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.

This pyramid continues to be a well-known guide to what is now universally recognized as the “gold standard” eating pattern that promotes lifelong good health. It has been widely used for years by consumers, educators, and health professionals alike to implement healthier eating habits.

The 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 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.

The “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.

Download a color illustration of the Med Pyramid (124K JPEG)

The Eating Pattern of The Mediterranean Diet Pyramid

Dietary data from the parts of the Mediterranean region that in the recent past enjoyed the lowest recorded rates of chronic diseases and the highest adult life expectancy are characterized by a pattern similar to the one illustrated in the list below. The healthfulness of this pattern is corroborated by more than 50 years of epidemiological and experimental nutrition research. The frequency and amounts suggested are in most cases intentionally nonspecific, since variation was considerable. The historical pattern includes the following (several parenthetical notes add a contemporary public health perspective): 

• An abundance of food from plant sources, including fruits and vegetables, potatoes, breads and grains, beans, nuts, and seeds.
• Emphasis on a variety of minimally processed and, wherever possible, seasonally fresh and locally grown foods (which often maximizes the health-promoting micronutrient and antioxidant content of these foods).
• Olive oil as the principal fat, replacing other fats and oils (including butter and margarine).
• Total fat ranging from less than 25 percent to over 35 percent of energy, with saturated fat no more than 7 to 8 percent of energy (calories).
• Daily consumption of low to moderate amounts of cheese and yogurt (low-fat and non-fat versions may be preferable).
• Twice-weekly consumption of low to moderate amounts of fish and poultry (recent research suggests that fish be somewhat favored over poultry); up to 7 eggs per week (including those used in cooking and baking).
• Fresh fruit as the typical daily dessert; sweets with a significant amount of sugar (often as honey) and saturated fat consumed not more than a few times per week.
• Red meat a few times per month (recent research suggests that if red meat is eaten, its consumption should be limited to a maximum of 12 to 16 ounces [340 to 450 grams] per month; where the flavor is acceptable, lean versions may be preferable).
• Regular physical activity at a level which promotes a healthy weight, fitness and well-being.
• Moderate consumption of wine, normally with meals; about one to two glasses per day for men and one glass per day for women. From a contemporary public health perspective, wine should be considered optional and avoided when consumption would put the individual or others at risk.

Updating the Mediterranean Diet Pyramid

During the 15th Anniversary Mediterranean Diet Conference in November 2008, several major updates were made to the Classic Mediterranean Diet Pyramid by the Scientific Advisory Board. 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.

A new feature on the Mediterranean Diet Pyramid 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. Click here to download the complete notes for the 2008 Mediterranean Diet Pyramid Update.

Some Common and Uncommon Foods and Flavors of The Mediterranean Diet Pyramid
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Licensing

Oldways welcomes requests for use of its Mediterranean, Vegetarian, Asian and Latin American Diet Pyramids,  EATWISE®, as well as other copyrighted material in publications, on packaging material and on websites.

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Please direct requests and inquiries to Birthe Creutz.