The Mediterranean Diet: good for our health, environment and climate

04 February 2021

Across the world there’s a growing interest in healthy food and lifestyles. Without a doubt one of the most widespread recommendations is to follow the so-called “Mediterranean diet”.

But what is it exactly? How should be interpret the famous food pyramid it represents? Can we limit ourselves to following quantity guidelines for certain foods, grouping them together in generic categories like vegetables, cereals or dairy products?

In a recent conference at Terra Madre dedicated to the topic we went beyond this generic concept of the Mediterranean diet based on a few categories of foods traditionally consumed by people in the countries surronding the Mediterranean Sea. As underlined by Nina Wolf, President of Slow Food Germany, we should adopt a more holistic approach. We need to move past recommendations to favor certain food types over others, and look deeper.

We’ll be discussing the concept further in “The Health of Planet and People” on February 5 at 6 p.m. Italian time. Register now!

La Mediterranean Way by Ancel and Margaret Keys

Mediterreanean Food Pyramid
The Mediterranean Food pyramind. Source:

Ancel and Margaret Keys, researchers among the first to promote the “Mediterranean way“, studied the habits and health of the population along the Cilento coast in the 1970s. They discovered how rare cases of cardio-vascular disease were, and established a link between this phenomenon and the traditional local diet, and not only. They also highlighted the benefits of a lifestyle that included time spent in the open air, physical movement, conviviality and the community relations typical of a pre-industrial society.

Many of these traditions – in particular those connected to food – are still alive and kicking after half a century. But much has changed.

Accordig to ISTAT 74.2% of Italian children eat fruit and/or vegetables every day, but only 12.6% eat four or more portions. Around a quarter of children and adolescents consume sweets and carbonated drinks daily; 13.8% eat savory snacks. Over 2 million children and adolescents are overweight. This statistic increases significantly from the North to the South of the country (18.8% in the Northwest, 22.5 in the Northeast, 24.2 in Central Italy, 29.9 on the islands and 32.7 in the South). The figure is particulaly high for Campania (35.4%), the very same region studied by Keys.

Obese and overweight people have at least double the risk of developing cardio-vascular diseases, cancer and diabetes: the non communicable diseases. According to the World Health Organization (2018), more problems are caused worldwide by obesity than by undernutrition. This phenomenon affects poorer people disproportionately. Cardio-vascular diseases, cancer and diabetes cause 41 million deaths a year, or 71 of all deaths, if we consider data that excludes Covid-19.

Beyond the Mediterranean diet: methods of production

Maremma Raw Milk Pecorino
Raw milk pecorino from Maremma, Tuscany, Slow Food Presidium. Photo: Roberto Giomi

The people that Keys studied engaged in physical activity for work and to move around; they rarely ate meat and occasionally cheese and fish. Their diet consisted predominantly of cereals, vegetables and fruit accompanied by olive oil. But, if we limit ourselves to this analysis, we lose sight of an essential element. We must highlight the importance of the way the food is made, the relation between agricultural systems, processing practices and the nutritional value of those foods. An industrially-produced hot dog and a portion of free range farm are not comparable. Nor is the bread made with ultra-refined flour comparable to homemade bread made with wholewheat flour from ancient grains. Nor is supermarket cream cheese comparable to a raw milk pecorino from pasture-raised animals.

The case of Angela Saba is emblematic in this regard. She’s a producer of  Maremma Raw Milk Pecorino, and shared her experience in the conference. In 2006 her farm started an experimental collaboration with the University of Pisa. The research involved regular analysis of the animals’ milk, who feed almost-exclusively on pasture, besides a small amount of linseed. The results showed the presence of omega-3 ad omega-6 fats in optimal quantities. The cheese produced with this milk was then given to a group of patients with high cholesterol and a control group. The results, published in 2013 in the British Journal of Nutrition show the positive effect of the cheese in containing levels of “bad” cholesterol (i.e. low-density lipoprotein, or LDL) in the blood.

The evolution of the Mediterranean diet

Cilento Cracked Salella Olive
Cilento Cracked Salella Olive, Campania, Slow Food Presidium. Photo: Giuseppe Cucco

As Antonia Trichopoulou, Emeritous Professor at the School of Medicine of the University of Athens, and vice-president of the Greek Health Foundation, explains: “The Mediterranean diet means a nutritional style that was predominant in the Mediterranean basin up until the 1970s. Afterwards, economies evolved and there were significant changes in food habits and food production. Today the Mediterranean diet is characterized by an abdundance of fruit and vegetable consumption, unrefined cereals, that is, whole cereals. At the same time the role of meat, dairy and fish is much reduced”.

According to EAT-Lancet Commission on Healthy Diets From Sustainable Food Systems, ensuring healthy diets by 2050 will require the global consumption of  fruit, vegetables and legumes to double, while red meat and sugar need to halve. A diet rich in whole, plant-based foods with less products of animal origin is also beneficial for our health and the environment.

A healthy diet with limited environmental impact

Trichopoulou: “So a healthy diet is today recognized as being sustainable, with reduced environmental impact due to the predominance of fruits and vegetables. Extra virgin olive oil, for example, doesn’t just have good nutritional value. It’s part of a sustainable diet, as olive trees are also a barrier against desertification, and they absorb more CO2 than they produce.”

“The olive tree seems to have its genetic origins in the Middle East,” affirms Nehaya Al Muhaisain, agronomist and spokesperson for the Slow Food Community “Women of Olive Oil”, in Jordan. “It’s part of our identity and we use it for creams, cosmetics and medicine. At breakfast we dip our bread in oil infused with thyme and other herbs. It’s a tradition to store the olives in brine at home to eat them with nuts and salads. Yet today in Jordan there are 137 olive mills and only four are of the traditional kind.”

Traditional agricultural models

Rif Einkorn Wheat
Rif Einkorn Wheat, a Slow Food Presidium in Morocco. Photo: Oliver Migliore

The importance of traditional agricultural models in obtaining the best nutritional characteristics from our food was documented  at length, including analyses (in Italian) of some Slow Food Presidia.

Souhad Azennoud, agroecology trainer and coordinator of the Rif Einkorn Wheat Presidium and the Slow Food Jballas Community for Moroccan Biodiversity, told us how this einkorn wheat is typical of the Mediterranean. The cultivation is situationed in a context of pastoral agroforestry, where there are forests linked to traditional food production methods and the raising on pastures of sheep and goats, an environment that favors biodviersity.

Azenoud continues: “Here there are ancient crops like the Rif Einkorn Wheat, ancient rye varieties, fava beans, lentils and chickpeas. Cous-cous made with these cereals is rich in carbohydrates and protein: 100 grams gives us the daily recommended intake of protein, lysine, an essential amino acid which is generally present in limited quantities in cereals, as well as minerals like magnesium, calcium, phosphorous and zinc. This Einkorn What is cultivated poor, rocky soils, with three-year rotations with legumes and using green manure to control pests. It’s an interesting crop because it’s also resistant to drought and torrential rain.”

The Mediterranean diet should be understood not just as a way to improve our health, but also to guarantee the promotion of local and regional agricultural biodiversity, to protect small-scale producers and ensure these foods may be enjoyed by future generations. We also need to underline that these benefits will not be reproduced on an industrial scale, where production processes begin with ingredients of low quality and artificial enhancements.

by Paola Nano,