The complex relationship between diet, quality of life and life expectancy: a narrative review of potential determinants based on data from Italy

  • Andrea Poli
  • Carlo Agostoni
  • Guendalina Graffigna
  • Claudio Bosio
  • Lorenzo Maria Donini
  • Franca MarangoniEmail author


The increasing life expectancy at birth and the improvement of general health observed worldwide over the previous years are likely due to many factors. In this regard, the Organisation for Economic Cooperation and Development (OECD) has highlighted the favourable situation of the Italian population, which is amongst the most privileged in the world. In Italy, the national healthcare system is easily accessible to the whole population without direct costs, and alcohol abuse and cigarette smoke are less widespread compared to neighbouring countries. Moreover, the population still largely follows a dietary pattern characterised by the consumption of foods rich in protective compounds (plant foods and their components, such as fibre, polyphenols and polyunsaturated fatty acids). According to recent data, a significant consumption of these foods, which are key components of the Mediterranean model, is likely to play a more important role compared to the limited consumption of nutrients considered less favourable (essentially, saturated fat and sugar). Based on these assumptions, it can be inferred that the adoption of coercive legislative interventions—which have been introduced in other western countries to improve diet quality—may not be an optimal strategy in a country like Italy. Such an intervention would contend with psychological and social aspects (namely with the belief that participating in decision-making is an essential right) and with broader indications emerging in the research within this field (the effectiveness of a nudge approach as opposed to constraining interventions). These factors may limit any expected positive impact on health within this context.

Level of evidence

Level V, narrative review.


Life expectancy Mediterranean diet Dietary pattern  Nutrient taxation   Italy  



The authors wish to thank Bianca Barbi for language editing.


The preparation of this paper has been made possible by an educational unrestricted grant from Soremartec Italia s.r.l. The sponsor had no role in the preparation of the manuscript or in the decision to publish the document.

Compliance with ethical standards

Conflict of interest

All the authors have signed a conflict of interest declaration. AP and FM are, respectively, president and head of research of NFI, a nonprofit organisation partially supported by 18 food companies. CA declares speaking fees from Soremartec Italia s.r.l.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed Consent

For this type of study, formal informed consent is not required.


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Authors and Affiliations

  1. 1.Nutrition Foundation of ItalyMilanItaly
  2. 2.Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico-Pediatric Intermediate Care Unit, DISCCO (Department of Clinical Sciences and Community Health)University of MilanMilanItaly
  3. 3.Faculty of Psychology Università Cattolica del Sacro CuoreMilanItaly
  4. 4.Department of Experimental MedicineSapienza UniversityRomeItaly

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