THE
MEDITERRANEAN
DIET PYRAMID
The Mediterranean diet pyramid
■ Since the Seven Countries Study in the 1950s, we know which foods were more or less
frequently consumed in the Mediterranean area
■ The traditional MDP has been popularized since 1995 using the world famous pyramid
representation that graphically highlights the food groups to be consumed daily, weekly
or less frequently
– In addition, an index or score was introduced to evaluate the adherence to the
MDP, allowing the study of its associated health effects
The old pyramid
Need for update !
■ but issues have been raised about the need to update the present recommendations
considering:
– the new lifestyle,
– dietary, sociocultural, environmental and health challenges the current
generations of different countries and sectors of the population are facing,
– especially low-income groups in which the prevalence of CVD has risen along
with the shift from the traditional MD
The Updated Pyramid
■ This pyramid results from the aforementioned scientific consensus among experts and is
based upon the latest research in the field of nutrition and health, scientific evidence
around the healthiness of the MD dietary pattern and its role in the prevention of many
chronic diseases by large epidemiological studies published in hundreds of peer-
reviewed scientific journal articles during recent decades.
The updated pyramid
■ The recommendations target the healthy adult population (18–65 years old) and should
be adapted to the special needs of children, pregnant women and those suffering from
health conditions.
Mediterranean diet pattern
■ The new MD pyramid provides key elements for the selection of foods, both quantitative and
qualitative, indicating the relative proportions and consumption frequency of servings of the
main food groups that constitute the MDP.
■ The pattern includes all food groups, and it is just a question of variety of food and culinary
techniques, along with adequate frequencies and quantities in the daily diet that make it healthy
or unhealthy
■ Higher adherence to the MDP has been associated with a better nutrient profile, with a lower
prevalence of individuals showing inadequate intakes of micronutrients in comparison to other
patterns such as the Western pattern
The base of the pyramid
■ Plant-origin foods are situated at the base of the pyramid.
■ This MD core, based on plant-origin foods, is responsible for the prevention of many
chronic diseases and for weight control
■ The graphic representation follows the previous pattern:
– at the base, food items that should sustain the diet and provide the highest energy
intake
– at the upper levels, foods to be eaten in moderate amounts such as those of animal
origin and/or rich in sugars and fats that should be eaten in moderation and some
of them left for special occasions. Meals have an essential role in the MD
Cultural and lifestyle elements
■ Moderation
– Serving sizes should be based on frugality and moderation
– Local habits of each country
■ Socialization
■ Culinary techniques
■ Physical activity
– Also include walking, taking the stairs v. the lift, housework, gardening, etc. Practicing leisure activities
outdoors, and preferably with others, makes them more enjoyable and strengthens the sense of community
■ Adequate rest : nap and adequate night sleep
■ Seasonality : seasonal , fresh, and minimally processed foods
■ Traditional local ecofriendly and biodiverse products