The Mediterranean food pyramid (WHO Europe/FAO 1994 )

The concept of the pyramid

Most of the food education publications were elaborated in the United States. One hundred years ago, W. O. Atwater, in an American farmers' bulletin of the United States' Department of Agriculture (USDA), put emphasis on the importance of diversity, right proportion, and moderation in order to preserve a healthy nutrition.

Toward 1940, the USDA identified seven food families and proposed a circular graphic representation illustrating the nutritional recommendations. In the fifties the message was simplified when the USDA proposed the ‘Basic Four' corresponding to four food groups and established the minimal portion to be consumed everyday

2 portions of dairy products
2 portions of meat, eggs, dried broad beans, or oleaginous fruits.
4 portions of fruits and vegetables.
4 portions of bread and/or cereals

In 1979, the USDA reviewed the ‘Basic Four' and added a fifth group ‘fat, carbohydrates and alcohol' to bring public attention to the importance of moderation in their consumption.

After the edition of the first American set of nutrition directives, in 1980, a new nutrition manual was elaborated to help the consumer implement these recommendations. It is revised and reedited once every five years. It includes five food families and advice on the portions to be taken daily:

2 to 3 portions of dairy products,
2 to 3 portions of meat, chicken, fish, eggs, dried broad beans or oleaginous fruits,
6 to 11 portions of bread, cereals, rice or pasta,
3 to 5 portions of vegetables,
2 to 4 portions of fruits

These groups were set to supply the necessary nutrients. Sweet and fat substances are not mentioned but are to be consumed with moderation.

Starting in 1988, circular graphics were added, then in 1991 came the pyramid. In 1992, the USDA produced the ‘Food Pyramid Guide' and the food pyramid was established. Since then, many food pyramids were elaborated, especially:

•  Mediterranean food pyramid 1 (1992)
•  Asia Minor food pyramid (1995)
•  Latin America food pyramid (1996)
•  Vegetarian pyramid (1997)
•  American children's food pyramid (1999).


The Food pyramid principle

In the fifties, more interest was shown in this type of diet, when professor Keys, of the School of Public Health of Minnesota University, observed in his study of the seven countries that the Crete inhabitants had a longer life-expectancy and a heart attack death rate equal to 10% of that of the United States. These observations were confirmed in 1991 when professor Willett, Head of the Nutrition Department of the Harvard Public Health School, reported that the Mediterranean diet constitutes the model to follow in preventive medicine, and also when, in 1993, the Pyramid of the Mediterranean diet was presented.

There are many cultures in the Mediterranean region and that's why, despite some similarities, there is no uniformity in food habits. It has in common, the consumption of cereals, fresh and dried vegetables, fruits, fish and olive oil along with a simple way of cooking and the abundant use of aromatic herbs, onion and garlic. Olive oil is the basis of the Mediterranean diet dishes.

The pyramid representing the optimal Mediterranean diet is based on the nutrition traditions of Crete and the south of Italy in the sixties. It was elaborated on the basis of the results of a nutrition research carried out in 1993 and presented by professor Walter Willett during the 1993 International Conference on the Mediterranean Diet, that was held in Cambridge , Massachusetts.

The Mediterranean diet pyramid shows the importance of the foods that make up the main dish groups. Each of these groups, separately considered, provides some, but not all, the necessary elements. Meals composed of a group of food cannot replace those belonging to another. For a healthy diet, all of them are essential.

The basic products in the Mediterranean diet are stated in decreasing order of recommended consumption quantity and frequency in the following:

- Cereals : they constitute the staple of most Mediterranean peoples' diets, bread (whole wheat or refined bread), couscous, pasta and rice.

- Fresh fruits and vegetables : To make a delicious meal, we select the product of the season that we cook in a simple manner. In the Mediterranean area, desert is generally fruit-based. We use a great variety of vegetables, fresh and dry legumes (chickpeas, lentils, white beans), fresh and dry fruits (nuts, almonds, hazel nuts, chestnuts, etc.

- Olive oil and olives : All over the Mediterranean area, regular olive oil and virgin olive oil are used. Regular olive oil is generally used in cooking. Virgin olive oil, which is very appropriate for all uses, is excellent when consumed raw and uncooked to better savour its flavour and taste, and benefit form all its natural components. Fat provision in Crete's traditional diet, as observed by Keys, was more than 40% kcal/day, 8% of which from saturated fat, 3% from polyunsaturated fat and 29% monounsaturated fat (olive oil).

- Dairy products: Cheese, yoghurt and other dairy products, without explicitly mentioning milk.

- Fish : It is considered as the main protein source, more so than eggs and poultry.

- Red meats : Red meat is at the top of the pyramid, which means that its consumption is the least advised. Directly below, in a small slot as well, is pastry.

Continuous activity remains essential for maintaining a good health and an optimal weight.