Summary
The Italian Health Institute has published official Mediterranean Diet Guidelines, a 600-page document with scientific information for physicians, evidence for policymakers, and recommendations for the general population. The guidelines are the result of a year-long review by health researchers and aim to promote the health benefits of the Mediterranean diet, which is increasingly important given the declining adherence to this diet in Italy and the European Union.
The Italian Health Institute (ISS), a public technical and scientific agency that researches and monitors public health, has published its official Mediterranean Diet Guidelines.
The 600-page document includes scientific information for physicians, evidence for policymakers and recommendations for the general population.
For over a year, dozens of health researchers, including oncologists, cardiologists and nutritionists, with the support of many associations and professional organizations, reviewed all meaningful evidence available about the Mediterranean diet’s impact on health.
For the first time, these guidelines offer an organized, evidence-based approach to the Mediterranean diet.- Vincenza Gianfredi, project coordinator, Mediterranean Diet Guidelines
“The official guidelines, a first for the Mediterranean diet, are the outcome of the review of more than 40,000 scientific papers published in different countries,” Vincenza Gianfredi, associate professor at the University of Milan’s biomedical sciences for health department and coordinator of the project, told Olive Oil Times.
“Until now, there were no specific guidelines dedicated to the Mediterranean diet,” she added. “Given the overwhelming amount of evidence supporting how beneficial it might be for human health and, increasingly, for its sustainability, there was a clear need for the guidelines.”
The cornerstone publication is now part of the national guidelines system ISS maintains.
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“For the first time, these guidelines offer an organized, evidence-based approach to the Mediterranean diet, addressing an enormous body of somewhat scattered research,” Gianfredi said.
The authors did not stop at reviewing the scientific literature but also aimed to interpret and analyze the available evidence to provide valuable solutions for the public.
“We worked both in terms of prevention, meaning how the Mediterranean diet can help healthy individuals avoid disease, and in terms of its usefulness for people who already have health conditions,” Gianfredi explained.
The Mediterranean diet prioritizes fruits, vegetables, whole grains, and moderate amounts of dairy, fish and poultry, while discouraging saturated fats and refined sugars. It also promotes extra virgin olive oil as the only daily fat for cooking and eating.
The Mediterranean Diet was included in UNESCO’s List of Intangible Heritage in 2010 and was recently named the best diet by U.S. News & World Report for the eighth consecutive year.
“Of course, we cannot present the Mediterranean diet as a therapy by itself, but rather as a support to standard treatments,” Gianfredi said.
The document’s first section lists dozens of recommendations for the general public and members of specific health-related high-risk groups.
“In individuals at high cardiovascular risk, the Mediterranean diet supplemented with extra virgin olive oil is recommended over a low-fat diet to reduce the incidence of type 2 diabetes mellitus,” one recommendation reads.
“While the document itself is quite technical, we included a more accessible section with a summary of 81 recommendations,” Gianfredi said.
“Each recommendation clearly states the target population, the specific health condition and the associated benefit of the Mediterranean diet, expressed simply in one sentence,” she added.
Some of the health conditions listed by the recommendations include cardiovascular diseases, tumors, anxiety, depression, Alzheimer’s disease, mild cognitive impairment and other conditions where it has been scientifically proven that the Mediterranean diet can make a difference.
According to the guidelines’ authors, the first target of the new document is clinicians.
“Since we not only evaluated the Mediterranean diet’s preventive role but also its supportive role in the management of diseases, the guidelines are particularly useful for healthcare professionals in advising patients,” Gianfredi said.
“They are also very important for public health experts, like myself, who work to support policymakers. Scientific evidence from the guidelines should inform public health policies aimed at improving population health and making healthy choices easier for people,” she added.
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According to the authors, the need for comprehensive and reliable guidelines also arose from the diminishing appeal of the Mediterranean diet in the general population, especially among young people.
“The latest data from the Italian National Institute of Health shows that only five percent of Italians currently adhere closely to the Mediterranean diet,” Gianfredi said.
The guidelines noted how the Western diet and ultra-processed food consumption are gaining traction in Italy and, more broadly, in the European Union.
“This is a serious problem because, as we show in the guidelines, following the Mediterranean diet has concrete health benefits,” Gianfredi said.
“Thus, it is crucial to raise awareness and make healthy choices easier,” she added. “For instance, ensuring that healthy Mediterranean options are readily available in supermarkets and restaurants. The healthiest choice should always be the easiest choice.”
“I am a strong advocate of the importance of truly spreading and communicating scientific information, not by simplifying or watering down the scientific rigor that underpins all this work, but by ensuring that important messages reach everyone,” Gianfredi continued.
“If we lock ourselves behind absolute scientific rigor, we risk losing the opportunity to disseminate crucial content to non-experts,” she remarked.
One of the most interesting aspects of the work was the inclusion of all reliable research on the Mediterranean diet without focusing on Italy alone.
According to the authors, such an approach makes the internationalization of the guidelines a viable project.
“We are already in contact with European scientific institutions to consider translating the guidelines, starting with English, since it is the international language of science,” Gianfredi said.
“We designed the guidelines with a broader scope since the beginning,” she added. “Therefore, our guidelines can be easily adopted or adapted by other countries without major modifications.”
Beyond health, the guidelines also examined the economic sustainability of the Mediterranean diet.
“We analyzed several aspects. One key point is that, although further research is needed, the Mediterranean diet could be economically viable in everyday grocery shopping at different latitudes,” Gianfredi said.
“However, it certainly proves economical in the long term. People adhering to the Mediterranean diet tend to maintain better health, thus avoiding healthcare costs such as exams, treatments and hospitalizations,” she added.
“Thus, it is important to think not just about short-term costs but about long-term savings, in terms of both money and quality of life,” Gianfredi concluded.