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PublicHealthNutrition:14(12A),2274Œ2284 doi:10.1017/S1368980011002515Mediterraneandietpyramidtoday.Scienceandcultural updatesAnnaBach-Faig 1,ElliotMBerry 2,DenisLairon 3,JoanReguant 1,AntoniaTrichopoulou 4,SandroDernini 5,6,FXavierMedina 7,MaurizioBattino 8,RekiaBelahsen 9,GemmaMiranda 1andLluõ «sSerra-Majem 1,10,*onbehalfoftheMediterraneanDiet FoundationExpertGroup 1MediterraneanDietFoundation,Barcelona,Spain: 2DepartmentofHumanNutritionandMetabolism,Braun SchoolofPublicHealth,HebrewUniversity-HadassahMedicalSchool,Jerusalem,Israel: 3ResearchUnit1025 Inserm/1260Inra/ÔÔHumanNutritionandLipids:Bioavailability,MetabolismandRegulationsÕÕ,Faculte «deMe«decine,Universite «delaMe «diterrane«e,Marseille,France: 4HellenicHealthFoundation,Athens,Greece: 5ForumonMediterraneanFoodCultures,Rome,Italy: 6InteruniversityInternationalCenterforMediterranean FoodCulturesStudies(CIISCAM),SapienzaUniversityofRome,Italy: 7DepartmentofFoodSystems, CultureandSociety,FacultyofHealthSciences,UniversitatObertadeCatalunya(UOC),Barcelona,Spain: 8DepartmentofBiochemistry,Universita `PolitecnicadelleMarche,Ancona,Italy: 9DepartmentofBiology, FacultyofSciences,Chouaõ ¬bDoukkaliUniversity,ElJadida,Morocco: 10DepartmentofClinicalSciences, UniversityofLasPalmasdeGranCanaria,POBox550,35080,LasPalmasdeGranCanaria,Spain Submitted13May2011:Accepted7September2011 AbstractObjective:TopresenttheMediterraneandiet(MD)pyramid:alifestylefortoday. Design:AnewgraphicrepresentationhasbeenconceivedasasimpliÞedmain frametobeadaptedtothedifferentnutritionalandsocio-economiccontextsof theMediterraneanregion.Thisreviewgathersupdatedrecommendationscon- sideringthelifestyle,dietary,sociocultural,environmentalandhealthchallenges thatthecurrentMediterraneanpopulationsarefacing. SettingandSubjects: Mediterraneanregionanditspopulations. Results:Manyinnovationshavearisensincepreviousgraphicalrepresentations oftheMD.First,theconceptofcompositionoftheÔmainmealsÕisintroduced toreinforcetheplant-basedcoreofthedietarypattern.Second,frugality andmoderationisemphasisedbecauseofthemajorpublichealthchallengeof obesity.Third,qualitativeculturalandlifestyleelementsaretakenintoaccount, suchasconviviality,culinaryactivities,physicalactivityandadequaterest, alongwithproportionandfrequencyrecommendationsoffoodconsumption. Theseinnovationsaremadewithoutomittingotheritemsassociatedwiththe production,selection,processingandconsumptionoffoods,suchasseasonality, biodiversity,andtraditional,localandeco-friendlyproducts. Conclusions:Adoptingahealthylifestyleandpreservingculturalelementsshould beconsideredinordertoacquireallthebeneÞtsfromtheMDandpreservethis culturalheritage.ConsideringtheacknowledgmentoftheMDasanIntangible CulturalHeritageofHumanitybyUNESCO(2010),andtakingintoaccountits contributiontohealthandgeneralwell-being,wehopetocontributetoamuch betteradherencetothishealthydietarypatternanditswayoflifewiththisnew graphicrepresentation. KeywordsMediterraneandiet PyramidAdultDietarypattern LifestyleCultureHealthThetraditionalMediterraneandiet(MD)istheheritageof millenniaofexchangesofpeople,culturesandfoodsof allcountriesaroundtheMediterraneanbasin.Ithasbeen thebasisoffoodhabitsduringthetwentiethcenturyinall countriesoftheregion,originallybasedonMediterranean agriculturalandruralmodels.However,thetraditional MDisnowprogressivelyerodingduetothewidespread disseminationoftheWestern-typeeconomy,urbanand technology-drivenculture,aswellastheglobalisationof foodproductionandconsumption,relatedtothehomo- genisationoffoodbehavioursinthemodernera. SincetheSevenCountriesStudyinthe1950s,weknow whichfoodsweremoreorlessfrequentlyconsumedinthe Mediterraneanarea (1),apatternfollowedmainlybypoor ruralsocieties (2).ThisledtodeÞningtheMDasadietary patternrichinplantfoods(cereals,fruits,vegetables, *Correspondingauthor: Emaillserra@dcc.ulpgc.es rTheAuthors2011
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