Mediterranean diet

Last updated

Some ingredients that form a large part of the Mediterranean diet DIETA MEDITERRANEA ITALIA.JPG
Some ingredients that form a large part of the Mediterranean diet

The Mediterranean diet is a concept first proposed in 1975 by American biologist Ancel Keys and chemist Margaret Keys. It is inspired by the eating habits and traditional foods of Greece (particularly Crete), Italy, and the Mediterranean coasts of France and Spain, as observed in the late 1950s to early 1960s. [1] [2] The diet is distinct from Mediterranean cuisine, which encompasses the diverse culinary traditions of Mediterranean countries, [3] and from the Atlantic diet of northwestern Spain and Portugal, albeit with some shared characteristics. [4] The Mediterranean diet is the most well-known and researched dietary pattern in the world. [5]

Contents

While based on a specific time and place, the "Mediterranean diet" generically describes an eating pattern that has been refined based on the results of multiple scientific studies. [6] It emphasizes plant-based foods, particularly unprocessed cereals, legumes, vegetables, and fruits; [7] moderate consumption of fish and dairy products (mostly cheese and yogurt); and low amounts of red meat, refined grains, and sugar. [7] [8] Alcohol intake is limited to wine (typically the red variety) consumed in low to moderate amounts, usually with meals. [9] [10] Olive oil is the principal source of fat and has been studied as a potential health factor for reducing all-cause mortality and the risk of chronic diseases. [11]

The Mediterranean diet is associated with a reduction in all-cause mortality in observational studies. [12] [13] A 2017 review provided evidence that the Mediterranean diet lowers the risk of heart disease and early death; [14] it may also help with weight loss in obese people. [15] The Mediterranean diet is one of three healthy diets recommended in the 2015–2020 Dietary Guidelines for Americans, along with the DASH diet and vegetarian diet. [16] It is also recognized by the World Health Organization as a healthy eating pattern. [17]

Mediterranean cuisine and its associated traditions and practices were recognized as an Intangible Cultural Heritage of Humanity by UNESCO in 2010 under the name "Mediterranean Diet". [a] [18] The Mediterranean diet is sometimes broadened to include particular lifestyle habits, social behaviors, and cultural values closely associated with certain Mediterranean countries, [19] such as simple but varied cooking methods, [20] communal meals, post-lunch naps, and regular physical activity. [17] [21]

Health effects

A 2017 review found evidence that practice of a Mediterranean diet could lead to reduced risk of cardiovascular diseases, overall cancer incidence, neurodegenerative diseases, diabetes, and early death. [14] A 2018 review showed that practice of the Mediterranean diet may improve overall health status, such as reduced risk of non-infectious diseases, reduced total costs of living, and reduced costs for national healthcare. [22] A 2016 review found similar weight loss as other diets. [23] A 2019 Cochrane review found that there is still uncertainty regarding the effects of Mediterranean‐style diet advice on cardiovascular disease occurrence and risk factors in people both with and without existing cardiovascular disease. [24]

The United States 2015–2020 national guidelines devised a "Healthy Mediterranean-Style Eating Pattern", assessed against and mirroring the Mediterranean diet patterns and its positive health outcomes. It was designed from the "Healthy U.S.-Style Eating Pattern", but it contains more fruits and seafood, and less dairy. [16] In the 2020s, research on the Mediterranean diet indicates that it may contribute to health. [25]

Cardiovascular disease

The Mediterranean diet is included among dietary patterns that may reduce the risk of cardiovascular diseases. [15] A 2013 Cochrane review found limited evidence that a Mediterranean diet favorably affects cardiovascular risk factors. [24] A 2013 meta-analysis compared Mediterranean, vegan, vegetarian, low-glycemic index, low-carbohydrate, high-fiber, and high-protein diets with control diets. The research concluded that Mediterranean, low-carbohydrate, low-glycemic index, and high-protein diets are effective in improving markers of risk for cardiovascular disease and diabetes, while there was limited evidence for an effect of vegetarian diets on glycemic control and lipid levels unrelated to weight loss. [26] However, more cautious reviews arose in early 2016, raising concerns about the quality of previous systematic reviews examining the impact of a Mediterranean diet on cardiovascular risk factors. [27] These reviews insisted upon the need for further standardized research, [28] stating that the evidence for possible prevention of cardiovascular disease by the diet was "limited and highly variable". [29] Reviews in 2016-17 reached similar conclusions about the ability of a Mediterranean diet to improve cardiovascular risk factors, such as lowering the risk for hypertension and other cardiovascular diseases. [14] [30] A Mediterranean diet is recommended as a means of lowering Apolipoprotein B. [31]

The Mediterranean diet is low in saturated fat with high amounts of monounsaturated fat and dietary fiber. One possible factor is the potential health effects of olive oil in the Mediterranean diet. Olive oil contains monounsaturated fats, most notably oleic acid, which is under clinical research for its potential health benefits. [32] The European Food Safety Authority Panel on Dietetic Products, Nutrition and Allergies approved health claims on olive oil, for protection by its polyphenols against oxidation of blood lipids [33] and for the contribution to the maintenance of normal blood LDL-cholesterol levels by replacing saturated fats in the diet with oleic acid [34] (Commission Regulation (EU) 432/2012 of 16 May 2012). [35] A 2014 meta-analysis concluded that an elevated consumption of olive oil is associated with reduced risk of all-cause mortality, cardiovascular events and stroke, while monounsaturated fatty acids of mixed animal and plant origin showed no significant effects. [36] The American Heart Association discussed the Mediterranean diet as a healthy dietary pattern that may reduce the risk of cardiovascular diseases. [37]

A 2023 review found evidence for a reduction of mortality and cardiovascular disease risk in women on a Mediterranean-type diet. [38]

Diabetes

In 2014, two meta-analyses found that the Mediterranean diet was associated with a decreased risk of type 2 diabetes, [39] [40] findings similar to those of a 2017 review. [14] The American Diabetes Association and a 2019 review indicated that the Mediterranean diet is a healthy dietary pattern that may reduce the risk of diabetes. [41] [42]

Cancer

A meta-analysis in 2008 found that strictly following the Mediterranean diet was correlated with a decreased risk of dying from cancer by 6%. [43] Another 2014 review found that adherence to the Mediterranean diet was associated with a decreased risk of death from cancer. [44] A 2017 review found a decreased rate of cancer, although evidence was weak. [14] An updated review in 2021 found that the Mediterranean diet is associated with a 13% lower risk of cancer mortality in the general population. [45]

Weight loss in obesity

Overweight adults who adopt Mediterranean diets may lose weight by consuming fewer calories. [46] [47] [48] A 2019 review found that the Mediterranean diet may help obese people lower the quantity and improve the nutritional quality of food intake, with an overall effect of possibly losing body weight. [15]

Cognitive ability

A 2016 systematic review found a relation between greater adherence to a Mediterranean diet and better cognitive performance; it is unclear if the relationship is causal. [49]

According to a 2013 systematic review, greater adherence to a Mediterranean diet is correlated with a lower risk of Alzheimer's disease and slower cognitive decline. [50] Another 2013 systematic review reached similar conclusions, and also found a negative association with the risk of progressing from mild cognitive impairment to Alzheimer's, but acknowledged that only a small number of studies had been done on the topic. [51]

Major depressive disorder

Observational studies have found a correlation between adherence to the Mediterranean diet and a lower risk of depression but do not prove cause and effect. [52] [53]

Gluten

As the Mediterranean diet usually includes products containing gluten, such as pasta and bread, increasing use of the diet may have contributed to the growing rate of gluten-related disorders. [54]

Dietary components

The Mediterranean diet food pyramid, summarizing the pattern of eating associated with this diet Harvard food pyramid.png
The Mediterranean diet food pyramid, summarizing the pattern of eating associated with this diet

There are variations of the "Mediterranean diets" in different countries and among the individual populations of the Mediterranean basin, due to ethnic, cultural, economic and religious diversities. [55] The "Mediterranean diet" as defined by dietitians generally includes the following components, [15] which are not typical of diets in the Mediterranean Basin: [56] [57]

These proportions are sometimes represented in the Mediterranean Diet Pyramid. In a diet with roughly this composition, the fat content accounts for 25% to 35% of the total intake of calories, while the amount of saturated fat is, at most, 8% of the calorie content. [57]

Some cuisines of the Mediterranean region are not fully consistent with Mediterranean diet guidelines. For instance, olive oil is not the staple fat in the cuisines of all countries which border the Mediterranean: in northern and central Italy, lard and butter are commonly used in cooking, and olive oil is reserved for dressing salads and cooked vegetables; [58] in both North Africa and the Middle East, sheep's tail fat and rendered butter (samna) are traditional staple fats. [59]

Comparison of dietary recommendations for three Mediterranean diet plans
Foods Oldway's Preservation
and Trust (2009) [60] 		Mediterranean Diet
Foundation (2001) [61] 		Greek Dietary
Guidelines (1999) [62] [63]
Olive oil Every mealEvery mealMain added lipid
Vegetables Every meal≥2 servings every meal6 serv./day
Fruits Every meal1–2 serv. every meal3 serv./day
Bread/cereals Every meal1–2 serv. every meal8 serv./day
Legumes Every meal≥2 serv./week3-4 serv./week
Nuts Every meal1–2 serv./day3–4 serv./week
Fish/seafood ≥2 serv./week≥2 serv./week5–6 serv./week
Eggs Moderate portions, daily to weekly2–4 serv./week3 serv./week
Poultry Moderate portions, daily to weekly2 serv./week4 serv./week
Dairy products Moderate portions, daily to weekly2 serv./day2 serv./day
Red meat Less often<2 serv./week4 serv./month
Sweets Less often<2 serv./week3 serv./week
Red wine In moderationIn moderationDaily, in moderation
Servings are defined as: bread 25 g., potato 100 g., cooked pasta 50–60 g., vegetables 100 g., apple 80 g., banana 60 g., orange 100 g., melon 200 g., grapes 30 g., milk or yogurt 1 cup, 1 egg, meat 60 g., cooked dry beans 100 g.

Environmental effects

Consuming a Mediterranean diet or plant-based diet may contribute to improving environmental and agricultural sustainability, [64] [65] possibly due to lower use of dairy products, ruminant meat, and ultra-processed foods. [66] [ better source needed ] The environmental impact and amount of energy needed to feed livestock exceeds its nutritional value. [67] [68] In a 2014 lifecycle analysis of greenhouse gas emissions, researchers found that a Mediterranean-like diet may reduce food production emissions below those of an omnivorous diet for 2050, with a per capita reduction of 30%. [69] [70]

History and research

Elements of the Mediterranean diet have been traced to several ancient cultures in the region, particularly the Greeks and Romans, using olive oil, seafood, bread, and wine. [71] The Mediterranean diet as a concept was first publicized in 1975 by American biologist Ancel Keys and chemist Margaret Keys, a husband-and-wife team. [71] The Keys were the first to draw a correlation between cardiovascular disease and diet, based on studies in the 1950s in southern Italy. [71]

Objective data showing possible benefits of the Mediterranean diet originated from epidemiological studies in southern Italy and Crete; these were confirmed later by the Seven Countries Study directed by Keys and published in 1970, [72] [73] which was followed by a book-length report in 1980. [74] A 25-year follow up study published in 1996 determined that populations that had adopted a "Mediterranean diet"—defined as incorporating olive oil, bread, pasta, vegetables, herbs and seafood, with moderate consumption of meat—presented low levels of blood cholesterol and reduced incidence of coronary heart disease. [73] [75]

The Mediterranean diet was further studied in the 1990s by Walter Willett and colleagues of the Harvard University School of Public Health. [76] [77] [78] [79] The Mediterranean diet is based on a paradox: although people living in Mediterranean countries tend to consume relatively high amounts of fat, they generally have lower incidence of cardiovascular disease than those living in countries with similar levels of fat consumption, such as the United States; a parallel phenomenon is known as the French paradox. [80]

Since about 2016, the American Heart Association and American Diabetes Association have recommended the Mediterranean diet as a dietary pattern that may reduce the risk of cardiovascular diseases and type 2 diabetes. [37] [41] [81] The National Health Service also recommends a Mediterranean diet to reduce cardiovascular disease risk. [82]

In 2018, clinical research showed favorable outcomes for using the Mediterranean diet to lower the risk of metabolic syndrome. [83]

See also

Commons-logo.svg Media related to Mediterranean diet at Wikimedia Commons

Notes

  1. ↑ In Cyprus, Croatia, Greece, Italy, Morocco, Spain, and Portugal

References

  1. ↑ Keys, Ancel Benjamin (1975). How to eat well and stay well the Mediterranean way. Internet Archive. Garden City, N.Y., Doubleday. pp. 1–2. ISBN   978-0-385-00906-5.
  2. ↑ Willett WC (June 1995). "Mediterranean diet pyramid: a cultural model for healthy eating". The American Journal of Clinical Nutrition. 61 (6): 1402S –1406S. doi: 10.1093/ajcn/61.6.1402S . PMID   7754995.
  3. ↑ "What is the Mediterranean Diet?". www.heart.org. Retrieved 10 July 2025.
  4. ↑ LaMotte, Sandee (13 February 2024). "A cousin to the Mediterranean diet: The Atlantic diet explained". CNN. Retrieved 10 July 2025.
  5. ↑ Kiani, Aysha Karim; Medori, Maria Chiara; Bonetti, Gabriele; Aquilanti, Barbara; Velluti, Valeria; Matera, Giuseppina; Iaconelli, Amerigo; Stuppia, Liborio; Connelly, Stephen Thaddeus; Herbst, Karen L.; Bertelli, Matteo (June 2022). "Modern vision of the Mediterranean diet". Journal of Preventive Medicine and Hygiene. 63 (2 Suppl 3): E36 –E43. doi:10.15167/2421-4248/jpmh2022.63.2S3.2745. ISSN   2421-4248. PMC   9710405 . PMID   36479477.
  6. ↑ "What is the Mediterranean Diet?". www.heart.org. Retrieved 10 July 2025.
  7. 1 2 "Mediterranean Diet". Cleveland Clinic. 20 November 2022. Retrieved 26 November 2023.
  8. ↑ "Diet Review: Mediterranean Diet". The Nutrition Source, Harvard University School of Public Health. 1 April 2023. Retrieved 26 November 2023.
  9. ↑ McManus KD (21 March 2019). "A practical guide to the Mediterranean diet". Harvard Health. Retrieved 10 July 2025.
  10. ↑ "Mediterranean diet for heart health". Mayo Clinic. Retrieved 10 July 2025.
  11. ↑ Larsson, S (2022). "Can Small Amounts of Olive Oil Keep the Death Away?". Journal of the American College of Cardiology. 79 (2): 113–115. doi: 10.1016/j.jacc.2021.11.006 . PMID   35027107. S2CID   245933012.
  12. ↑ Arnett, Donna K.; Blumenthal, Roger S.; Albert, Michelle A.; et al. (17 March 2019). "2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease". Circulation. 140 (11): e596 –e646. doi: 10.1161/CIR.0000000000000678 . PMC   7734661 . PMID   30879355.
  13. ↑ Guasch-Ferré, M; Willett, WC (2021). "The Mediterranean diet and health: a comprehensive overview". Journal of Internal Medicine . 290 (3): 549–566. doi: 10.1111/joim.13333 . PMID   34423871.
  14. 1 2 3 4 5 Dinu, M; Pagliai, G; Casini, A; Sofi, F (10 May 2017). "Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials". European Journal of Clinical Nutrition. 72 (1): 30–43. doi:10.1038/ejcn.2017.58. hdl: 2158/1081996 . PMID   28488692. S2CID   7702206.
  15. 1 2 3 4 Pallazola, Vincent A.; Davis, Dorothy M.; Whelton, Seamus P.; et al. (2019). "A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention". Mayo Clinic Proceedings: Innovations, Quality & Outcomes. 3 (3): 251–267. doi:10.1016/j.mayocpiqo.2019.05.001. ISSN   2542-4548. PMC   6713921 . PMID   31485563.
  16. 1 2 "2015–2020 Dietary Guidelines for Americans" (National guidelines). Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services. 7 November 2019. Retrieved 7 November 2019.
  17. 1 2 "Mediterranean diet for heart health". Mayo Clinic. Retrieved 10 July 2025.
  18. ↑ "Intangible Cultural Heritage". UNESCO Med Diet. Retrieved 21 June 2025.
  19. ↑ Godos, Justyna; Scazzina, Francesca; Paternò Castello, Corrado; Giampieri, Francesca; Quiles, José L.; Briones Urbano, Mercedes; Battino, Maurizio; Galvano, Fabio; Iacoviello, Licia; de Gaetano, Giovanni; Bonaccio, Marialaura; Grosso, Giuseppe (21 March 2024). "Underrated aspects of a true Mediterranean diet: understanding traditional features for worldwide application of a "Planeterranean" diet". Journal of Translational Medicine. 22 (1): 294. doi: 10.1186/s12967-024-05095-w . ISSN   1479-5876. PMC   10956348 . PMID   38515140.
  20. ↑ Godos, Justyna; Scazzina, Francesca; Paternò Castello, Corrado; Giampieri, Francesca; Quiles, José L.; Briones Urbano, Mercedes; Battino, Maurizio; Galvano, Fabio; Iacoviello, Licia; de Gaetano, Giovanni; Bonaccio, Marialaura; Grosso, Giuseppe (21 March 2024). "Underrated aspects of a true Mediterranean diet: understanding traditional features for worldwide application of a "Planeterranean" diet". Journal of Translational Medicine. 22 (1): 294. doi: 10.1186/s12967-024-05095-w . ISSN   1479-5876. PMC   10956348 . PMID   38515140.
  21. ↑ "Fostering healthier and more sustainable diets – learning from the Mediterranean and New Nordic experience". www.who.int. Retrieved 10 July 2025.
  22. ↑ Martinez-Lacoba, R; Pardo-Garcia, I; Amo-Saus, E; Escribano-Sotos, F (2018). "Mediterranean diet and health outcomes: a systematic meta-review". European Journal of Public Health. Advance articles (5): 955–961. doi: 10.1093/eurpub/cky113 . PMID   29992229.
  23. ↑ Mancini, JG; Filion, KB; Atallah, R; Eisenberg, MJ (April 2016). "Systematic Review of the Mediterranean Diet for Long-Term Weight Loss". American J Med. 129 (4): 407–415.e4. doi: 10.1016/j.amjmed.2015.11.028 . PMID   26721635.
  24. 1 2 Rees, K; Takeda, A; Martin, N; Ellis, L; Wijesekara, D; Vepa, A; Das, A; Hartley, L; Stranges, S (13 March 2019). "Mediterranean-style diet for the primary and secondary prevention of cardiovascular disease". The Cochrane Database of Systematic Reviews. 2019 (3): CD009825. doi:10.1002/14651858.CD009825.pub3. ISSN   1469-493X. PMC   6414510 . PMID   30864165.
  25. ↑ O'Keefe, James H.; Torres-Acosta, Noel; O'Keefe, Evan L.; Saeed, Ibrahim M.; Lavie, Carl J.; Smith, Sarah E.; Ros, Emilio (22 September 2020). "A Pesco-Mediterranean Diet With Intermittent Fasting: JACC Review Topic of the Week". Journal of the American College of Cardiology. 76 (12): 1484–1493. doi: 10.1016/j.jacc.2020.07.049 . ISSN   1558-3597. PMID   32943166.
  26. ↑ Ajala O.; English P.; Pinkney J. (2013). "Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes". The American Journal of Clinical Nutrition. 97 (3): 505–516. doi: 10.3945/ajcn.112.042457 . PMID   23364002.
  27. ↑ Huedo-Medina, TB; Garcia, M; Bihuniak, JD; Kenny, A; Kerstetter, J (March 2016). "Methodologic quality of meta-analyses and systematic reviews on the Mediterranean diet and cardiovascular disease outcomes: a review". American Journal of Clinical Nutrition (Review). 103 (3): 841–50. doi: 10.3945/ajcn.115.112771 . PMID   26864357.
  28. ↑ Nissensohn M, Román-Viñas B, Sánchez-Villegas A, Piscopo S, Serra-Majem L (January 2016). "The Effect of the Mediterranean Diet on Hypertension: A Systematic Review and Meta-Analysis". Journal of Nutrition Education and Behavior (Review). 48 (1): 42–53.e1. doi:10.1016/j.jneb.2015.08.023. PMID   26483006.
  29. ↑ Liyanage T, Ninomiya T, Wang A, Neal B, Jun M, Wong MG, Jardine M, Hillis GS, Perkovic V (2016). "Effects of the Mediterranean Diet on Cardiovascular Outcomes-A Systematic Review and Meta-Analysis". PLOS ONE (Review). 11 (8): e0159252. Bibcode:2016PLoSO..1159252L. doi: 10.1371/journal.pone.0159252 . PMC   4980102 . PMID   27509006.
  30. ↑ Gay, HC; Rao, SG; Vaccarino, V; Ali, MK (April 2016). "Effects of Different Dietary Interventions on Blood Pressure: Systematic Review and Meta-Analysis of Randomized Controlled Trials". Hypertension. 67 (4): 733–9. doi: 10.1161/HYPERTENSIONAHA.115.06853 . PMID   26902492. S2CID   24011456.
  31. ↑ Lamantia V, Sniderman A, Faraj M (2016). "Nutritional management of hyperapoB". Nutrition Research Reviews. 29 (2): 202–233. doi:10.1017/S0954422416000147. PMID   27821191.
  32. ↑ Buckland G, González CA (April 2015). "The role of olive oil in disease prevention: a focus on the recent epidemiological evidence from cohort studies and dietary intervention trials". Br J Nutr (Review). 113 (Suppl 2): S94–101. doi: 10.1017/S0007114514003936 . PMID   26148926.
  33. ↑ European Food Safety Authority (2011). "Scientific Opinion on the substantiation of health claims related to polyphenols in olive". EFSA Journal. 9 (4): 2033. doi: 10.2903/j.efsa.2011.2033 .
  34. ↑ European Food Safety Authority (2011). "Scientific Opinion on the substantiation of health claims related to oleic acid intended to replace saturated fatty acids (SFAs) in foods or diets". EFSA Journal. 9 (4): 2043. doi: 10.2903/j.efsa.2011.2043 .
  35. ↑ "COMMISSION REGULATION (EU) No 432/2012 of 16 May 2012 establishing a list of permitted health claims made on foods, other than those referring to the reduction of disease risk and to children's development and health. Text with EEA relevance". Official Journal of the European Union. Retrieved 31 August 2016.
  36. ↑ Schwingshackl L, Hoffmann G (1 October 2014). "Monounsaturated fatty acids, olive oil and health status: a systematic review and meta-analysis of cohort studies". Lipids Health Dis (Review). 13 154. doi: 10.1186/1476-511X-13-154 . PMC   4198773 . PMID   25274026.
  37. 1 2 Van Horn L, Carson JA, Appel LJ, et al. (29 November 2016). "Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association". Circulation. 134 (22): e505 –e529. doi: 10.1161/CIR.0000000000000462 . PMID   27789558. S2CID   37889352.
  38. ↑ Pant, Anushriya; et al. (14 March 2023). "Primary prevention of cardiovascular disease in women with a Mediterranean diet: systematic review and meta-analysis". Heart . 109 (16): 1208–1215. doi:10.1136/heartjnl-2022-321930. PMID   36918266. S2CID   257533347 . Retrieved 16 March 2023.
  39. ↑ Schwingshackl, L; Missbach, B; König, J; Hoffmann, G (22 August 2014). "Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis". Public Health Nutrition. 18 (7): 1292–9. doi: 10.1017/S1368980014001542 . PMC   10273006 . PMID   25145972.
  40. ↑ Koloverou, E; Esposito, K; Giugliano, D; Panagiotakos, D (July 2014). "The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants". Metabolism: Clinical and Experimental. 63 (7): 903–11. doi:10.1016/j.metabol.2014.04.010. PMID   24931280.
  41. 1 2 American Diabetes Association (January 2019). "5. Lifestyle Management: Standards of Medical Care in Diabetes-2019". Diabetes Care. 42 (Suppl 1): S46 –S60. doi: 10.2337/dc19-S005 . PMID   30559231.
  42. ↑ "8 eating plans for patients with prediabetes". American Medical Association. 25 December 2019. Retrieved 4 October 2020.
  43. ↑ Sofi F, Cesari F, Abbate R, Gensini GF, Casini A (2008). "Adherence to Mediterranean diet and health status: meta-analysis". BMJ (Clinical Research Ed.). 337 (sep11 2): a1344. doi:10.1136/bmj.a1344. PMC   2533524 . PMID   18786971.
  44. ↑ Schwingshackl, L; Hoffmann, G (15 October 2014). "Adherence to Mediterranean diet and risk of cancer: a systematic review and meta-analysis of observational studies". International Journal of Cancer. 135 (8): 1884–97. doi: 10.1002/ijc.28824 . PMID   24599882. S2CID   10389033.
  45. ↑ Morze J, Danielewicz A, Przybyłowicz K (2021). "An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer". European Journal of Nutrition. 60 (3): 1561–1586. doi:10.1007/s00394-020-02346-6. PMC   7987633 . PMID   32770356.
  46. ↑ Estruch, Ramon; Ros, Emilio (1 September 2020). "The role of the Mediterranean diet on weight loss and obesity-related diseases" . Reviews in Endocrine and Metabolic Disorders. 21 (3): 315–327. doi:10.1007/s11154-020-09579-0. ISSN   1573-2606. PMID   32829455. S2CID   221235205 . Retrieved 23 March 2021.
  47. ↑ Esposito K, Kastorini CM, Panagiotakos DB, Giugliano D (February 2011). "Mediterranean diet and weight loss: meta-analysis of randomized controlled trials". Metabolic Syndrome and Related Disorders. 9 (1): 1–12. doi:10.1089/met.2010.0031. ISSN   1557-8518. PMID   20973675.
  48. ↑ Mancini, Joseph G.; Filion, Kristian B.; Atallah, Renée; Eisenberg, Mark J. (April 2016). "Systematic Review of the Mediterranean Diet for Long-Term Weight Loss". The American Journal of Medicine. 129 (4): 407–415.e4. doi: 10.1016/j.amjmed.2015.11.028 . PMID   26721635.
  49. ↑ Petersson, SD; Philippou, E (September 2016). "Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence". Advances in Nutrition. 7 (5): 889–904. doi:10.3945/an.116.012138. PMC   5015034 . PMID   27633105.
  50. ↑ Lourida, Ilianna; Soni, Maya; Thompson-Coon, Joanna; Purandare, Nitin; Lang, Iain A.; Ukoumunne, Obioha C.; Llewellyn, David J. (July 2013). "Mediterranean Diet, Cognitive Function, and Dementia". Epidemiology. 24 (4): 479–489. doi: 10.1097/EDE.0b013e3182944410 . PMID   23680940. S2CID   19602773.
  51. ↑ Singh, B; Parsaik, AK; Mielke, MM; Erwin, PJ; Knopman, DS; Petersen, RC; Roberts, RO (2014). "Association of mediterranean diet with mild cognitive impairment and Alzheimer's disease: a systematic review and meta-analysis". Journal of Alzheimer's Disease. 39 (2): 271–82. doi:10.3233/JAD-130830. PMC   3946820 . PMID   24164735.
  52. ↑ Lassale, C; Batty, GD; Baghdadli, A; Jacka, F; Sánchez-Villegas, A; Kivimäki, M; Akbaraly, T (July 2019). "Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies". Molecular Psychiatry. 24 (7): 965–986. doi:10.1038/s41380-018-0237-8. PMC   6755986 . PMID   30254236.
  53. ↑ Psaltopoulou, T; Sergentanis, TN; Panagiotakos, DB; Sergentanis, IN; Kosti, R; Scarmeas, N (October 2013). "Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis". Annals of Neurology. 74 (4): 580–91. doi:10.1002/ana.23944. PMID   23720230. S2CID   5995461.
  54. ↑ Volta U, Caio G, Tovoli F, De Giorgio R (2013). "Non-celiac gluten sensitivity: questions still to be answered despite increasing awareness". Cellular and Molecular Immunology (Review). 10 (5): 383–392. doi:10.1038/cmi.2013.28. ISSN   1672-7681. PMC   4003198 . PMID   23934026. Many factors have contributed to the development of gluten-related pathology, starting with the worldwide spread of the Mediterranean diet, which is based on a high intake of gluten-containing foods.
  55. ↑ Trichopoulou, A; Martínez-González, MA; Tong, TY; Forouhi, NG; Khandelwal, S; Prabhakaran, D; Mozaffarian, D; de Lorgeril, M (24 July 2014). "Definitions and potential health benefits of the Mediterranean diet: views from experts around the world". BMC Medicine. 12 112. doi: 10.1186/1741-7015-12-112 . PMC   4222885 . PMID   25055810.
  56. ↑ Lin PH, Aronson W, Freedland SJ (8 January 2015). "Nutrition, dietary interventions and prostate cancer: the latest evidence". BMC Medicine (Review). 13 3. doi: 10.1186/s12916-014-0234-y . PMC   4823849 . PMID   25573005.
  57. 1 2 Willett WC; Sacks, F; Trichopoulou, A; Drescher, G; Ferro-Luzzi, A; Helsing, E; Trichopoulos, D (1 June 1995). "Mediterranean diet pyramid: a cultural model for healthy eating". American Journal of Clinical Nutrition. 61 (6): 1402S –6S. doi: 10.1093/ajcn/61.6.1402s . PMID   7754995.
  58. ↑ Massimo Alberini, Giorgio Mistretta, Guida all'Italia gastronomica, Touring Club Italiano, 1984
  59. ↑ Tapper, Richard; Zubaida, Sami (2001). A Taste of Thyme: Culinary Cultures of the Middle East. Tauris Parke Paperbacks. p. 43. ISBN   978-1-86064-603-4.
  60. ↑ "Mediterranean Diet Pyramid" . Retrieved 27 February 2013.
  61. ↑ Bach-Faig, A.; Berry, E. M.; Lairon, D.; Reguant, J.; Trichopoulou, A.; Dernini, S.; Medina, F. X.; Battino, M.; Belahsen, R.; Miranda, G.; Serra-Majem, L.; Mediterranean Diet Foundation Expert Group (2011). "Mediterranean diet pyramid today. Science and cultural updates". Public Health Nutrition. 14 (12A): 2274–84. doi: 10.1017/S1368980011002515 . hdl: 10609/92329 . PMID   22166184.
  62. ↑ Food and Agriculture Organization of the United Nations, "Food-based dietary guidelines—Greece"
  63. ↑ Martínez-González, M. A.; Sánchez-Villegas, A. (2004). "The emerging role of Mediterranean diets in cardiovascular epidemiology: Monounsaturated fats, olive oil, red wine or the whole pattern?". European Journal of Epidemiology. 19 (1): 9–13. doi:10.1023/b:ejep.0000013351.60227.7b. PMID   15012018. S2CID   8863511.
  64. ↑ Willett, Walter (26 April 2021). "Mediterranean Dietary Pyramid". International Journal of Environmental Research and Public Health. 18 (9): 4568. doi: 10.3390/ijerph18094568 . ISSN   1660-4601. PMC   8123460 . PMID   33925778. The fundamental innovation in the updated MDP is a dimension representing environmental sustainability
  65. ↑ Tucci, Massimiliano; Martini, Daniela; Vinelli, Valentina; Biscotti, Paola; Porrini, Marisa; Del Bo', Cristian; Riso, Patrizia (2024). "The MED_EAT-IT approach: A modelling study to develop feasible, sustainable and nutritionally targeted dietary patterns based on the Planetary health diet". Current Research in Food Science. 8 100765. doi:10.1016/j.crfs.2024.100765. ISSN   2665-9271. PMC   11109324 . PMID   38779344. This study reports on strategies to improve the previous pattern and align it more closely with the Mediterranean Diet, resulting in the MED_EAT-IT pattern.
  66. ↑ "How our diets impact climate change — and what we can do about it". NBC News. 12 August 2019. Retrieved 23 March 2021.
  67. ↑ "U.S. could feed 800 million people with grain that livestock eat, Cornell ecologist advises animal scientists". Cornell Chronicle. 7 August 1997. Retrieved 26 April 2019.
  68. ↑ "Tackling climate change through livestock". United Nations. 21 October 2014.
  69. ↑ Magkos, Faidon; Tetens, Inge; Bügel, Susanne Gjedsted; et al. (1 January 2020). "A Perspective on the Transition to Plant-Based Diets: a Diet Change May Attenuate Climate Change, but Can It Also Attenuate Obesity and Chronic Disease Risk?". Advances in Nutrition. 11 (1): 1–9. doi:10.1093/advances/nmz090. ISSN   2161-8313. PMC   7442415 . PMID   31504086.
  70. ↑ Tilman, David; Clark, Michael (1 November 2014). "Global diets link environmental sustainability and human health" . Nature. 515 (7528): 518–522. Bibcode:2014Natur.515..518T. doi:10.1038/nature13959. ISSN   1476-4687. PMID   25383533. S2CID   4453972.
  71. 1 2 3 Ancel Keys; Margaret Keys (December 1975). How to eat well and stay well the Mediterranean way. Doubleday. ISBN   978-0-385-00906-5.
  72. ↑ Ancel Keys, ed. (April 1970). "Coronary heart disease in seven countries". Circulation. 41 (4 Suppl): I1–211. doi:10.1161/01.CIR.41.4S1.I-1. PMID   5442782. S2CID   80146863.
  73. 1 2 Sarah Boseley (2 September 2016). "What actually is the Mediterranean diet – and does it work?". The Guardian . Retrieved 14 September 2021.
  74. ↑ Ancel Keys (February 1980). Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease . Harvard University Press. ISBN   978-0-674-80237-7.
  75. ↑ Menotti A, Keys A, Blackburn H, Kromhout D, Karvonen M, Nissinen A, Pekkanen J, Punsar S, Fidanza F, Giampaoli S, Seccareccia F, Buzina R, Mohacek I, Nedeljkovic S, Aravanis C, Dontas A, Toshima H, Lanti M (February 1996). "Comparison of multivariate predictive power of major risk factors for coronary heart diseases in different countries: results from eight nations of the Seven Countries Study, 25-year follow-up". Journal of Cardiovascular Risk. 3 (1): 69–75. doi:10.1097/00043798-199602000-00010. PMID   8783033.
  76. ↑ Burros, Marian (29 March 1995). "Eating Well". The New York Times . Archived from the original on 28 October 2008.
  77. ↑ Kushi LH, Lenart EB, Willett WC (1995). "Health implications of Mediterranean diets in light of contemporary knowledge. 1. Plant foods and dairy products". Am. J. Clin. Nutr. 61 (6 Suppl): 1407S –1415S. doi: 10.1093/ajcn/61.6.1407S . PMID   7754996.
  78. ↑ Kushi LH, Lenart EB, Willett WC (1995). "Health implications of Mediterranean diets in light of contemporary knowledge. 2. Meat, wine, fats, and oils". Am. J. Clin. Nutr. 61 (6 Suppl): 1416S –1427S. doi: 10.1093/ajcn/61.6.1407S . PMID   7754997.
  79. ↑ Willett WC (2006). "The Mediterranean diet: science and practice". Public Health Nutr. 9 (1A): 105–10. doi: 10.1079/phn2005931 . PMID   16512956.
  80. ↑ Simini Bruno (2000). "Serge Renaud: from French paradox to Cretan miracle". The Lancet. 355 (9197): 48. doi:10.1016/S0140-6736(05)71990-5. PMID   10615898. S2CID   8142036.
  81. ↑ Evert, Alison B.; Dennison, Michelle; Gardner, Christopher D.; et al. (May 2019). "Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report". Diabetes Care (Professional society guidelines). 42 (5): 731–754. doi: 10.2337/dci19-0014 . PMC   7011201 . PMID   31000505.
  82. ↑ "Prevention of heart attack". UK National Health Service. 13 July 2023. Retrieved 22 October 2023.
  83. ↑ Villani A, Sultana J, Doecke J, Mantzioris E (2018). "Differences in the interpretation of a modernized Mediterranean diet prescribed in intervention studies for the management of type 2 diabetes: how closely does this align with a traditional Mediterranean diet?" . European Journal of Nutrition. 58 (4): 1369–1380. doi:10.1007/s00394-018-1757-3. PMID   29943276. S2CID   49420773.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.