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ITALIAN JOURNAL OF PUBLIC HEALTH
IJPH - Year 8, Volume 7, Number 4, 2010
414 FREE PAPERS
The term “Mediterranean Diet” was coined,
paradoxically, by Americans in the early’60s and
today – only 50 years from the “discovery” of
this characteristic, traditional food model – the
UNESCO declares that this century-long cookery
culture, belonging to populations overlooking
the Mediterranean Basin, represents a “Cultural
Heritage of Humanity”.
This recognition by UNESCO values and
emphasizes these, long universally appreciated
and approved culinary practices as part of a wider
popular culture wherein quality, simplicity and
healthfulness of autochthonous (native) food
products marry with food folkway practices, with
territoriality , biodiversity and with full respect
and regard for seasonality. All these attributes
co-jointly acquire a determining and characterizing
role as a reference point for excellence.
What is the “Mediterranean Diet”? Several
authors recognise that this diet is based on the
following dietetic pattern [1]:
a) high intake of vegetables, pulses (beans, lentils
etc), fruit and cereals;
b) medium-high intake of fish;
c) low intake of meat and saturated fat;
d) high intake of unsaturated fat (particularly
olive oil);
e) medium-low intake of dairy produces (mainly
yogurt and cheese),
f) a moderate intake of wine.
This is the dietetic pattern common to many
Mediterranean Countries, but in this historical
period in which food consumption is characterised
by products produced at the industrial level (think
of globalization and mass production), is it still
useful to speak about this diet? The answer is yes,
if we consider that it may fade typical regional
identity and membership profiles, tending towards a
depersonalization of the authentic eno-gastronomic
folkways and customs, and, to counteract this, the
UNESCO takes sides in defence of genuineness,
flavour, food taste and chiefly health promotion in
order to promote healthy eating habits, handing
over the legitimized sceptre to “Our” peculiar food
tradition as well as to our benevolent good –nature.
Into this framework, credit is due to the remarks
produced through epidemiological research –and
an ethnological one at that: this research has
“paid attention to human habits, diversity and
geographical distribution” [2] that, in the guise
of physiologist researcher Ancel Keys, first
disclosed the virtues of the “Mediterranean Diet”
and hence ‘he’ perceived and communicated its
beneficial and protective effects [3].
The large epidemiological study – conducted
among seven Nations - “Seven Countries Study”
[3] resulted in high geographical variability
concerning incidence rates for cardiovascular
diseases: Regions considered from the
Mediterranean Basin reported, with respect to
Northern Europe and USA, a lower incidence of
cardiovascular diseases (CHD) [4, 5].
Populations that follow the Mediterranean diet
pattern show a 50% lower rate of cardiovascular
mortality due to cardiovascular disease and show
highest longevity [6].
Actually, cardiovascular diseases are the
main cause of death and avoidable death in the
industrialized countries and this risk is associated
with and amplified by obesity, that in turn is a
risk factor for other chronic diseases, such as
diabetes, hypertension, dyslipidemia, cancers,
respiratory and cardiovascular diseases, stroke
and myocardial infarction.
The WHO considers obesity as one of the main
public health problems and being overweight
as a global epidemic of great dimension. The
increasing trend of obesity and overweight in
the world is related to unhealthy diet patterns:
in the last decades, Italian lifestyles have become
more “westernalized”, and with the highest
consumption of meat and animal fats.
The Mediterranean Diet, recognized by UNESCO as a cultural heritage of
humanity
Rosella Saulle, Giuseppe La Torre
Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma. Italy
Correspondence to: Rosella Saulle, Dipartimento di Sanità Pubblica e Malattie infettive, Piazzale Aldo Moro 5, 00185 Roma, Italy.
E-mail: rosellasaulle@libero.it
Key words: Mediterranean Diet, UNESCO, eating habits, cardiovascular diseases prevention
ITALIAN JOURNAL OF PUBLIC HEALTH
IJPH - Year 8, Volume 7, Number 4, 2010
FREE PAPERS 415
The Mediterranean diet is not only a diet: it is a
culture, a tradition, a high quality and sustainable
“art”. There is evidence that the traditional
Mediterranean diet is a dietary model mainly
followed in rural zones and mainly by older age
classes, due to both a higher attention to their
health status and to their bonds with traditional
foods. So, the aim is to achieve the highest
adherence to this type of diet by younger age
groups , and this goal must be reached using all
the tools we have available now and in the future,
at the European level [7, 8]: the research, the
training, the health care, the prevention, through
the use of specific nutritional campaigns, in order
to divulge the Mediterranean Diet really as a
cultural patrimony for humanity.
And we know right now from research that
the Mediterranean diet can be promoted even in
Northern and Central Europe countries [10,11],
and in particular using not only the co-operation
with parents, that is assumed to be one way to lead
to a stabilization of newly learned behavior [11],
but also using new communication tools, such as
the Internet [12] . Thanks now to the involvement
of UNESCO, that recognises the point recently
raised by the Istanbul Declaration of the World
federation of Public Health Associations [13] that
“The rights and the healthy traditions and cultures
of indigenous people and communities need to be
recognised, respected, promoted and protected”,
these goals may be achieved.
References
1) Ricco A, Chiaradia G, Piscitelli M, La Torre G. The effects
of Mediterranean Diet on Cardiovascular diseases: a systematic
review. Ital J Public Health 2007; 4(2): 119-27.
2) Leach ER. Social Anthropology. New York ; Oxford : Oxford
University Press, 1982.
3) Keys A, Menotti A, Karoven MI. The diet and the 15-year
death rate in the Seven Countries Study. Am J Epidemiol
1986;124:903–15.
4) Tunstall-Pedoe H, Kuulasmaa K, Mahonen M, et al.
Contribution of trends in survival and coronary-event rates
to changes in coronary heart disease mortality: 10-year results
from 37 WHO MONICA project populations. Monitoring
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5) Masiá R, Pena J, Marrugat J, et al. High prevalence of
cardiovascular risk factors in Gerona, Spain, a province with
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6) Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence
to Mediterranean diet and health status: meta-analysis. BMJ
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7) Mannocci A, Ricciardi W, La Torre G. Public-health
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8) La Torre G, Fadda G, Fara GM, Gasparini R, Panà A, Ricciardi
W. The Decalogue on the future of Public Health in Europe.
Ital J Public Health 2008;4:310-8.
9) Dietrich S, Pietrobelli A, Dämon S, Widhalm K. Obesity
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PRESTO (PrEvention STudy of Obesity) Study. Ital J Public
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10) Hillger C, Wolfram N, Kirch W. Nutrition sciences as part
of school education on secondary level. Ital J Public Health
2008;1:18-21.
11) Hassel H, Keimer KM. Parent involvement when
developing health education programmes. Ital J Public Health
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12) Papadaki A, Scott JA. The Mediterranean eating in
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