Italian Health Institute Publishes Mediterranean Diet Guidelines

Summary

The Italian Health Institute has pub­lished offi­cial Mediterranean Diet Guidelines, which are based on a review of over 40,000 sci­en­tific papers and aim to pro­vide evi­dence-based rec­om­men­da­tions for the gen­eral pop­u­la­tion and high-risk groups. The guide­lines empha­size the health ben­e­fits of the Mediterranean diet, advo­cate for its adop­tion in the pre­ven­tion and man­age­ment of var­i­ous health con­di­tions, and high­light the need to make healthy choices more acces­si­ble to the pub­lic.

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.

“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.

“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.

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.