The healthy lifestyle of the Mediterranean diet
The traditional Mediterranean diet is the heritage of millennia of exchange of people, cultures and foodstuffs throughout the Mediterranean basin. This diet was the basis of food habits until the mid-twentieth century in all countries of the region, but it is now progressively disappearing because of the widespread dissemination of Western-type lifestyle and globalisation.
The Mediterranean diet, recognised as a healthy dietary pattern and a healthy lifestyle, is still an underexplored resource for valuing biodiversity and understanding human nutrition. More than just food, it is also a potential model of sustainable development, although this too has not been fully realised. In the Mediterranean region, there is widespread awareness of the social, cultural, health and economic dimensions of food, shared by all Mediterranean people(Reference Dernini1).
In 2009, in Parma, Italy, the international conference The Mediterranean Diet as a Model of Sustainable Diet was organised by CIISCAM in collaboration with the FAO Nutrition and Consumer Protection Division, the Forum on Mediterranean Food Cultures, and the CIHEAM-IAM of Bari. Its aim was to promote the Mediterranean diet as an example of a sustainable diet in which nutrition, local food production, biodiversity, culture and sustainability were strongly interconnected, with a low impact on the environment.
The Mediterranean diet, based on a variety of diversified local traditional foods strictly linked to the Mediterranean environment, was presented as an intangible heritage(Reference Reguant-Aleix, Arbore and Bach-Faig2) as well as an under-explored resource for biodiversity and nutrition towards nutritional security and sustainable development(Reference Toledo and Burlingame3).
The notion of sustainable diets
In the early 1980s, the notion of ‘sustainable diets’ was described by Gussow and Clancy(Reference Gussow and Clancy4) to recommend diets that are healthier for the environment as well as for consumers. The concept of a ‘sustainable diet’, borrowed from ‘sustainable agriculture,’ promoted activities that minimised the waste of natural resources and addressed food production for local and seasonal consumption.
With the food globalisation process and the increased production of agricultural systems, and with no attention paid to the sustainability of ecosystems, the sustainable diet's concept was neglected for many years. But recently interest in sustainable diets has again been raised by international scientific societies and institutions of various European governments(5).
There is growing recognition of the complexity of defining sustainability, as well as a growing body of evidence of the unsustainable nature of current diets. A definition of sustainable diets should address sustainability of the whole food chain, while acknowledging the interdependencies of food production systems and food and nutrient requirements.
The notion of a sustainable diet would have been curious a few hundred years ago, when people obtained the majority of their foods out of their ecosystems. Biodiversity was valued and utilised; ecosystems and agro-ecological zones produced the foods that they had produced for millennia.
Traditional knowledge and practices ensured the conservation and sustainable use of food biodiversity within healthy ecosystems. But agriculture, diet and nutrition have changed so dramatically in recent decades that now the concept of a sustainable diet seems novel.
The confounding result, according to FAO estimates, is that the number of undernourished people has increased to nearly one billion(6). This number reflects only the dietary energy supply, whereas micronutrient malnutrition exists on an even larger scale. In addition to the problems of undernourishment, obesity and its associated chronic diseases are rising. This, coupled with the alarming pace of food biodiversity loss and ecosystem degradation, makes a compelling case for re-examining agricultural systems and diets. Although good nutrition should be a goal of agriculture, it is imperative that concerns about sustainability are not lost in the process. Many dietary patterns can be healthy, but they can vary substantially in terms of the cost of their resource.
The Mediterranean diet has been characterised, analysed and promoted through a variety of methods within a number of scientific and applied disciplines. It continues to be recognised and appreciated as a healthy diet, even if its practice in the Mediterranean region is diminishing.
In 2008, delegates at the FAO Regional Conference for Europe made important statements: ‘They highlighted the Mediterranean diet as rich in biodiversity and nutritionally healthy. The promotion of the Mediterranean diet could play a beneficial role of in the sustainable development of agriculture in the Mediterranean region’, and ‘remarked that the goal of increased global food production, including biofuels, should be balanced against the need to protect biodiversity, ecosystems, traditional foods and traditional agricultural practices’(7).
In 2010, participants at the international symposium on ‘Biodiversity and Sustainable Diets: United against Hunger’, reached a consensus position on the following definition of sustainable diets: ‘Sustainable diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimizing natural and human resources’(8).
The Mediterranean diet as an example of a sustainable diet
The importance of the Mediterranean diet as an example of a sustainable diet lies not in its specific foods and nutrients but in the methods used to characterise and analyse it and the philosophy of sustainability that is at its core.
The concept of sustainable diets involves economic, environmental and sociocultural issues that influence nutrition and health outcomes. The new approach to present the Mediterranean diet as a sustainable diet, rich in biodiversity, should provide more eco-friendly food-based dietary guidelines and goals to consumers and help clarify what is required for an environmentally sustainable food system.
Integrating the notion of sustainable diets with the food chain approach (i.e. ‘getting biodiversity from the farm to the plate’) should guide an innovative intersectoral effort to counteract the simplification of diets, loss of biodiversity and the degradation of ecosystems and prevent further erosion of food cultures. It will serve to further promote traditional foods of indigenous peoples with their many sources of nutritionally rich species and varieties as readily accessible, locally empowering and sustainable sources of quality nutrition. Furthermore, it will highlight that in an increasingly global, urban and commercial environment, fulfilment of the potential of local resources must successfully integrate production, marketing, consumption and the health of rural and urban dwellers alike as components of sustainable food systems.
The Mediterranean diet provides opportunities for conserving diversity in the cultural knowledge of foods and diets, understanding indigenous or local food systems using a multicultural approach to sustainable diets. It also raises the question of safeguarding traditional knowledge on food and culture.
In conclusion, there is a need to develop new cross-cutting, intersectoral case studies on the Mediterranean diet as a sustainable diet to demonstrate the synergies of biodiversity, nutrition and sustainability expressed by the Mediterranean diet for the benefit of present and future generations. More than before, we have to act together by revitalising local capacities to reduce the increasing erosion of the diversity of Mediterranean food cultures, to safeguard it as an intangible cultural heritage, as well as to reinforce the sustainability of the agro-food systems of all Mediterranean countries and food security in the entire region.
These same methods can be used to characterise sustainable diets in other cultures and agro-ecological zones, to identify the necessary new paradigms of reference to solve the many challenges that face humankind, with almost one billion hungry people worldwide.
The authors have no conflict of interest to declare. Authors' contributions: S.D. and B.B. contributed to the study conception, design and drafting of manuscript.