Historical origins of the Mediterranean Diet, Regional Dietary Profiles, and the Development of the Dietary Guidelines

  • Nadine R. SahyounEmail author
  • Kavitha Sankavaram
Part of the Nutrition and Health book series (NH)


The diet of the Mediterranean basin (22 countries located within Europe, Africa, and Asia) is abundant in foods of plant origin such as legumes, whole grains, fruits and vegetables, nuts and seeds, and olive oil as a main source of fat and has a low intake of saturated fat. There are a few regional differences in dietary patterns around the Mediterranean Sea but also many similarities. The diet’s origins reflect the interactions of diverse populations and civilizations over thousands of years.


Mediterranean diet origins Regional dietary patterns Mediterranean dietary pyramid Mediterranean diet indexes Mediterranean lifestyle 


  1. 1.
    Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008;337:a1344.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Serra-Majem L, Roman B, Estruch R. Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev. 2006;64(2 Pt 2):S27–47.CrossRefPubMedGoogle Scholar
  3. 3.
    da Silva R, Bach-Faig A, Raidó QB, Buckland G, Vaz de Almeida MD, Serra-Majem L. Worldwide variation of adherence to the Mediterranean diet, in 1961-1965 and 2000-2003. Public Health Nutr. 2009;12(9A):1676–84.CrossRefPubMedGoogle Scholar
  4. 4.
    Noah A, Truswell AS. There are many Mediterranean diets. Asia Pac J Clin Nutr. 2001;10(1):2–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Karamanos B, Thanopoulou A, Angelico F, et al. Nutritional habits in the Mediterranean Basin. The macronutrient composition of diet and its relation with the traditional Mediterranean diet. Multi-centre study of the Mediterranean Group for the Study of Diabetes (MGSD). Eur J Clin Nutr. 2002;56(10):983–91.CrossRefPubMedGoogle Scholar
  6. 6.
    Owl & Mouse Educational Maps (2014). Retrieved 29 July 2014 from
  7. 7.
    Simopoulos AP. The Mediterranean diets: what is so special about the diet of Greece? The scientific evidence. J Nutr. 2001;131(11 Suppl):3065s–73s.PubMedGoogle Scholar
  8. 8.
    Essid MY. History of Mediterranean food. In Mediterra: The Mediterranean diet for sustainable regional development, 1st ed. Presses de Sciences Po; 2012. p. 51–69.Google Scholar
  9. 9.
    Nestle M. Mediterranean diets: historical and research overview. Am J Clin Nutr. 1995;61(6 Suppl):1313S–20.PubMedGoogle Scholar
  10. 10.
    Keys AE. Seven countries: a multivariate analysis of death and coronary heart disease. Cambridge, MA: Harvard University Press; 1980.CrossRefGoogle Scholar
  11. 11.
    Trichopoulou A, Lagiou P. Healthy traditional Mediterranean diet: an expression of culture, history, and lifestyle. Nutr Rev. 1997;55(11 Pt 1):383–9.PubMedGoogle Scholar
  12. 12.
    Grigg D. Food consumption in the Mediterranean region. Tijdschrift voor economische en sociale geografie. 1999;90(4):391–409.CrossRefGoogle Scholar
  13. 13.
    Reguant-Aleix J. The Mediterranean Diet: Designed for the future. In MediTerra: The Mediterranean diet for sustainable regional development, 1st ed. Presses de Sciences Po; 2012. p. 504.Google Scholar
  14. 14.
    Rivera D, Obón C, Heinrich M, Inocencio C, Verde A, Fajardo J. Gathered Mediterranean food plants—ethnobotanical investigations and historical development. Forum Nutr. 2006;59:18–74.CrossRefPubMedGoogle Scholar
  15. 15.
    Willett WC, Sacks F, Trichopoulou A, et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995;61(6 Suppl):1402S–6.PubMedGoogle Scholar
  16. 16.
    Dernini S, Berry EM, Bach-Faig A, Belahsen R, Donini LM, Lairon D, Serra-Majem L, Cannella C. A dietary model constructed by scientists. In MediTerra: The Mediterranean diet for sustainable regional development, 1st ed. Presses de Sciences Po; 2012. p. 71–88.Google Scholar
  17. 17.
    Fundación Dieta Mediterránea. Proceedings of International Congress. Retrieved 29 July 2014 from
  18. 18.
    Serra-Majem L, Trichopoulou A, Ngo de la Cruz J, et al. Does the definition of the Mediterranean diet need to be updated? Public Health Nutr. 2004;7(7):927–9.PubMedGoogle Scholar
  19. 19.
    Bach-Faig A, Berry EM, Lairon D, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011;14(12A):2274–84.CrossRefPubMedGoogle Scholar
  20. 20.
    Fundación Dieta Mediterránea. Mediterranean diet pyramid. Retrieved 29 July 2014 from
  21. 21.
    US Department of Agriculture. Choose MyPlate. Retrieved 19 March 2014 from
  22. 22.
    Dernini S. Towards the advancement of the Mediterranean food cultures. Public Health Nutr. 2006;9(1A):103–4.CrossRefPubMedGoogle Scholar
  23. 23.
    Dernini S. Transmitting Mediterranean food culture through art: a creative interdisciplinary approach. Public Health Nutr. 2006;9(8A):1141–3.CrossRefPubMedGoogle Scholar
  24. 24.
    Reguant-Aleix J, Arbore MR, Bach-Faig A, Serra-Majem L. Mediterranean heritage: an intangible cultural heritage. Public Health Nutr. 2009;12(9A):1591–4.CrossRefPubMedGoogle Scholar
  25. 25.
    Milà-Villarroel R, Bach-Faig A, Puig J, et al. Comparison and evaluation of the reliability of indexes of adherence to the Mediterranean diet. Public Health Nutr. 2011;14(12A):2338–45.CrossRefPubMedGoogle Scholar
  26. 26.
    Bach A, Serra-Majem L, Carrasco JL, et al. The use of indexes evaluating the adherence to the Mediterranean diet in epidemiological studies: a review. Public Health Nutr. 2006;9(1A):132–46.CrossRefPubMedGoogle Scholar
  27. 27.
    Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, et al. Diet and overall survival in elderly people. BMJ. 1995;311(7018):1457–60.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003;348(26):2599–608.CrossRefPubMedGoogle Scholar
  29. 29.
    Trichopoulou A, Bamia C, Trichopoulos D. Mediterranean diet and survival among patients with coronary heart disease in Greece. Arch Intern Med. 2005;165(8):929–35.CrossRefPubMedGoogle Scholar
  30. 30.
    Trichopoulou A, Orfanos P, Norat T, et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ. 2005;330(7498):991.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Psaltopoulou T, Naska A, Orfanos P, Trichopoulos D, Mountokalakis T, Trichopoulou A. Olive oil, the Mediterranean diet, and arterial blood pressure: the Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr. 2004;80(4):1012–8.PubMedGoogle Scholar
  32. 32.
    Osler M, Schroll M. Diet and mortality in a cohort of elderly people in a north European community. Int J Epidemiol. 1997;26(1):155–9.CrossRefPubMedGoogle Scholar
  33. 33.
    Schröder H, Marrugat J, Vila J, Covas MI, Elosua R. Adherence to the traditional Mediterranean diet is inversely associated with body mass index and obesity in a Spanish population. J Nutr. 2004;134(12):3355–61.PubMedGoogle Scholar
  34. 34.
    Fung TT, McCullough ML, Newby PK, et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2005;82(1):163–73.PubMedGoogle Scholar
  35. 35.
    Panagiotakos DB, Milias GA, Pitsavos C, Stefanadis C. MedDietScore: a computer program that evaluates the adherence to the Mediterranean dietary pattern and its relation to cardiovascular disease risk. Comput Methods Programs Biomed. 2006;83(1):73–7.CrossRefPubMedGoogle Scholar
  36. 36.
    Panagiotakos DB, Pitsavos C, Arvaniti F, Stefanadis C. Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; the accuracy of the MedDietScore. Prev Med. 2007;44(4):335–40.CrossRefPubMedGoogle Scholar
  37. 37.
    Panagiotakos DB, Chrysohoou C, Pitsavos C, Stefanadis C. Association between the prevalence of obesity and adherence to the Mediterranean diet: the ATTICA study. Nutrition. 2006;22(5):449–56.CrossRefPubMedGoogle Scholar
  38. 38.
    Panagiotakos DB, Tzima N, Pitsavos C, et al. The association between adherence to the Mediterranean diet and fasting indices of glucose homoeostasis: the ATTICA Study. J Am Coll Nutr. 2007;26(1):32–8.CrossRefPubMedGoogle Scholar
  39. 39.
    Panagiotakos DB, Pitsavos C, Stefanadis C. Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis. 2006;16(8):559–68.CrossRefPubMedGoogle Scholar
  40. 40.
    Alberti A, Fruttini D, Fidanza F. The Mediterranean Adequacy Index: further confirming results of validity. Nutr Metab Cardiovasc Dis. 2009;19(1):61–6.CrossRefPubMedGoogle Scholar
  41. 41.
    Alberti-Fidanza A, Fidanza F. Mediterranean Adequacy Index of Italian diets. Public Health Nutr. 2004;7(7):937–41.CrossRefPubMedGoogle Scholar
  42. 42.
    Fidanza F, Alberti A, Lanti M, Menotti A. Mediterranean Adequacy Index: correlation with 25-year mortality from coronary heart disease in the Seven Countries Study. Nutr Metab Cardiovasc Dis. 2004;14(5):254–8.CrossRefPubMedGoogle Scholar
  43. 43.
    Alexandratos N. The Mediterranean diet in a world context. Public Health Nutr. 2006;9(1A):111–7.CrossRefPubMedGoogle Scholar
  44. 44.
    Belahsen R, Rguibi M. Population health and Mediterranean diet in southern Mediterranean countries. Public Health Nutr. 2006;9(8a):1130–5.CrossRefPubMedGoogle Scholar
  45. 45.
    Bellisle F. Infrequently asked questions about the Mediterranean diet. Public Health Nutr. 2009;12(9A):1644–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Nutrition and Food ScienceUniversity of MarylandCollege ParkUSA
  2. 2.Expanded Food and Nutrition Education ProgramUniversity of MarylandCollege ParkUSA

Personalised recommendations