The Portuguese MEDITERRANEAN DIET Wheel: development considerations

Abstract Scientific evidence has been reporting the health and environmental benefits of the Mediterranean Diet. However, countries of the Mediterranean region, Portugal included, are gradually abandoning this traditional food pattern. The aim of the present work was to develop the Portuguese Mediterranean Diet Wheel. Three main steps were followed: 1) Establishment of the most relevant Mediterranean diet and lifestyle principles to improve this pattern among the Portuguese population; 2) Converting those principles into a captivating and easy to understand tool; 3) Obtaining experts’ opinion. By a matter of consistency, the preservation and transmission of the Mediterranean heritage was represented through an upgrade of the current Portuguese food wheel guide. This complementary tool highlights the Mediterranean Diet enlarged character that encompasses a healthy lifestyle and reinforces sociocultural and environmental features. It was launched at the end of 2016 and was nationally disseminated with the support of the Portuguese Health Directorate. Initially it was presented in a poster format image that was subsequently spread in different communication formats. This newly developed Mediterranean Food Guide is a complementary educational tool that will support health and education professionals in the never ending mission of promoting healthy food choices.

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Infrequently asked questions about the Mediterranean diet

Public Health Nutrition ◽

10.1017/s1368980009990498 ◽

2009 ◽

Vol 12 (9A) ◽

pp. 1644-1647 ◽

Cited By ~ 17

Author(s):

France Bellisle

Keyword(s):

Mediterranean Diet ◽

Health Benefits ◽

Food Choices ◽

Fixed Number ◽

Mediterranean Populations ◽

Mediterranean Regions ◽

The Mediterranean ◽

Diet And Lifestyle ◽

Specific Food

AbstractNumerous health benefits have been attributed to the ‘Mediterranean diet’ over the last decades. Selecting foods that were common in the Mediterranean regions (especially Crete) in the 1970s, with a frequent and abundant intake of fruit, vegetables, fish, olive oil and perhaps wine, has been reported to be associated with wide-ranging benefits including improved glucose metabolism and decreased risk of type 2 diabetes, obesity and CVD. While the respective contributions of various types of food have been widely investigated, less attention has been paid to other factors, also characteristic of the Mediterranean lifestyle, which may contribute to the health benefits perhaps as much as specific food choices. Traditionally, the Mediterranean diet was consumed in the context of a particular lifestyle, with a fixed number of daily meals, generally consumed at later hours (compared to North of Europe), and some specific meal-related behaviours such as the post-lunch siesta. In addition, the Mediterranean diet and lifestyle that were so beneficial to health, 40 years ago, were considerably different from present-day practices. The changes are particularly clear in younger individuals and countries of the Mediterranean region presently have the highest child overweight rates in Europe. The present paper will address research about meal and satiety patterns and examine how the recent changes from traditional practices are likely to have an impact on health risks and benefits in Mediterranean populations.

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The Beneficial Health Effects of Vegetables and Wild Edible Greens: The Case of the Mediterranean Diet and Its Sustainability

Applied Sciences ◽

10.3390/app10249144 ◽

2020 ◽

Vol 10 (24) ◽

pp. 9144

Author(s):

Elena Chatzopoulou ◽

Márcio Carocho ◽

Francesco Di Gioia ◽

Spyridon A. Petropoulos

Keyword(s):

Health Effects ◽

Mediterranean Diet ◽

Healthy Lifestyle ◽

Scientific Interest ◽

Mediterranean Populations ◽

Cultural Aspects ◽

Positive Effects ◽

Healthy Diets ◽

The World ◽

The Mediterranean

The Mediterranean diet (MD) concept as currently known describes the dietary patterns that were followed in specific regions of the area in the 1950s and 1960s. The broad recognition of its positive effects on the longevity of Mediterranean populations also led to the adoption of this diet in other regions of the world, and scientific interest focused on revealing its health effects. MD is not only linked with eating specific nutritional food products but also with social, religious, environmental, and cultural aspects, thus representing a healthy lifestyle in general. However, modern lifestyles adhere to less healthy diets, alienating people from their heritage. Therefore, considering the increasing evidence of the beneficial health effects of adherence to the MD and the ongoing transitions in consumers’ behavior, the present review focuses on updating the scientific knowledge regarding this diet and its relevance to agrobiodiversity. In addition, it also considers a sustainable approach for new marketing opportunities and consumer trends of the MD.

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Family Meals, Conviviality and the Mediterranean Diet among Families with Adolescents

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052499 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2499

Author(s):

Andrea de la Torre-Moral ◽

Sergi Fàbregues ◽

Anna Bach-Faig ◽

Albert Fornieles-Deu ◽

F. Xavier Medina ◽

...

Keyword(s):

Mediterranean Diet ◽

Eating Habits ◽

Family Meals ◽

Structured Interviews ◽

Family Meal ◽

Food Pattern ◽

Mediterranean Countries ◽

The Family ◽

The Mediterranean ◽

Meal Composition

Two aspects that characterize the Mediterranean diet (MD) are “what” and “how” we eat. Conviviality relates to “how” we eat and to the pleasure of sharing meals with significant people. The most studied concept is “family meals”, which includes conviviality, which involves “enjoying” family meals. Given the lack of research on convivial family meals in Mediterranean countries, the purpose of this qualitative study was to analyze the family meal representations and practices of families with 12- to 16-year-old adolescents to assess whether they responded to a pattern of conviviality, and to examine their association with MD adherence. Twelve semi-structured interviews were conducted and food frequency and family meal questionnaires were administered. A food pattern analysis was carried out and digital photos of meals were analyzed to examine eating habits and meal composition, respectively. The findings showed that parents believed family meals are a space for socialization and communication. Items relating to the conviviality of family meals identified in the study were meal frequency, meals at the table, lack of digital distractions, pleasant conversations, and time spent on family meals. Attention should be paid to conviviality in Mediterranean families when designing multi-approach strategies to promote healthy eating among adolescents.

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Associations between Adherence to the Mediterranean Diet and Lifestyle Assessed with the MEDLIFE Index among the Working Population

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15102126 ◽

2018 ◽

Vol 15 (10) ◽

pp. 2126 ◽

Cited By ~ 5

Author(s):

Sandra Pavičić Žeželj ◽

Gordana Kenđel Jovanović ◽

Nataša Dragaš Zubalj ◽

Vladimir Mićović ◽

Željko Sesar

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Mediterranean Diet ◽

Body Fat ◽

High Density Lipoproteins ◽

High Educational Level ◽

Working Population ◽

Physically Active ◽

The Mediterranean ◽

Diet And Lifestyle

The adherence to the Mediterranean diet is beneficial for cardiovascular diseases prevention. The study aim is to use Mediterranean lifestyle (MEDLIFE) questionnaire for estimation of Mediterranean lifestyle habits among the working population and to establish MEDLIFE score correlation with the risk factors for cardiovascular diseases. In the study has participated 366 workers from Croatia, which fulfilled MEDLIFE and validated food frequency questionnaire (FFQ) questionnaire. The multivariate logistic regression was performed to evaluate the association between MEDLIFE index, workers’ obesity and cardiovascular diseases risk. The lowest adherence to Mediterranean lifestyle was associated to younger, low education, body fat above acceptable ranges and unfavorable lipid profile. Significant association to Mediterranean lifestyle was more among women (p = 0.002), middle aged (p = 0.02), highly physically active (p = 0.009) and those who play collective sports >2 h/w (p = 0.001), having body fat within acceptable range (p = 0.003), total cholesterol less (p = 0.03) and high-density lipoproteins (HDL-C) (p = 0.04) more than recommended. Inverse significant association was for high educational level (p = 0.02). The Mediterranean lifestyle adherence is associated to lower risk factors for cardiovascular diseases among studied working population. MEDLIFE index revealed that physical activity and conviviality are better ingrained among younger population but not the Mediterranean diet.

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Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review

Nutrients ◽

10.3390/nu12082236 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2236 ◽

Cited By ~ 1

Author(s):

Sandra Martín-Peláez ◽

Montse Fito ◽

Olga Castaner

Keyword(s):

Type 2 Diabetes ◽

Mediterranean Diet ◽

Healthy Lifestyle ◽

Diabetes Type 2 ◽

Antioxidant Compounds ◽

Published Evidence ◽

Quality Diet ◽

The Mediterranean ◽

Traditional Mediterranean Diet

The search for a quality diet has grown over the past decade. Diet is considered one of the pillars for the prevention and progression of several diseases, among them: diabetes. Type 2 diabetes (T2D) is an epidemic of western countries that increases the vulnerability of other diseases, such as cardiovascular and cancer. T2D is associated with lifestyle and diet. The traditional Mediterranean diet has proven its benefits over several cardiovascular risk factors, and specifically on diabetes. This review compiles recent published evidence on the effects of the Mediterranean diet on the incidence and progression of type 2 diabetes (T2D) and its relation with several other cardiovascular healthy diets. We will also focus on how the Mediterranean diet could play a role in T2D-related mechanisms, such as anti-inflammatory or antioxidant compounds, glucagon-like peptide agonist compounds, and changes in gut microbiota. Each component of the Mediterranean diet could be involved in processes related to diabetes homeostasis, many of them sharing common physio-pathological pathways. The importance of this diet within the set of habits of a healthy lifestyle must be emphasized.

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Risky Behaviours of Spanish University Students: Association with Mediterranean Diet, Sexual Attitude and Chronotype

Nutrients ◽

10.3390/nu13114042 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4042

Author(s):

Pedro Manuel Rodríguez-Muñoz ◽

Juan Manuel Carmona-Torres ◽

Cristina Rivera-Picón ◽

Ignacio Morales-Cané ◽

Fabio Fabbian ◽

...

Keyword(s):

Alcohol Consumption ◽

University Students ◽

Mediterranean Diet ◽

Fast Food ◽

Healthy Lifestyle ◽

Heavy Drinking ◽

Extrinsic Factors ◽

Risky Alcohol ◽

Risky Alcohol Consumption ◽

The Mediterranean

The most common drugs that are consumed by young people are alcohol and tobacco, which are especially prevalent in universities. These risk behaviours can be determined by a series of intrinsic and extrinsic factors. The aim of this study was to evaluate the consumption of alcohol and tobacco by Spanish university students and the relationship between the Mediterranean diet, sexual attitudes and opinions, and chronotype. A multicentre observational study enrolled 457 students from two public universities in Spain. The study period was from December 2017 to January 2018. The majority of the participants consumed alcohol (90.2%), tobacco consumption was low (27.2%), with a high percentage of students (78.6%) having a low dependence on nicotine. The surveyed students demonstrated a high adherence to the Mediterranean diet, which was shown to be associated with less risky alcohol consumption. The Mediterranean diet is a part of healthy lifestyle, and avoiding heavy drinking results in the intention to maintain such a lifestyle. In addition, unhealthy eating habits (skipping breakfast, eating sweets and pastries daily, and fast-food consumption) had a tendency to induce risky alcohol consumption. Therefore, to promote healthy lifestyle habits, it is considered important to establish programs that promote healthy diets in university settings and to evaluate them periodically.

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Experimental Outcomes of the Mediterranean Diet: Lessons Learned from the Predimed Randomized Controlled Trial

Nutrients ◽

10.3390/nu11122991 ◽

2019 ◽

Vol 11 (12) ◽

pp. 2991 ◽

Cited By ~ 8

Author(s):

Dicle Kargin ◽

Laura Tomaino ◽

Lluís Serra-Majem

Keyword(s):

Mediterranean Diet ◽

Controlled Trial ◽

Scientific Evidence ◽

Olive Tree ◽

Energy Restriction ◽

Lessons Learned ◽

Long Term Effects ◽

Beneficial Effects ◽

The Mediterranean ◽

Predimed Study

The Mediterranean Diet (MD) is, culturally and historically, the nutritional pattern shared by people living in the olive-tree growing areas of the Mediterranean basin. It is of great importance for its potential preventive effect against cardiovascular diseases (CVDs). The PREvención con DIeta MEDiterránea (PREDIMED) study, a Spanish multicentre randomised controlled trial (RCT), was designed to assess the long-term effects of the MD, without any energy restriction, on the incidence of CVD in individuals at high cardiovascular (CV) risk. Since its inception, it gave a great contribution to the available literature on the issue. It is well known that, in the field of the health sciences, RCTs provide the best scientific evidence. Thus, the aim of the present review is to analyse the results of the RCTs performed within the frame of the PREDIMED study. Our findings showed that MD has beneficial effects in the primary prevention of CVDs, diabetes and in the management of metabolic syndrome.

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Natural Products Derived from the Mediterranean Diet with Antidiabetic Activity: from Insulin Mimetic Hypoglycemic to Nutriepigenetic Modulator Compounds

Current Pharmaceutical Design ◽

10.2174/1381612825666190705191000 ◽

2019 ◽

Vol 25 (15) ◽

pp. 1760-1782 ◽

Cited By ~ 4

Author(s):

Georgia-Eirini Deligiannidou ◽

Elena Philippou ◽

Melita Vidakovic ◽

Wim V. Berghe ◽

Alexandros Heraclides ◽

...

Keyword(s):

Mediterranean Diet ◽

Healthy Lifestyle ◽

Pancreatic Beta Cell ◽

Critical Role ◽

Virgin Olive Oil ◽

Antidiabetic Activity ◽

Eating Pattern ◽

Insulin Mimetic ◽

The Mediterranean ◽

Sugar Levels

Background: The Mediterranean diet is a healthy eating pattern that protects against the development of Type 2 diabetes mellitus (T2DM), a metabolic disease characterized by elevated blood sugar levels due to pancreatic beta-cell functional impairment and insulin resistance in various tissues. Inspired by the ancient communities, this diet emphasizes eating primarily plant-based foods, including vegetables, legumes, fruits, cereals, and nuts. Importantly, virgin olive oil is used as the principal source of fat. Red meat is consumed in low amounts while wine and fish are consumed moderately. Objective: Here, we review the most beneficial components of the Mediterranean Diet and tentative mechanisms of action for prevention and/or management of T2DM, based on research conducted within the last decade. Methods: The references over the last five years have been reviewed and they have been selected properly according to inclusion/ exclusion criteria. Results: Several bioactive diet components were evaluated to prevent inflammation and cytokine-induced oxidative damage, reduce glucose concentration, carbohydrate absorption and increase insulin sensitivity and related gene expression. Conclusion: The adherence to a healthy lifestyle, including diet, exercise and habits remains the best approach for the prevention of diabetes as well as frequent check-ups and education. Though diabetes has a strong genetic component, in recent years many reports strongly point to the critical role of lifestyle specific epigenetic modifications in the development of T2DM. It remains to be established how different components of the Mediterranean Diet interact and influence the epigenetic landscape to prevent or treat the disease.

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Comparison and evaluation of the reliability of indexes of adherence to the Mediterranean diet

Public Health Nutrition ◽

10.1017/s1368980011002606 ◽

2011 ◽

Vol 14 (12A) ◽

pp. 2338-2345 ◽

Cited By ~ 64

Author(s):

Raimon Milà-Villarroel ◽

Anna Bach-Faig ◽

Josep Puig ◽

Anna Puchal ◽

Andreu Farran ◽

...

Keyword(s):

Factor Analysis ◽

Mediterranean Diet ◽

Dietary Pattern ◽

Common Factor ◽

Dietary Quality ◽

Food Pattern ◽

Acid Ratio ◽

The Mediterranean ◽

The University ◽

Adherence Index

AbstractObjectiveTo compare and evaluate the reliability of several indexes of adherence to the Mediterranean diet.DesignThe ten indexes included in the analysis were: Mediterranean Diet Score (MDS), Mediterranean Score (MS), Dietary Score (DS), Mediterranean-Dietary Quality Index (Med-DQI), Mediterranean Dietary Pattern adherence index (MDP), Mediterranean Adequacy Index (MAI), Mediterranean Style Dietary Pattern Score (MSDPS), Mediterranean food pattern PREDIMED Study (MeDiet-PREDIMED), relative Mediterranean diet (rMED) and Cardioprotective Mediterranean diet index. Factor analysis using the correlations between indexes was applied. The correlation with factors and the reliability coefficient were calculated.SettingA total of 324 healthy undergraduates at the University of Barcelona, Spain, were surveyed.ResultsThe highest correlations were observed between MDP adherence index and MAI (0·82); MAI and MSDPS (0·80); and MDS and rMED (0·77). Factor analysis showed a hidden common factor that explained over 70 % of the variability (71·03 %). This factor is understood as ‘adherence to the Mediterranean diet’. The indexes that showed the highest correlation with this factor were Med-DQI (0·85), MDS (0·84), rMED (0·80) and MAI (0·80). These indexes showed acceptable performance in measuring the adherence to the Mediterranean diet. The components that correlated strongly with this factor were monounsaturated-to-saturated fatty acid ratio (MS ratio), fruit and vegetables. Furthermore, a second common factor was found explaining 18 % of the variability. This second factor is highly positive related to dairy products and lean meat, and negative related to MS ratio.ConclusionsThe indexes showed satisfactory performance in assessing adherence to the Mediterranean diet. However, in order to improve the reliability and concordance between the indexes, further studies are required to select the components, the number of components, and the scoring criteria of the indexes to improve their internal consistency.

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Mediterranean diet pyramid today. Science and cultural updates

Public Health Nutrition ◽

10.1017/s1368980011002515 ◽

2011 ◽

Vol 14 (12A) ◽

pp. 2274-2284 ◽

Cited By ~ 654

Author(s):

Anna Bach-Faig ◽

Elliot M Berry ◽

Denis Lairon ◽

Joan Reguant ◽

Antonia Trichopoulou ◽

...

Keyword(s):

Cultural Heritage ◽

Mediterranean Diet ◽

Dietary Pattern ◽

Mediterranean Region ◽

Healthy Lifestyle ◽

Well Being ◽

Graphic Representation ◽

Mediterranean Populations ◽

Cultural Elements ◽

The Mediterranean

AbstractObjectiveTo present the Mediterranean diet (MD) pyramid: a lifestyle for today.DesignA new graphic representation has been conceived as a simplified main frame to be adapted to the different nutritional and socio-economic contexts of the Mediterranean region. This review gathers updated recommendations considering the lifestyle, dietary, sociocultural, environmental and health challenges that the current Mediterranean populations are facing.Setting and SubjectsMediterranean region and its populations.ResultsMany innovations have arisen since previous graphical representations of the MD. First, the concept of composition of the ‘main meals’ is introduced to reinforce the plant-based core of the dietary pattern. Second, frugality and moderation is emphasised because of the major public health challenge of obesity. Third, qualitative cultural and lifestyle elements are taken into account, such as conviviality, culinary activities, physical activity and adequate rest, along with proportion and frequency recommendations of food consumption. These innovations are made without omitting other items associated with the production, selection, processing and consumption of foods, such as seasonality, biodiversity, and traditional, local and eco-friendly products.ConclusionsAdopting a healthy lifestyle and preserving cultural elements should be considered in order to acquire all the benefits from the MD and preserve this cultural heritage. Considering the acknowledgment of the MD as an Intangible Cultural Heritage of Humanity by UNESCO (2010), and taking into account its contribution to health and general well-being, we hope to contribute to a much better adherence to this healthy dietary pattern and its way of life with this new graphic representation.

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