Perspectives and challenges for adoption of the Mediterranean diet

Despite the well-documented health benefits associated with adherence to the Mediterranean diet, societal and environmental drives provide mixed stimuli to the general population toward adopting or moving away from this dietary pattern. Countries in which the Mediterranean diet represents a cultural heritage are facing a so-called “nutrition transition” process, especially among the younger generations, characterized by a higher consumption of high-energy poor nutritional foods. Potential reasons for such decline in adherence to the Mediterranean diet in the Mediterranean region or barriers for adopting this dietary pattern across the borders of the Mediterranean basin are represented by lifestyle changes, food globalization, economic, and socio-cultural factors. Emerging socioeconomic inequalities in other domains of healthy dietary behaviors such as dietary variety, access to organic foods and food purchasing behavior seems to affect Southern Mediterranean countries while countries in Northern Europe and some other Countries around the world are currently embracing a Mediterranean-like dietary pattern. A potential cause of this downward trend could be the increasing prices of some food items of the Mediterranean diet pyramid. Recent evidence has shown a possible involvement of the economic crisis, material resources becoming strong determinants of the adherence to the Mediterranean diet just after the recession started in 2007-2008. Beyond intake, the MD also encourages increasing dietary diversity, while international dietary recommendations suggest replacing regular foods with healthier ones.