Skip to main content Accessibility help
×
×
Home

Changing the Irish dietary guidelines to incorporate the principles of the Mediterranean diet: proposing the MedÉire diet

  • Audrey C Tierney (a1) (a2) and Ioannis Zabetakis (a3)
Abstract
Objective

In Ireland, the major causes of death are CVD. The current Irish healthy eating guidelines and food pyramid primarily advocate a low-fat diet. However, there is overwhelming scientific evidence for the benefits of a Mediterranean diet (Med Diet) in the prevention and management of metabolic disease as well as improving overall health and well-being. In the current commentary, the rationale to incorporate the principles of the Med Diet into the Irish dietary guidelines is presented.

Design

Perspectives of authors.

Setting

Local and international.

Subjects

Populations in Europe, North America and Australia.

Results

Adopting components of the Med Diet presents a more evidence-based approach to updating the current Irish dietary guidelines. Experience and lessons from other non-Mediterranean countries show that it could be a feasible and effective solution to improving the dietary habits of the Irish population to prevent and mange chronic diseases.

Conclusions

Policies and programmes to address perceived barriers to the Med Diet’s implementation and uptake in non-Mediterranean countries should be promoted.

Copyright
Corresponding author
*Corresponding author: Email Audrey.Tierney@ul.ie
References
Hide All
1. Irish Universities Nutrition Alliance (2011) National Adult Nutrition Survey Summary Report. https://irp-cdn.multiscreensite.com/46a7ad27/files/uploaded/The%20National%20Adult%20Nutrition%20Survey%20Summary%20Report%20March%202011.pdf (accessed September 2018)
2. Irish Universities Nutrition Alliance (2012) National Pre-School Survey: Summary Report. https://irp-cdn.multiscreensite.com/46a7ad27/files/uploaded/The%20National%20Pre-School%20Nutrition%20Survey%20Summary%20Report%20June%202012.pdf (accessed September 2018).
3. Perry, IJ, Millar, SR, Balanda, KP et al. (2017) What are the estimated costs of childhood overweight and obesity on the island of Ireland? http://www.safefood.eu/SafeFood/media/SafeFoodLibrary/Documents/Publications/Research%20Reports/Cost-of-childhood-obesity-Report.pdf (accessed September 2018).
4. Ley, SH, Hamdy, O, Mohan, V et al. (2014) Prevention and management of type 2 diabetes: dietary components and nutritionals strategies. Lancet 383, 19992007.
5. Ipsos, MRBI (2015) Healthy Ireland Survey 2015: Summary of Findings. http://health.gov.ie/wp-content/uploads/2015/10/Healthy-Ireland-Survey-2015-Summary-of-Findings.pdf (accessed September 2018).
6. Central Statistics Office ( 2016) CSO statistical publication, 31 May 2016, 11am. http://www.cso.ie/en/releasesandpublications/ep/p-vsys/vitalstatisticsyearlysummary2015/ (accessed September 2018).
7. Brug, J (2008) Determinants of healthy eating: motivation, abilities and environmental opportunities. Fam Pract 25, Suppl. 1, i50i55.
8. Trichopoulou, A, Martínez-González, MA, Tong, TYN et al. (2014) Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med 12, 112.
9. Dinu, M, Pagliai, G, Casini, A et al. (2017) Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. Eur J Clin Nutr 72, 3043.
10. Trichopoulou, A, Costacou, T, Mamja, C et al. (2003) Adherence to a Mediterranean Diet and survival in a Greek population. N Engl J Med 348, 25992608.
11. Sofi, F, Macchi, C, Abbate, R et al. (2014) Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr 17, 27692782.
12. Trichopoulou, A, Orfanos, P, Norat, T et al. (2005) Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ 330, 991.
13. Trichopoulou, A, Bamia, C & Trichopoulos, D (2009) Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. BMJ 338, b2337.
14. Martínez-González, MA, Soledad Hershey, M, Zazpe, I et al. (2017) Transferability of the Mediterranean diet to non-Mediterranean countries. What is and what is not the Mediterranean diet. Nutrients 9, E1226.
15. Mente, A, de Koning, L, Shannon, HS et al. (2009) A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 169, 659669.
16. Benetou, V, Trichopoulou, A, Orfanos, P et al. (2008) Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. Br J Cancer 99, 191195.
17. Couto, E, Boffetta, P, Lagiou, P et al. (2011) Mediterranean dietary pattern and cancer risk in the EPIC cohort. Br J Cancer 104, 14931499.
18. Trichopoulou, A, Bamia, C, Lagiou, P et al. (2010) Conformity to traditional Mediterranean diet and breast cancer risk in the Greek EPIC (European Prospective Investigation into Cancer and Nutrition) cohort. Am J Clin Nutr 92, 620625.
19. Bamia, C, Lagiou, P, Buckland, G et al. (2013) Mediterranean diet and colorectal cancer risk: results from a European cohort. Eur J Epidemiol 28, 317328.
20. Misirli, G, Benetou, V, Lagiou, P et al. (2012) Relation of the traditional Mediterranean diet to cerebrovascular disease in a Mediterranean population. Am J Epidemiol 176, 11851192.
21. Martinez-Gonzalez, MA, de la Fuente-Arrillaga, C, Nunez-Cordoba, JM et al. (2008) Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ 336, 13481351.
22. Salas-Salvado, J, Bullo, M, Estruch, R et al. (2014) Prevention of diabetes with Mediterranean diets: a subgroup analysis of a randomized trial. Ann Intern Med 160, 110.
23. Kastorini, CM, Milionis, HJ, Esposito, K et al. (2011) The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol 57, 12991313.
24. Estruch, R, Ros, E, Salas-Salvadó, J et al.; PREDIMED Study Investigators (2013) Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 368, 12791290.
25. Salas-Salvadó, J, Bulló, M, Babio, N et al.; PREDIMED Study Investigators (2011) Reduction in the incidence of type 2 diabetes with the Mediterranean diet. Results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care 34, 1419.
26. Shai, I, Schwarzfuchs, D, Henkin, Y et al.; Dietary Intervention Randomized Controlled Trial (DIRECT) Group (2008) Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 359, 229241.
27. Mozaffarian, D, Hao, T, Rimm, EB et al. (2011) Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 364, 23922404.
28. Ajala, O, English, P & Pinkney, J (2013) Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr 97, 505516.
29. Jacka, FN, O’Neill, A, Opie, R et al. (2017) A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Med 15, 23.
30. Loughrey, DG, Lavecchia, S, Brennan, S et al. (2017) The impact of the Mediterranean diet on the cognitive functioning of healthy older adults: a systematic review and meta-analysis. Adv Nutr 8, 571586.
31. Lourida, I, Soni, M, Thompson-Coon, J et al. (2013) Mediterranean diet, cognitive function, and dementia: a systematic review. Epidemiology 24, 479489.
32. Singh, B, Parsaik, AK, Mielke, MM et al. (2014) Association of Mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis 39, 271282.
33. Fransen, HP, Beulens, JW, May, AM et al. (2015) Dietary patterns in relation to quality-adjusted life years in the EPIC-NL cohort. Prev Med 77, 119124.
34. May, AM, Struijk, EA, Fransen, HP et al. (2015) The impact of a healthy lifestyle on disability-adjusted life years: a prospective cohort study. BMC Med 13, 39.
35. Burlingame, B and Demini, S (2011) Sustainable diets: the Mediterranean diet as an example. Public Health Nutr 14, 22852287.
36. Abdullah, MMH, Jones, JPH & Jones, PJH (2015) Economic benefits of the Mediterranean-style diet consumption in Canada and the United States. Food Nutr Res 59, 27541.
37. Goulet, J, Lamarche, B, Nadeau, G et al. (2003) Effect of a nutritional intervention promoting the Mediterranean food pattern on plasma lipids, lipoproteins and body weight in healthy French-Canadian women. Atherosclerosis 170, 11524.
38. Gardener, H, Wright, CB, Gu, Y et al. (2011) Mediterranean-style diet and risk of ischemic stroke, myocardial infarction, and vascular death: the Northern Manhattan Study. Am J Clin Nutr 94, 14581464.
39. Tangney, CC, Kwasny, MJ, Li, H et al. (2011) Adherence to a Mediterranean-type dietary pattern and cognitive decline in a community population. Am J Clin Nutr 93, 601607.
40. Leblanc, V, Begin, C, Hudon, AM et al. (2014) Gender differences in the long-term effects of a nutritional intervention program promoting the Mediterranean diet: changes in dietary intakes, eating behaviors, anthropometric and metabolic variables. Nutr J 13, 107.
41. Zbeida, M, Goldsmith, R, Shimony, T et al. (2014) Mediterranean diet and functional indicators among older adults in non-Mediterranean and Mediterranean countries. J Nutr Health Aging 18, 411418.
42. Tognon, G, Nilsson, LML, Lissner, L et al. (2012) The Mediterranean diet score and mortality are inversely associated in adults living in the subarctic region. J Nutr 142, 15471553.
43. Tong, TYN, Wareham, NJ, Khaw, KT et al. (2016) Prospective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: the EPIC-Norfolk study. BMC Med 14, 135.
44. Papamiltiadous, ES, Roberts, SK, Nicoll, AJ et al. (2016) A randomised controlled trial of a Mediterranean Dietary Intervention for Adults with Non Alcoholic Fatty Liver Disease (MEDINA): study protocol. BMC Gastroenterol 16, 14.
45. Ryan, MC, Itsiopoulos, C, Thodis, T et al. (2013) The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatol 59, 138143.
46. Itsiopoulos, C, Brazionis, L, Kaimakamis, M et al. (2011) Can the Mediterranean diet lower HbA1c in type 2 diabetes? Results from a randomized cross-over study. Nutr Metab Cardiovasc Dis 21, 740747.
47. George, ES, Kucianski, T, Mayr, HL et al. (2018) A Mediterranean model in Australia: strategies for translating the traditional Mediterranean Diet into a mulitcultural setting. Nutrients 10, E465.
48. Nutrition Australia (2013) Healthy Eating Pyramid. http://www.nutritionaustralia.org/national/resource/healthy-eating-pyramid (accessed September 2018).
49. National Institute for Health and Care Excellence (2013) 1.2 Lifestyle changes after an MI. Myocardial infarction: cardiac rehabilitation and prevention of further MI, NICE Guidelines CG172. https://www.nice.org.uk/guidance/cg172/chapter/1-recommendations#lifestyle-changes-after-an-mi2 (accessed September 2018).
50. Middleton, G, Keegan, R, Smith, MF et al. (2015) Brief report: Implementing a Mediterranean diet intervention into a RCT: lessons learned from a non-Mediterranean based country. J Nutr Health Aging 19, 10191022.
51. Moore, SE, McEvoy, CT, Prior, L et al. (2017) Barriers to adopting a Mediterranean diet in Northern European adults at high risk of developing cardiovascular disease. J Hum Nutr Diet. Published online: 21 November 2017. doi: 10.1111/jhn.12523.
52. US Department of Health and Human Services, National Heart, Lung, and Blood Institute (2016) The National Heart, Lung, and Blood Institute Workshop: ‘Toward Testing the Effects of a Mediterranean Dietary Pattern on Cardiovascular and Other Diseases in the United States’. https://www.nhlbi.nih.gov/events/2016/national-heart-lung-and-blood-institute-workshop-toward-testing-effects-mediterranean (accessed September 2018).
53. Stone, NJ, Robinson, J, Lichtenstein, AH et al. (2014) 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 129, 25 Suppl. 2, S1S45.
55. Choe, E & Min, DB (2006) Mechanisms and factors for edible oil oxidation. Compr Rev Food Sci Food Saf 5,169186.
56. De Alzaa, F, Guillaume, C & Ravetti, L (2018) Evaluation of chemical and physical changes in different commercial oils during heating. Acta Sci Nutr Health 2, 211.
57. Visiolo, F & Martinez-Gonzalez, MA (2018) Olive oil and prevention of chronic diseases: summary of an international conference. Nutr Metab Cardiovasc Dis 28, 649656.
58. Nasopoulou, C, Karantonis, HC, Perrea, DN et al. (2010) In vivo anti-atherogenic properties of cultured gilthead sea bream (Sparus aurata) polar lipid extracts in hypercholesterolaemic rabbits. Food Chem 120, 831836.
59. Karantonis, HC, Antonopoulou, S, Perrea, DN et al. (2006) In vivo antiatherogenic properties of olive oil and its constituent lipid classes in hyperlipidemic rabbits. Nutr Metab Cardiovasc Dis 16, 174185.
60. Tsantila, N, Karantonis, HC, Perrea, DN et al. (2007) Antithrombotic and antiatherosclerotic properties of olive oil and olive pomace polar extracts in rabbits. Mediators Inflamm 2007, 36204.
61. Poutzalis, S, Anastasiadou, A, Nasopoulou, C et al. (2016) Evaluation of the in vitro anti-atherogenic activities of goat milk and goat dairy products. Dairy Sci Technol 96, 317327.
62. Lordan, R, Tsoupras, A & Zabetakis, I (2017) Phospholipids of animal and marine origin: structure, function, and anti-inflammatory properties. Molecules 22, E1964.
63. Megalemou, K, Sioriki, E, Lordan, R et al. (2017) Evaluation of sensory and in vitro anti-thrombotic properties of traditional Greek yogurts derived from different types of milk. Heliyon 3, e00227.
64. Xanthopoulou, MN, Kalathara, K, Melachroinou, S et al. (2017) Wine consumption reduced postprandial platelet sensitivity against platelet activating factor in healthy men. Eur J Nutr 56, 14851492.
65. International Agency for Research on Cancer (2018) Red Meat and Processed Meat . IARC Monographs on the Evaluation of Carcinogenic Risks to Humans no. 114. Lyon: IARC.
66. Abete, I, Romaguera, D, Vieira, AR et al. (2014) Association between total, processed, red and white meat consumption and all-cause, CVD and IHD mortality: a meta-analysis of cohort studies. Br J Nutr 112, 762775.
67. Liu, G, Zong, G, Wu, K et al. (2018) Meat cooking methods and risk of type 2 diabetes: results from three prospective cohort studies. Diabetes Care 41, 10491060.
68. Zheng, J, Huang, T, Yu, Y et al. (2012) Fish consumption and CHD mortality: an updated meta-analysis of seventeen cohort studies. Public Health Nutr 15, 725737.
69. Dernini, S & Berry, EM (2015) Mediterranean diet: from a healthy diet to a sustainable dietary pattern. Front Nutr 2, 15.
70. Tong, TYN, Imamura, F, Monsivais, P et al. (2018) Dietary cost associated with adherence to the Mediterranean diet, and its variation by socio-economic factors in the UK Fenland study. Br J Nutr 119, 685694.
71. BBC good food (2017) Why are Mediterranean diets so healthy? https://www.bbcgoodfood.com/howto/guide/why-are-mediterranean-diets-so-healthy (accessed October 2018).
72. Bach-Faig, A, Berry, EM, Lairon, D et al. (2011) Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr 14, 22742284.
73. An Taisce (2016) Ireland’s Agricultural Sector’s Role in Food Security in the Wake of Climate Change. http://www.antaisce.org/file/1593/download?token=BcZ28AuL (accessed October 2018).
74. Garnett T (2010) Livestock, feed and food security. Food Climate Research Network Briefing Paper. https://www.fcrn.org.uk/sites/default/files/FCRN_livestockfeed_foodsecurity.pdf (accessed October 2018).
75. Health Service Executive (2018) Healthy Eating and Active Living Programme. https://www.hse.ie/eng/about/who/healthwellbeing/our-priority-programmes/heal/ (accessed September 2018).
76. Department of Health (2015) A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016–2025. https://health.gov.ie/wp-content/uploads/2016/09/A-Healthy-Weight-for-Ireland-Obesity-Policy-and-Action-Plan-2016-2025.pdf (accessed September 2018).
77. safefood (2015) The healthy incentive for pre-schools project. http://www.safefood.eu/Publications/Research-reports/The-healthy-incentive-for-pre-schools-project.aspx (accessed September 2018).
78. Department of Employment Affairs and Social Protection (2018) Schools Meals Programme. http://www.welfare.ie/en/Pages/School-Meals-Programme.aspx (accessed September 2018).
79. Drewnowski, A & Eichelsdoerfer, P (2009) The Mediterranean diet: does it have to cost more? Public Health Nutr 12, 16211628.
80. Mente, A, de Koning, L, Shannon, HS et al. (2009) A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med 169, 659669.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed