits, vegetables, legumes, tree nuts, and seeds), the moderate consumption of fish, seafood, and dairy, and low-to-moderate alcohol (mostly red wine) intake, balanced by a comparatively limited use of red meat and other meat products. A few decades ago, the Mediterranean diet drew the attention of medical professionals by proving extended health benefits. The first reports ascertained cardiovascular protection, as multiple large-scale clinical studies, starting with Ancel Keys’ Seven Countries Study, showed a marked reduction of atherosclerotic clinical events in populations with a Mediterranean dietary pattern. Ensuing trials confirmed favorable influences on the risk for metabolic syndrome, obesity, type 2 diabetes mellitus, cancer, and neurodegenerative diseases. While its health benefits are universally recognized today by medical professionals, the present state of the Mediterranean diet is challenged by major difficulties in implementing this protective dietary pattern in other geographical and cultural areas and keeping it alive in traditional Mediterranean territories, also tainted by the unhealthy eating habits brought by worldwide acculturation.
Highlights
Traditional eating habits seen in geographical territories surrounding the Mediterranean Sea, differentiated by some food choices and cooking practices specific to each country and culture, share a common set of basic features [1]
At the same time, when international guidelines include it among the recommended healthy dietary patterns [8], the United Nations Educational, Scientific and Cultural Organization (UNESCO) considers the Mediterranean diet an “Intangible Cultural Heritage of Urgent Safeguarding” [9]. Given this contradictory stand between universal medical recognition and cultural extinction, this paper aims to review the current information referring to the inception and development of the Mediterranean diet, the major medical evidence supporting its health benefits, and the challenges it must outrun in order to avoid erosion, to maintain survival and sustainability, and to serve public health with the best resources it can offer
In a set of studies on United States firefighters, a profession at high risk for cardio-metabolic disease, a greater adherence to the Mediterranean diet was associated with significant improvement of weight, low-density lipoprotein (LDL)-cholesterol and high-density lipoprotein (HDL)-cholesterol values, with reductions in total weight, body fat compartment, and prevalence of metabolic syndrome and with higher popularity scores and better adherence between Fire Service members [84]
Summary
Traditional eating habits seen in geographical territories surrounding the Mediterranean Sea, differentiated by some food choices and cooking practices specific to each country and culture, share a common set of basic features [1]. The specific dietary dimension of the Mediterranean lifestyle consists of a plant-based cuisine using vegetables, fruits, cereals, nuts, and legumes, most of them cooked by adding substantial amounts of olive oil, with moderate usage of fish, seafood or dairy, and limited intake of meat and alcohol (mostly red wine) [2] This unique dietary pattern, the result of a complex and multi-millennial interaction between the natural food resources available in the Mediterranean environment and the human element inhabiting the Mediterranean basin throughout history, came to acquire new valences in the last century and to become a precious medical tool in the contemporaneous world [3]. Given this contradictory stand between universal medical recognition and cultural extinction, this paper aims to review the current information referring to the inception and development of the Mediterranean diet, the major medical evidence supporting its health benefits, and the challenges it must outrun in order to avoid erosion, to maintain survival and sustainability, and to serve public health with the best resources it can offer
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