The Mediterranean Italian diet: keys to contemporary thinking.

The Mediterranean diet, which is usual for people from countries whose coasts arc washed by this sea, is a moderate diet in which cereal products, fish, legumes, olive oil, fruit and vegetables and little meat and wine, are prevalent. This type of diet, with variants characteristic for each Mediterranean population, results from an amalgamation over a period of time of local and foreign cooking cultures (first, the Greek-Latin and Arabic ones). The Medieval and post-Medieval cookbooks of Spain, France and Italy are a good example of this. Healthy character of the Mediterranean diet The best proof of the healthy character of the Mediterranean diet is emerging from the International Cooperative Study on the Epidemiology of Coronary Heart Disease, more commonly known as the Seven Countries Study (Keys, 1980). The details of this complex longitudinal study are now well known and so will not be dealt with here. In this study we observed that the death rate from coronary heart disease (CHD) is significantly related to the monounsaturated:saturated fatty acids ratio in the diet (Keys et al. 1986). Even more striking is the difference if we consider the nine cohorts of rural Europeans. The five Mediterranean cohorts (Crete, Corfu, Crevalcore, Montegiorgio and Dalmatia) have a diet in which olive oil, cereals, fruit, fresh vegetables and wine prevail. The diet of four non-Mediterranean cohorts (East and West Finland, Slavonia and Velika Krsna) is characterized by milk and meat fats and the alcoholic beverages are beer and distilled liquors which are very often consumed outside meals. These dietary differences are associated with marked differences in the 15-year CHD death rate (284 v. 655 per 10 OOO). More recently we have further examined some characteristics of the two rural Italian cohorts of men from the Seven Countries Study. The dietary data of 1536 middle-aged men from Crevalcore in the north near Bologna and Montegiorgio in the centre near Ancona, were collected in 1965 at the 5th-year follow-up, by means of the dietary history method (Alberti Fidanza et af. 1988). The two cohorts were followed for the next 20 years for total and specific mortality with 100% coverage of individuals (Farchi et af. 1989). In order to investigate whether a different destiny was associated with subgroups of people with different eating habits, all individuals were classified into different groups, depending on the nutrient densities of their diet, using a K-means cluster-analysis technique. After different attempts …