Original Mediterranean Diet Pyramid

Oldways, the Harvard School of Public Health, and the European Office of the World Health Organization introduced the classic Mediterranean Diet in 1993 at a conference in Cambridge, MA, along with a Mediterranean Diet Pyramid graphic to represent it visually. 

The initial Mediterranean Diet pyramid was created using the most current nutrition research to represent a healthy, traditional Mediterranean diet. It was based on the dietary traditions of Crete, Greece and southern Italy circa 1960 at a time when the rates of chronic disease among populations there were among the lowest in the world, and adult life expectancy was among the highest even though medical services were limited.

The key to this longevity is a diet that successfully resisted the last 50 years and more of “modernizing” foods and drinks in industrialized countries. These modern trends led to more meat (mostly beef) and other animal products, fewer fresh fruits and vegetables, and more processed convenience foods. Ironically, this diet of “prosperity” was responsible for burgeoning rates of heart disease, obesity, diabetes, and other chronic diseases.


Updating the Mediterranean Diet PyramidThe “poor” diet of the people of the southern Mediterranean, consisting mainly of fruits and vegetables, beans and nuts, healthy grains, fish, olive oil, small amounts of dairy, and red wine, proved to be much more likely to lead to lifelong good health.

 Other vital elements of the Mediterranean Diet are daily exercise, sharing meals with others, and fostering a deep appreciation for the pleasures of eating healthy and delicious foods.

Oldways Pyramid before 2008

As you can see above, the original graphic consisted of simple words. Soon after the original pyramid’s introduction, Oldways added graphics, to more clearly emphasize the foods making up the pyramid. Although we updated the graphics from time to time, the same underlying science was depicted.

By the time of our 15th Anniversary Mediterranean Diet Conference in November 2008, we decided it was important to make a major review of the latest research findings related to the Mediterranean Diet, and revisit the science.

New Med Pyramid graphic 2008

A new feature on the 2008 Mediterranean Diet Pyramid update is the addition of herbs and spices, for reasons of both health and taste. Also, herbs and spices contribute to the national identities of various Mediterranean cuisines. The committee changed the placement of fish and shellfish on the pyramid, recognizing the benefits of eating fish and shellfish at least two times per week.We gathered a distinguished Scientific Advisory Board, which reached consensus on several major updates to the Classic Mediterranean Diet Pyramid. These changes focused on gathering plant foods (fruits, vegetables, grains, nuts, legumes, seeds, olives and olive oil) in a single group to visually emphasize their health benefits. The scientific committee made this change to draw attention to the key role of these delicious and healthy plant foods in this health-promoting eating pattern – and to put all foods in this group on an equal footing. 

The 2008 scientific update inspired a 2009 graphic update. With the help of artist George Middleton, we created an entirely new pyramid graphic to better reflect the delicious and appetizing nature of the foods in the Mediterranean Diet.

Download notes from the 2008 Mediterranean Diet Pyramid Update.

For information about licensing and getting permission to use the Mediterranean Diet Pyramid, visit our Co-Branding and Licensing page.