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The relationship between adherence to a Mediterranean diet and reduced mortality or a lower incidence of major chronic diseases has been widely studied. The purpose of this study was to assess the adherence of a Lebanese adult sample to the Mediterranean diet.

This cross-sectional dietary survey involved a Lebanese population sample aged 19 to 70 years. A total of 615 men and women were asked to fill a diet history questionnaire (144 items), assisted by trained nutrition research assistants. Data were analyzed and compared to the Mediterranean diet recommendations, and the Mediterranean diet score, a ten-point scale based on above and below median levels of consumption, was estimated.

There was no significant difference in terms of adherence between men and women participants below the age of 30 years, while women over 30 years had a poorer score than men within this age group. The surveyed sample was found to have a 4.2 Mediterranean diet score and, thus, has a low adherence to the Mediterranean dietary pattern. Consumption of fruits, vegetables, dairy products, legumes and nuts of this Lebanese sample met the Mediterranean diet recommendations, while whole grains, poultry and fish consumption was lower than the recommended Mediterranean diet intake, and meat consumption was found to be much higher than what was recommended.

Facing the fast increase in non-communicable disease incidence, and with a more spread Western-type culture, it is central to raise awareness about the role of traditional Mediterranean diet in preventing and protecting against these diseases. This study contributes to the limited literature on the adherence to the Mediterranean diet in Lebanon.

The chapter is an auto-ethnographic account of the self-management of a chronic illness within the context of a participatory research project on Mediterranean Diet (MD). A group of Italian women with type 2 diabetes is following a non-medical, personal interpretation of the Mediterranean-style diet. The research account is preceded by a critical appraisal of the scientific narratives of the MD.

Analysis of epidemiological research on MD examines some methodological aspects of gender blindness in its scientific approach. The ethnography concerns self-management of MD diet and redefinition of gender relations.

MD is analyzed as a case of transplantation of yesterday’s cultural and social capitals of the peasant classes, to today’s discourses on food considered as appropriate for affluent people suffering from satiety diseases. The ethnography highlights gender aspects of biographical work, examining in particular a “conversion” dietary model.

The ethnography must be amplified to include women and men from different social classes with various Mediterranean cooking habits, and family and gender patterns.

The chapter highlights cultural processes for women’s empowerment in self-managing type 2 diabetes.

This chapter may represent a seminal sociological work on chronic illness, gender and food studies in one of the “native” contexts of the Mediterranean-style diet.

The purpose of this paper is to review the Mediterranean diet and its association to disease and health benefits derived from the adherence to it.

The review includes the most updated studies found in PubMed all in relation to the adaptation of the Mediterranean diet.

The cardioprotection of Mediterranean diet has been established. A number of cancer types could be prevented by following the Mediterranean type diet and the specific ingredients of it are also investigated to find their impact on health. Longevity is also favored by the adoption of this dietary pattern as is the population group diagnosed with metabolic syndrome and mental health disorders. The results about its consumption and obesity need further investigation. Patients with HIV, being on specific treatment, are advised not to follow the Mediterranean diet.

This paper gives a concise, up‐to‐date overview to nutritionists and dietitians on the Mediterranean diet and its relation to health and disease.

The purpose of this paper is to inform readers of the cultural and scientific basis of the Mediterranean diet.

This review was compiled using peer reviewed articles and with the support of Oldways, the non‐profit organisation responsible for designing the Mediterranean diet pyramid in association with Harvard School of Public Health. It is designed to create a resource, which could be disseminated within the food industry to stimulate debate and an understanding of the commercial opportunities for products based on the Mediterranean diet.

From the review of information on the subject there is compelling evidence of the benefits of a Mediterranean diet having a beneficial effect on health status with a reduction in conditions such as coronary heart disease and cancers.

This is a literature review based on large studies of the Mediterranean diet and is not an intervention study.

It is hoped that the food industry can consider the scientific and market research evidence presented and, through innovation and new brand development, offer the possibility of products, which will promote choice and access to increasingly healthy foods.

The compilation of evidence citing the benefits of the Mediterranean diet supports an easily adapted and flavourful diet with numerous health benefits. For the food industry it provides an original concept designed to support the research and development of new initiatives to promote healthy food products.

The benefits of the Mediterranean diet are shown to have significant benefits on health and are easily implemented.

This study aims to analyze the antioxidant properties of the Mediterranean diet and describe methods that are used in clinical studies to assess its role in reducing oxidative stress.

The review presents the results of interventional and observational clinical trials aimed at assessing the influence of the Mediterranean diet on the level of enzymatic and non-enzymatic antioxidants, as well as the total blood antioxidant capacity.

The Mediterranean diet as a varied diet can be a better way to provide antioxidants to the body than supplements. Individual compounds administered in an isolated form can give the opposite effect to the expected, stimulating oxidative stress. The administration of antioxidants in the form of supplements instead of a varied diet is also associated with a lack of synergism of action. In studies on the importance of the Mediterranean diet in the reduction of oxidative stress, single markers are used to measure oxidative damage, the activity of enzymatic antioxidants and the concentration of individual non-enzymatic antioxidants. At the same time, the need to find markers that would assess the level of oxidative stress and the body’s antioxidant capacity more comprehensively is emphasized.

It should be taken into account that differences between in vivo and in vitro results may result from the fact of various factors, including genetic, smoking, intestinal microflora or diet composition. It is also necessary to answer the question about which marker or set of markers could in the most comprehensive way to assess the level of oxidative stress and the body’s antioxidant capacity.

The literature review shows not only the source of antioxidants in the Mediterranean diet. This paper also presents a critical approach to markers that allow the assessment of the antioxidant properties of the diet.

The Mediterranean Diet (MD) is an expression of different Mediterranean food cultures and lifestyles. It is characterized by high consumption of olive oil, vegetables, legumes, whole grain products, fruits and nuts. This paper aims to emphasize on the evolution of human diet from earliest human ancestors to current civilization, the effect of MD on human health and the role of globalization to shift traditional diet, particularly MD to processed foods.

Different published papers were collected from the internet by using the following phrases: evolution of human diet, human ancestors, the effect of globalization on a regional diet, Mediterranean diet, healthy food, food pyramid, evolution of human diet and effect of globalization on diet. Finally, the papers were read and summarized as a review paper.

MD has been accepted worldwide owing to its health impact such as prevention and control of type 2 diabetes, anti-inflammatory effects and decrease in the risk of cardiovascular diseases and incidence of Parkinson’s disease and Alzheimer’s disease. However, in conjunction with this discordance between our ancient, genetically determined biology and the nutritional, cultural and activity patterns of contemporary Western populations, many of the so-called diseases of civilization have emerged. Particularly, the food staples and food-processing procedures introduced during the Neolithic and Industrial periods have fundamentally altered nutritional characteristics of ancestral hominin diets. MD is currently under the risk of extinction for a result of the effects of globalization.

The review paper focuses on the evolution of human diet as an effect of globalization on the regional diet with emphasis on the MD. It specifically focuses on the link between diet and earliest human ancestors, about MD and its health benefit, diet pyramid and effect of globalization on regional diet.

The purpose of this study is to address the challenges faced by rural areas and promote their sustainable development. It emphasizes the importance of re-establishing connections and cultivating a sense of belonging within rural communities, while safeguarding their cultural heritage. The study explores the potential of digital and creative tools in enhancing learning, supporting food production and tourism, facilitating research and providing engaging experiences. It also examines the economic condition of rural areas and the potential for their contribution to the national economy. Additionally, the study highlights the significance of sustainable community development, the role of rural areas in resilience and climate change adaptation and the complexities surrounding rural migration. The aim is to provide insights and recommendations for policymakers and stakeholders involved in rural development initiatives, focusing on the Mediterranean region.

This study develops an understanding of the role of digital and creative strategies in rural communities, highlighting their significance in preserving food heritage, culture and community capital while driving economic development. It specifically focuses on the Unesco Intangible Mediterranean Diet (UIMD) as a potential catalyst for regeneration through the integration of creative and digital tools and three cases are presented. The first is the impact of the Future Food Institute (FFI) ecosystem in the Living Lab in Pollica (Salerno, Italy); the second focuses on the digital tools provided by the CKF to support rural areas; and the third is a new identity and promotion of territorial development, co-designed in the Val di Vara (VdV) a rural region of the Ligurian inland in Italy, through digital strategies, heritage preservation and slow tourism development. The three cases highlight different ways of enhancing environmental and cultural heritage and demonstrate how collaborative creativity and digital tools contribute to the co-construction of knowledge and addressing critical issues to promote sustainable growth in rural areas.

The findings of this study indicate that re-establishing connections and fostering a sense of belonging within rural communities is crucial for their sustainable development. The use of digital and creative tools presents significant opportunities in enhancing various aspects such as learning, food production, tourism and research in rural areas. The study also reveals the potential economic contributions of rural areas to the national economy. It emphasizes the importance of sustainable community development and highlights the role of rural areas in resilience and climate change adaptation. Additionally, the study addresses the complexities surrounding rural migration and emphasizes the need for comprehensive policies to ensure the well-being and rights of migrant workers. The insights and recommendations provided in this study aim to guide policymakers and stakeholders involved in rural development initiatives, particularly in the Mediterranean region.

Nonetheless, it is imperative to acknowledge certain limitations within the scope of this study, primarily associated with the specific sample selection, potentially influencing the broader applicability of the findings. There is potential to explore a wider geographic area in future research. Additionally, the research underscores the importance of conducting further inquiries into certain aspects that have received limited attention. Living labs are a relatively recent phenomenon, warranting further in-depth scientific research. Additionally, the existing literature on this subject is often limited in scope.

The study and project aim to illustrate the feasibility of initiating a transformative process, centered on a visionary approach with a core focus on creative knowledge and the Mediterranean diet as a way of life, to revitalize marginalized communities. Furthermore, it seeks to emphasize that these neglected regions possess untapped potential for innovative ideas and opportunities. Rural communities, in their role as farmers of primary goods, are the ones who nurture the environment, and the landscape, and are the true protagonists of every era. Rurality is the place that preserves the most resources and potential in terms of biodiversity and rural knowledge. Every territory, like every human being, has its own characteristics and vocations to pursue. The existing Genius Loci is already an existing value that requires policies and governance to rediscover roots, identity and worth. The stratification of existing collective intelligence must become central and must be individually assessed and enhanced, also taking advantage of new digital technologies.

The social implications of this study are significant. By emphasizing the importance of re-establishing connections and cultivating a sense of belonging within rural communities, the study recognizes the social value of strong community ties. This can lead to increased social cohesion, a sense of identity and improved overall well-being within rural areas. The study also highlights the potential of digital and creative tools in enhancing learning, which can contribute to the empowerment and educational opportunities of individuals in rural communities. Furthermore, by promoting sustainable community development and addressing the complexities surrounding rural migration, the study acknowledges the social impact of inclusive policies that protect the rights and well-being of both local populations and migrant workers. Overall, the study's recommendations have the potential to foster social resilience, equity and a more vibrant social fabric within rural areas.

This study can offer valuable insights and recommendations for policymakers and stakeholders involved in rural development initiatives, particularly those focused on preserving food and cultural heritage in rural areas. By analyzing real-life examples, it bridges the gap between theory and practice, illustrating how these ideas have been effectively applied in specific contexts. This paper emphasizes the potential of the Mediterranean Diet as a sustainable and nutritious model with sociocultural, health, economic and environmental benefits, highlighting the importance of bottom-up approaches that empower local communities as custodians of knowledge and culture. It also provides practical strategies, such as investments in educational programs, the establishment of international campuses and the use of multichannel platforms for immersive experiences, which can be adapted for broader rural development initiatives, promoting sustainability and community engagement.

This study aims to evaluate the nutrient profile, carbon footprint and water footprint of one-month menus presented in five hospitals in Turkey and compare their environmental impacts with that of the Mediterranean diet.

The energy and nutrient content of menus were compared with recommendations of the Turkey Dietary Guidelines (TUBER) 2022. Nutrient profiles of hospital menus were evaluated using Nutrient Rich Food 9.3 (NRF 9.3) and SAIN-LIM models. The carbon and water footprints of the menus were calculated and compared with those of the Mediterranean diet.

Menus’ energy and nutrient content did not conform with TUBER 2022. The SAIN-LIM score of Hospital A (5.7 ± 1.1) was significantly higher than that of Hospitals C (4.8 ± 0.7, p = 0.001) and E (5.1 ± 0.7, p = 0.025). The carbon footprint of Hospital A was significantly lower (2.6 ± 0.3 kg CO₂ eq/person/day) and that of Hospital D (4 ± 0.9 kg CO₂ eq/person/day) was significantly higher than those of others (p < 0.001). While other menus were similar (p > 0.05), the water footprint of Hospital A was significantly lower (3.5 ± 0.7 L/kg, p < 0.001). In addition, if the menus were suitable for the Mediterranean diet, a reduction of 2.2–23.4% in the carbon footprint and 37.5–58.6% in the water footprint could be achieved. Moreover, menus’ carbon and water footprints were negatively correlated with NRF 9.3 and SAIN-LIM scores.

The primary aim should be to ensure that the planned menus follow the dietary guidelines. In addition, it is an undeniable fact that sustainable nutrition is a complex process with many dimensions. However, it seems possible to improve the nutrient profiles of the menus and reduce their environmental footprint with minor changes to be made in food services.

It seems possible to improve the nutrient profiles of the menus and reduce their environmental footprint with minor changes. For both health and environmental impacts, food services should switch to menus suitable for the Mediterranean diet.

The findings provide new insights into hospital menus’ quality and environmental impact.

The purpose of this paper is to develop and validate the Greek version of the Mediterranean Diet Adherence Screener (MEDAS).

The MEDAS was translated to the Greek language forward and backward, twice and subsequently was administered to 50 healthy adult participants living in Attica, Greece. The participants had to complete the tool twice, within a period of 15 days. Participants also completed the well-recognized Mediterranean Diet Score (MedDietScore), for comparison purposes with the tested tool. Socioeconomic and anthropometric characteristics were also assessed.

There was a moderate association between the Greek MEDAS (MEDAS-Gr) and the MedDietScore [(Pearson r = 0.50, p < 0.001; Intraclass Correlation Coefficient (ICC)=0.46, p = 0.015)]. The concordance between these two questionnaires varied between the items (Intraclass correlation coefficient of 0.62 for fruit at the highest and −0.09 for alcohol consumption). The Cronbach’s a coefficient of reliability for the Greek MEDAS was good (a = 0.62). The two administrations of the MEDAS-Gr produced similar mean total scores (7.6 vs 7.9, p = 0.090), which were correlated (r = 0.71, p < 0.001; ICC = 0.85, p < 0.001) and agreed substantially [k statistic (k)=0.72, 95% CI 0.54–0.89, p < 0.001)].

The MEDAS-Gr seems to be a valid tool for assessing adherence to the Mediterranean diet in the Greek population.

Diet therapy or nutritional therapy has become a real challenge in the fight against the increasing number of modern illnesses such as obesity, diabetes, cardiovascular diseases and cancers. The scientific community has recognized the importance of studies that will support or rebut the association of certain nutrition/energy inputs with the prevention and/or improvement of certain diseases. Patient counseling is offered by medical doctors, nutritionists and dieticians, but patients often seek additional sources of information from popular media that may not be adequately scientifically supported. Whose responsibility is it when the Diet Therapy is not an effective treatment and where does the consequent ethical and moral responsibility lie?

This chapter argues for the importance of a nutritionally educated scientist evaluating the diets that are seen to be related with the health improvement also excluding diets that are mostly related to the patients’ well-being as the Mediterranean, DASH (Dietary Approaches to Stop Hypertension), Ketogenic and Vegetarian diet. Diet guidelines are often explained with linguistic variables (as “reduce the input of” etc.) which can be differently perceived by the end user. The interpretation if a linguistic variable is presented using the body mass index categories using a bell-shaped curve. The preferable area fits to the linguistic variable “acceptable BMI.” But also are indicated those areas which are less preferable. Those examples of information interpretations show the necessity of knowledge transfer. The quantity of information presented in diet guidelines can be experienced as a great muddle for patients; leaving them not knowing where and how to start. So, remains the ethical and moral responsibility of all links in the chain of nutritional and diet research and recommendations. Only objective and open-minded recommendations based on the latest scientific facts can gain confidence of the social, economical, and political subjects which must put the well-being of the population uppermost in their mind.