LETTER FROM THE EDITOR Mediterranean diet? no, thanks: mediterranean lifestyle!

Dear readers, Starting in the 1980s, Ancel Keys and other nutritionists recognised how the Mediterranean diet was able to prevent the cardiovascular conditions, cancers and disorders that result from a diet lacking nutrients essential to health. The basis of such diet is not a geographic location, but the result of historic exchanges between various Countries in the Mediterranean basin, that were established over time in any particular region, with many proposals, products and variants. The staple foods of the Mediterranean diet comprise wholegrain breads and pastas, cereals, legumes, all kinds of vegetables, fruit in season, fish, aromatic herbs, sheep and goat’s milk and cheeses, wine (in moderation) and, above all, olive oil as the main condiment. Meat consumption is reduced and white meat, such as chicken, turkey and rabbit predominate. Nutritional experts agree that a diet inspired by the principles of the Mediterranean diet is healthy, as is confirmed by studies of populations that are particularly long-lived or protected from degenerative vascular, osteoarticular and neoplastic diseases. This is also a gratifying cuisine with intense flavours and colours. Scientific studies show that in addition to protecting against cardiovascular and neoplastic diseases, the Mediterranean diet also has potential protective effects on the brain, contributing to the prevention of cognitive decline. It has emerged that people who follow this type of nutritional regimen have a lower probability of cognitive decline [1]. The Mediterranean diet can also reduce the possibility of developing Alzheimer’s disease in people showing signs of cognitive difficulty. Adherence to a form of the healthy Mediterranean diet is associated with significant improvement in health as was shown in a study [2] conducted in about 1.5 million people, with a follow-up that varied from 3 to 18 years, in which a reduction of 13% in both Alzheimer’s and Parkinson’s diseases, of 6% in death from cancer, of 9% for cardiovascular disease and 9% for death from all causes was demonstrated. Recently, a study by De Lorenzo et al. has highlighted the positive impact of the organic Mediterranean diet on health (Italian Mediterranean diet as reference) with respect to the conventional diet [3], in terms of reduction of inflammatory status and of endothelial dysfunction associated with obesity and kidney disease. It should also be pointed out, for the first time, that daily consumption of organic foods in the context of the Mediterranean diet could be linked to a reduction in homocysteine, phosphorous, total cholesterol, microalbuminuria, and to an increase in circulating vitamin B12 levels [4]. Moreover, in a follow-up clinical study, the Mediterranean diet combined with broader lifestyle changes improved renal arterial circulation in essential hypertension. This occurs through the reduction in intra-renal resistance, and does not involve modification of insulin resistance [5]. Through this vascular mechanism, the Mediterranean diet seems to be able to modify an important component of the pathophysiology of arterial hypertension and atherosclerosis. In the long-term, personal behaviours and the lifestyle adopted, environmental and socioeconomic conditions have been shown to be the most important factors both for life expectancy and for health [6]. S. G. Sukkar (&) Dir. Resp.le U.O.D. Dietetica e Nutrizione Clinica, Az.Ospedale-Università San Martino di Genova, Università di Genova, Pad. VII piano 2 , Largo R. Benzi 10, 16132 Genoa, Italy e-mail: [email protected]