Skip to main content
    • Aa
    • Aa
  • Access
  • Cited by 35
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Grosso, Giuseppe and Galvano, Fabio 2016. Mediterranean diet adherence in children and adolescents in southern European countries. NFS Journal, Vol. 3, p. 13.

    Knight, Alissa Bryan, Janet and Murphy, Karen 2016. Is the Mediterranean diet a feasible approach to preserving cognitive function and reducing risk of dementia for older adults in Western countries? New insights and future directions. Ageing Research Reviews, Vol. 25, p. 85.

    Wiklund, Petri 2016. The role of physical activity and exercise in obesity and weight management: Time for critical appraisal. Journal of Sport and Health Science, Vol. 5, Issue. 2, p. 151.

    Ghelfi, Francesca and Titta, Lucilla 2015. Connecting Indian Wisdom and Western Science.

    Kyriacou, Alexis Evans, Josie M.M. Economides, Nicholas and Kyriacou, Angelos 2015. Adherence to the Mediterranean diet by the Greek and Cypriot population: a systematic review. The European Journal of Public Health, Vol. 25, Issue. 6, p. 1012.

    Papadopoulou, A. Panagiotakos, D.B. Hatziagorou, E. Antonogeorgos, G. Matziou, V.N. Tsanakas, J.N. Gratziou, C. Tsabouri, S. and Priftis, K.N. 2015. Antioxidant foods consumption and childhood asthma and other allergic diseases: The Greek cohorts of the ISAAC II survey. Allergologia et Immunopathologia, Vol. 43, Issue. 4, p. 353.

    Sette, Stefania D’Addezio, Laura Piccinelli, Raffaela Hopkins, Sinead Le Donne, Cinzia Ferrari, Marika Mistura, Lorenza and Turrini, Aida 2015. Intakes of whole grain in an Italian sample of children, adolescents and adults. European Journal of Nutrition,

    Erbe Healy, Amy 2014. Convergence or difference? Western European household food expenditure. British Food Journal, Vol. 116, Issue. 5, p. 792.

    Schwingshackl, Lukas and Hoffmann, Georg 2014. Adherence to Mediterranean diet and risk of cancer: A systematic review and meta-analysis of observational studies. International Journal of Cancer, Vol. 135, Issue. 8, p. 1884.

    Tyrovolas, Stefanos Polychronopoulos, Evangelos Tountas, Yannis and Panagiotakos, Demosthenes 2014. Assessment of the dietitian's influence on the dietary habits of older adults living in Greek Islands and Cyprus. Nutrition & Dietetics, Vol. 71, Issue. 1, p. 2.

    Cabrera-Vique, Carmen and Mesías, Marta 2013. Content and Bioaccessibility of Aluminium in Duplicate Diets from Southern Spain. Journal of Food Science, Vol. 78, Issue. 8, p. T1307.

    Vandevijvere, S. Monteiro, C. Krebs-Smith, S. M. Lee, A. Swinburn, B. Kelly, B. Neal, B. Snowdon, W. and Sacks, G. 2013. Monitoring and benchmarking population diet quality globally: a step-wise approach. Obesity Reviews, Vol. 14, p. 135.

    Filipe, Ana Filipa Lawrence, Justin E. and Bonada, Núria 2012. Vulnerability of stream biota to climate change in mediterranean climate regions: a synthesis of ecological responses and conservation challenges. Hydrobiologia,

    Golzarand, Mahdieh Mirmiran, Parvin Jessri, Mahsa Toolabi, Karamollah Mojarrad, Mehdi and Azizi, Fereidoun 2012. Dietary trends in the Middle East and North Africa: an ecological study (1961 to 2007). Public Health Nutrition, Vol. 15, Issue. 10, p. 1835.

    Tyrovolas, Stefanos Tountas, Yannis Polychronopoulos, Evangelos and Panagiotakos, Demosthenes 2012. A parametric model of the role of nutritional services within the health care system, in relation to cardiovascular disease risk among older individuals. International Journal of Cardiology, Vol. 155, Issue. 1, p. 110.

    Couto, E Boffetta, P Lagiou, P Ferrari, P Buckland, G Overvad, K Dahm, C C Tjønneland, A Olsen, A Clavel-Chapelon, F Boutron-Ruault, M-C Cottet, V Trichopoulos, D Naska, A Benetou, V Kaaks, R Rohrmann, S Boeing, H von Ruesten, A Panico, S Pala, V Vineis, P Palli, D Tumino, R May, A Peeters, P H Bueno-de-Mesquita, H B Büchner, F L Lund, E Skeie, G Engeset, D Gonzalez, C A Navarro, C Rodríguez, L Sánchez, M-J Amiano, P Barricarte, A Hallmans, G Johansson, I Manjer, J Wirfärt, E Allen, N E Crowe, F Khaw, K-T Wareham, N Moskal, A Slimani, N Jenab, M Romaguera, D Mouw, T Norat, T Riboli, E and Trichopoulou, A 2011. Mediterranean dietary pattern and cancer risk in the EPIC cohort. British Journal of Cancer, Vol. 104, Issue. 9, p. 1493.

    Kontou, Niki Psaltopoulou, Theodora Panagiotakos, Demosthenes Dimopoulos, Meletios A. and Linos, Athena 2011. The Mediterranean Diet in Cancer Prevention: A Review. Journal of Medicinal Food, Vol. 14, Issue. 10, p. 1065.

    Penelo, Eva Granero, Roser Krug, Isabel Treasure, Janet Karwautz, Andreas Anderluh, Marija Bellodi, Laura Cellini, Elena di Bernardo, Milena Nacmias, Benedetta Ricca, Valdo Sorbi, Sandro Tchanturia, Kate Wagner, Gudrun Collier, David Bonillo, Albert and Fernández-Aranda, Fernando 2011. Factors of risk and maintenance for eating disorders: psychometric exploration of the cross-cultural questionnaire (CCQ) across five European countries. Clinical Psychology & Psychotherapy, Vol. 18, Issue. 6, p. 535.

    Sheehy, Tony and Sharma, Sangita 2011. The nutrition transition in the Republic of Ireland: trends in energy and nutrient supply from 1961 to 2007 using Food and Agriculture Organization food balance sheets. British Journal of Nutrition, Vol. 106, Issue. 07, p. 1078.

    Tyrovolas, S. Psaltopoulou, T. Pounis, G. Papairakleous, N. Bountziouka, V. Zeimbekis, A. Gotsis, E. Antonopoulou, M. Metallinos, G. Polychronopoulos, E. Lionis, C. and Panagiotakos, D.B. 2011. Nutrient intake in relation to central and overall obesity status among elderly people living in the Mediterranean islands: The MEDIS study. Nutrition, Metabolism and Cardiovascular Diseases, Vol. 21, Issue. 6, p. 438.


Trends in food availability determined by the Food and Agriculture Organization's food balance sheets in Mediterranean Europe in comparison with other European areas

  • Rafael Balanza (a1), Pilar García-Lorda (a1), Carmen Pérez-Rodrigo (a2), Javier Aranceta (a2), Mònica Bulló Bonet (a1) and Jordi Salas-Salvadó (a1) (a3)
  • DOI:
  • Published online: 01 February 2007

The aims of this study were to assess the changes that have occurred in food patterns in Europe over the last 40 years based on food availability data and to compare the stability of the traditional Mediterranean diet in the south of Europe in this period.


An ecological study carried out on the basis of Food and Agriculture Organization food balance sheets for three geographical areas of Europe (Mediterranean, north and east) over two time periods: 1961–1963 and 1998–2000. The average availability of total energy, energy provided from macronutrients and food groups was calculated for each area and each period studied.


Over the last 40 years total energy availability and energy availability from lipids have increased considerably in the three European areas, while the percentage of energy from carbohydrates has fallen. The greatest changes have occurred in Mediterranean Europe, with an increase of 20.1% in total energy availability, an increase of 48.1% in energy availability from lipids and a fall of 20.5% from carbohydrates. Moreover, Mediterranean Europe showed a significant fall in the energy supplied by cereals (29.9%) and wine (55.2%), while the contribution of milk (77.8%) and dairy products (23.6%) increased.


The results of this study suggest that European Mediterranean countries should take nutrition policy action to maintain their traditional healthy food pattern, with a cultural added value. This implies actions at all levels, including raising awareness of consumers, collaboration with the food sector and a call to set the agenda of the concerned politicians and stakeholders.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Trends in food availability determined by the Food and Agriculture Organization's food balance sheets in Mediterranean Europe in comparison with other European areas
      Your Kindle email address
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Trends in food availability determined by the Food and Agriculture Organization's food balance sheets in Mediterranean Europe in comparison with other European areas
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Trends in food availability determined by the Food and Agriculture Organization's food balance sheets in Mediterranean Europe in comparison with other European areas
      Available formats
Corresponding author
*Corresponding author: Email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1M De Lorgeril , P Salen , JP Martin , J Delaye , M Nicole . Mediterranean diet, traditional risk factors and rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 1999; 99: 779–85.

4A Trichopoulou , T Costacou , C Bamia , D Trichopoulos . Adherence to a Mediterranean diet and survival in a Greek population. New England Journal of Medicine 2003; 348: 2599–608.

5H Tunstall-Pedoe , K Kuulasmaa , M Mahonen . Contribution of trends in survival and coronary-events rates to changes in coronary heart disease mortality: 10 years results from 37 WHO MONICA project populations. Monitoring trends and determinants in cardiovascular disease. Lancet 1999; 353: 1547–57.

7A Trichopoulou , A Kouris-Blazos , ML Walqvist , Ch Gnordellis , P Lagiou , E Polychonopoulos , . Diet and overall survival in elderly people. British Medical Journal 1995; 311: 1457–60.

12A Ferro-Luzzi , WP James , A Kafatos . The high-fat Greek diet: a recipe for all? European Journal of Clinical Nutrition 2002; 56: 928–9.

13T Costacou , C Bamia , P Ferrari , E Riboli , D Trichopoulos , A Trichopoulou . Tracing the Mediterranean diet through principal components and cluster analyses in the Greek population. European Journal of Clinical Nutrition 2003; 57: 1378–85.

14B Karamanos , A Thanopoulou , F Angelico , S Assaad-Khalil , A Barbato , M Del Ben , Nutritional habits in the Mediterranean Basin. The macronutrient composition of diet and its relation with the traditional Mediterranean diet. Multi-centre study of the Mediterranean Group for the Study of Diabetes (MGSD). European Journal of Clinical Nutrition 2002; 56: 983–91.

15A Alberti-Fidanza , F Fidanza , MP Chiuchiu , G Verducci , D Fruttini . Dietary studies on two rural Italian population groups of the Seven Countries Study. 3. Trend of food and nutrient intake from 1960 to 1991. European Journal of Clinical Nutrition 1999; 53: 854–60.

16D Trichopoulos , P Lagiou . Mediterranean diet and overall mortality differences in the European Union. Public Health Nutrition 2004; 7: 949–51.

17A Bach , L Serra-Majem , JL Carrasco , B Roman , J Ngo , I Bertomeu , . The use of indexes evaluating the adherence to the Mediterranean diet in epidemiological studies: a review. Public Health Nutrition 2006; 9(1A): 132–46.

19GE Gray , MC Pike , BE Henderson . Breast-cancer incidence and mortality rates in different countries in relation to known risk factors and dietary practices. British Journal of Cancer 1979; 39: 17.

20RL Prentice , F Kakar , S Hursting , L Sheppard , R Klein , LH Kushi . Aspects of the rationale for the Women's Health Trial. Journal of the National Cancer Institute 1988; 80: 802–4.

21H Kesteloot , E Lesaffre , JV Joossens . Dairy fat, saturated animal fat, and cancer risk. Preventive Medicine 1991; 20: 226–36.

22SD Hursting , M Thornquist , MM Henderson . Types of dietary fat and the incidence of cancer at five sites. Preventive Medicine 1990; 19: 242–53.

23A Gjonca , M Bobak . Albanian paradox, another example of protective effect of Mediterranean lifestyle? Lancet 1990; 350: 1815–7.

26L Serra-Majem , D MacLean , L Ribas , D Brulé , W Sekula , R Prattala , . Comparative analysis of nutrition data from national, household, and individual levels: results from a WHO-CINDI collaborative project in Canada, Finland, Poland, and Spain. Journal of Epidemiology and Community Health 2003; 57: 7480.

27F Rodriguez-Artalejo , JR Banegas , A Graciani , R Hernandez-Vecino , J del Ray-Calero . Food supply versus household survey data: nutrient consumption trends for Spain, 1958–1988. European Journal of Epidemiology 1996; 12: 367–71.

28L Serra-Majem . Food availability and consumption at national, household and individual levels: implications for food-based dietary guidelines development. Public Health Nutrition 2001; 4(2B): 673–6.

31G Block , WF Rosenberg , BH Patterson . Calories, fat and cholesterol: intake patterns in the US population by race, sex and age. American Journal of Public Health 1988; 78: 1150–5.

34GE McKeown-Eyssen , E Bright-See . Dietary factors in colon cancer: international relationships. Nutrition and Cancer 1984; 6: 160–70.

35R Garcia-Closas , A Berenguer , CA Gonzalez . Changes in food supply in Mediterranean countries from 1961 to 2001. Public Health Nutrition 2006; 9: 5360.

36S Tessier , M Gerber . Factors determining the nutrition transition in two Mediterranean islands: Sardinia and Malta. Public Health Nutrition 2005; 8: 1286–92.

37A Trichopoulou , A Naska , T Costacou . DAFNE III Group. Disparities in food habits across Europe. Proceedings of the Nutrition Society 2002; 61: 553–8.

38A Alberti-Fidanza , F Fidanza . Mediterranean adequacy index of Italian diets. Public Health Nutrition 2004; 7: 937–41.

39N Alexandratos . The Mediterranean diet in a world context. Public Health Nutrition 2006; 9(1A): 111–7.

40N Slimani , M Fahey , AA Welch , E Wirfalt , C Stripp , E Bergstrom , . Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project. Public Health Nutrition 2002; 5: 1311–28.

41JM Gil , A Gracia , L Perez . Food consumption and economic development in the European Union. European Review of Agricultural Economics 1995; 22: 385–99.

43EAK Wirfält , RW Jeffery . Using cluster analysis to examine dietary patterns: nutrient intakes, gender and weight status differ across food pattern clusters. Journal of the American Dietetic Association 1997; 97: 272–9.

45KT Knoops , LC de Groot , D Kromhout , AE Perrin , O Moreiras-Varela , A Menotti , . Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women. The HALE Project. Journal of the American Medical Association 2004; 292: 1433–9.

46JS Perona , J Cañizares , E Montero , JM Sánchez-Domínguez , A Catalá , V Ruiz-Gutiérrez . Virgin olive oil reduces blood pressure in hypertensive elderly subjects. Clinical Nutrition 2004; 23: 1113–21.

47D Zambón , J Sabaté , S Muñoz , B Campero , E Casals , M Merlos , . Substituting walnuts for monounsaturated fat improves the serum lipid profile of hypercholesterolemic men and women. A randomized crossover trial. Annals of Internal Medicine 2000; 132: 538–46.

49F Fuentes , J López-Miranda , E Sánchez , P Sánchez , J Paéz , E Paz-Rojas , . Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men. Annals of Internal Medicine 2001; 134: 1115–9.

50C Chrysohoou , DB Panagiotakos , C Pitsavos , UN Das , C Stefanadis . Adherence to the Mediterranean diet attenuates inflammation and coagulation processes in healthy adults. The ATTICA Study. Journal of the Americn College of Cardiology 2004; 44: 152–8.

51K Esposito , R Marfella , M Ciotola , C Di Palo , F Guigliano , G Giugliano , . Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome. Journal of the American Medical Association 2004; 292: 1440–6.

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? *