Defining the traditional mediterranean lifestyle : joint international consensus statement

Journal article


Sidossis, Labros S, Lawson, Rob, Aprilakis, Emmanuel, Barata, Bernardo C., Baska, Alicja, Beneka, Anastasia, Bird, Robert, Birrell, Fraser, Chatzinikola, Charistoula, Chondronikola, Maria, Chrousos, George P, Conduit, Russell, Constantinou, Constantina, Karagounis, Leonidas, de Courten, Barbora, Cvejic, Jelena Helene, Davis, Andrew M, Demetriou, Christiana A., Errington, Linda, ... Itsiopoulos, Catherine. (2024). Defining the traditional mediterranean lifestyle : joint international consensus statement. Lifestyle Medicine. 5(4), pp. 1-13. https://doi.org/10.1002/lim2.115
AuthorsSidossis, Labros S, Lawson, Rob, Aprilakis, Emmanuel, Barata, Bernardo C., Baska, Alicja, Beneka, Anastasia, Bird, Robert, Birrell, Fraser, Chatzinikola, Charistoula, Chondronikola, Maria, Chrousos, George P, Conduit, Russell, Constantinou, Constantina, Karagounis, Leonidas, de Courten, Barbora, Cvejic, Jelena Helene, Davis, Andrew M, Demetriou, Christiana A., Errington, Linda, Feehan, Jack, Figueroa, Catalina, Flynn, Mary M., Frates, Beth, Kabthymer, Robel Hussen, Karimi, Leila, Kennedy, Gerard, Kolokotroni, Ourania, Korovljev, Darinka, Kouris-Blazos, Antigone, Kushkestani, Mehdi, Kyriakides, Tassos C., Hutanu, Emanuela Mercore, Mosquera, Maria Cecilia, Nikiphorou, Elena, O'Brien, Nicola, Philippou, Elena, Piątek, Karolina, Poole, Simon, Popescu-Spineni, Dana, Radd-Vagenas, Sue, Sidossis, Amalia, Simonis, Magdalena, Soultanakis, Helen, Telinga, Aleksandra, Tierney, Audrey, Tkacz, Anna, Vlachopoulos, Dimitris, Yaman-Dent, Gulnur, Yap, Yang, Zervides, Zoe and Itsiopoulos, Catherine
Abstract

The term “Mediterranean lifestyle” has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the “traditional Mediterranean lifestyle (tMedL),” referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term “traditional Mediterranean lifestyle.”

Methods
Major medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the “traditional Mediterranean lifestyle.”

Results
This proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. “The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life.”

Conclusions
This definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well-being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development.

Keywordsdiet; exercise; lifestyle choices; sleep pattern; social/emotional support
Year01 Jan 2024
JournalLifestyle Medicine
Journal citation5 (4), pp. 1-13
PublisherJohn Wiley and Sons Ltd (UK)
ISSN2688-3740
Digital Object Identifier (DOI)https://doi.org/10.1002/lim2.115
Web address (URL)https://onlinelibrary.wiley.com/doi/10.1002/lim2.115
Open accessOpen access
Research or scholarlyResearch
Page range1-13
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online16 Aug 2024
Publication process dates
Accepted25 Jul 2024
Deposited18 Feb 2025
Additional information

© 2024 The Author(s). Lifestyle Medicine published by John Wiley & Sons Ltd.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly
cited.

Place of publicationUnited Kingdom
Permalink -

https://acuresearchbank.acu.edu.au/item/915q2/defining-the-traditional-mediterranean-lifestyle-joint-international-consensus-statement

Download files


Publisher's version
  • 10
    total views
  • 6
    total downloads
  • 7
    views this month
  • 6
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Skeletal muscle myostatin mRNA expression is upregulated in aged human adults with excess adiposity but is not associated with insulin resistance and ageing
Wilhelmsen, Andrew, Stephens, F, Bennett, Andrew J., Karagounis, Leonidas, Jones, Simon W. and Tsintzas, Kostas. (2023). Skeletal muscle myostatin mRNA expression is upregulated in aged human adults with excess adiposity but is not associated with insulin resistance and ageing. GeroScience. 46(2), pp. 2033-2049. https://doi.org/10.1007/s11357-023-00956-6
A meta-analysis comparing the effectiveness of alternate day fasting, the 5:2 diet, and time-restricted eating for weight loss
Elortegui Pascual, Paloma, Rolands, Maryann R., Eldridge, Alison L., Kassis, Amira, Mainardi, Fabio, Lê, Kim-Anne, Karagounis, Leonidas G., Gut, Philipp and Varady, Krista A.. (2023). A meta-analysis comparing the effectiveness of alternate day fasting, the 5:2 diet, and time-restricted eating for weight loss. Obesity. 31(Supp. 1), pp. 9-21. https://doi.org/10.1002/oby.23568
A randomized controlled clinical trial in healthy older adults to determine efficacy of glycine and n-acetylcysteine supplementation on glutathione redox status and oxidative damage
Lizzo, Giulia, Migliavacca, Eugenia, Lamers, Daniela, Frézal, Adrien, Corthesy, John, Vinyes-Parès, Gerard, Bosco, Nabil, Karagounis, Leonidas, Hövelmann, Ulrike, Heise, Tim, Von Eynatten, Maximilian and Gut, Philipp. (2022). A randomized controlled clinical trial in healthy older adults to determine efficacy of glycine and n-acetylcysteine supplementation on glutathione redox status and oxidative damage. Frontiers in Aging. 3, p. Article 852569. https://doi.org/10.3389/fragi.2022.852569
Impact of moderate dietary protein restriction on glucose homeostasis in a model of estrogen deficiency
Fournier, Carole, Karagounis, Leonidas G., Sacco, Sandra M., Horcajada, Marie-Noelle, Decaens, Thomas, Offord, Elizabeth A., Bouzakri, Karim and Ammann, Patrick. (2022). Impact of moderate dietary protein restriction on glucose homeostasis in a model of estrogen deficiency. Journal of Nutritional Biochemistry. 102, p. Article 108952. https://doi.org/10.1016/j.jnutbio.2022.108952
A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults
Templeman, Iain, Smith, Harry Alex, Chowdhury, Enhad, Chen, Yung-Chih, Carroll, Harriet, Johnson-Bonson, Drusus, Hengist, Aaron, Smith, Rowan, Creighton, Jade, Clayton, David, Varley, Ian, Karagounis, Leonidas Georgios, Wilhelmsen, Andrew, Tsintzas, Kostas, Reeves, Sue, Walhin, Jean-Philippe, Gonzalez, Javier T., Thompson, Dylan and Betts, James A.. (2021). A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults. Science Translational Medicine. 13(598), pp. 1-12. https://doi.org/10.1126/scitranslmed.abd8034
Low-grade systemic inflammation interferes with anabolic and catabolic characteristics of the aged human skeletal muscle
Draganidis, Dimitrios, Jamurtas, Athanasios Z., Chondrogianni, Niki, Mastorakos, Georgios, Jung, Tobias, Grune, Tilman, Papadopoulos, Constantinos, Papanikolaou, Konstantinos, Papassotiriou, Ioannis, Papaevgeniou, Nikoletta, Poulios, Athanasios, Batrakoulis, Alexios, Deli, Chariklia K., Georgakouli, Kalliopi, Chatzinikolaou, Athanasios, Karagounis, Leonidas G. and Fatouros, Ioannis G.. (2021). Low-grade systemic inflammation interferes with anabolic and catabolic characteristics of the aged human skeletal muscle. Oxidative Medicine and Cellular Longevity. 2021, p. Article 8376915. https://doi.org/10.1155/2021/8376915
Unacylated ghrelin, leptin, and appetite display diurnal rhythmicity in lean Adults
Templeman, Iain, Smith, Harry A., Walhin, Jean-Philippe, Middleton, Benita, Gonzalez, Javier T., Karagounis, Leonidas G., Johnston, Jonathan D. and Betts, James A.. (2021). Unacylated ghrelin, leptin, and appetite display diurnal rhythmicity in lean Adults. Journal of Applied Physiology. 130(5), pp. 1534-1543. https://doi.org/10.1152/japplphysiol.00920.2020
Systemic and metabolic signature of sarcopenia in community-dwelling older adults
Lu, Yanxia, Karagounis, Leonidas G., Ng, Tze Pin, Carre, Christophe, Narang, Vipin, Wong, Glenn, Tan, Crystal Tze Ying, Nyunt, Ma Shwe Zin, Gao, Qi, Abel, Brian, Poidinger, Michael, Fulop, Tamas, Bosco, Nabil and Larbi, Anis. (2020). Systemic and metabolic signature of sarcopenia in community-dwelling older adults. Journals of Gerontology: Series A Biological Sciences and Medical Sciences. 75(2), pp. 309-317. https://doi.org/10.1093/gerona/glz001
The importance of dietary protein at breakfast in childhood
Karagounis, Leonidas. (2019). The importance of dietary protein at breakfast in childhood. In In Nicklas, Theresa A., Nicklaus, Sophie and Henry, Christiani J. (Ed.). Nurturing a Healthy Generation of Children: Research Gaps and Opportunities : 91st Nestlé Nutrition Institute Workshop, Manila, March 2018 pp. 143 - 151 Karger. https://doi.org/10.1159/000493706
Chronotype : Implications for Epidemiologic Studies on Chrono-Nutrition and Cardiometabolic Health
Almoosawi, Suzana, Vingeliene, Snieguole, Gachon, Frédéric, Voortman, Trudy, Palla, Luigi, Johnston, Jonathan D., Van Dam, Rob, Darimont, Christian and Karagounis, Leonidas. (2019). Chronotype : Implications for Epidemiologic Studies on Chrono-Nutrition and Cardiometabolic Health. Advances in Nutrition. 10(1), pp. 30-42. https://doi.org/10.1093/advances/nmy070
Ingestion of a pre-bedtime protein containing beverage prevents overnight induced negative whole body protein balance in healthy middle-aged men : A randomized trial
Karagounis, Leonidas G., Beaumont, Maurice, Donato-Capel, Laurence, Godin, Jean-Philippe, Kapp, Anne-France, Draganidis, Dimitrios, Pinaud, Stéphane, Vuichoud, Jacques, Shevlyakova, Maya, Rade-Kukic, Koraljka and Breuillé, Denis. (2019). Ingestion of a pre-bedtime protein containing beverage prevents overnight induced negative whole body protein balance in healthy middle-aged men : A randomized trial. Frontiers in Nutrition. 6, p. Article 181. https://doi.org/10.3389/fnut.2019.00181
Longitudinal association of dietary protein intake in infancy and adiposity throughout childhood
Jen, Vincent, Braun, Kim V. E., Karagounis, Leonidas G., Nguyen, Anh N., Jaddoe, Vincent W. V., Schoufour, Josje D., Franco, Oscar H. and Voortman, Trudy. (2019). Longitudinal association of dietary protein intake in infancy and adiposity throughout childhood. Clinical Nutrition. 38(3), pp. 1296-1302. https://doi.org/10.1016/j.clnu.2018.05.013
Transcriptomic analyses reveal rhythmic and CLOCK-driven pathways in human skeletal muscle
Perrin, Laurent, Loizides-Mangold, Ursula, Chanon, Stéphanie, Gobet, Cédric, Hulo, Nicolas, Isenegger, Laura, Weger, Benjamin D., Migliavacca, Eugenia, Charpagne, Aline, Betts, James A., Walhin, Jean-Philippe, Templeman, Iain, Stokes, Keith A., Karagounis, Leonidas, Thompson, Dylan, Tsintzas, Kostas, Robert, Maud, Howald, Cedric, Riezman, Howard, ... Dibner, Charna. (2018). Transcriptomic analyses reveal rhythmic and CLOCK-driven pathways in human skeletal muscle. eLife. 7, pp. 1-30. https://doi.org/10.7554/eLife.34114
Intermittent fasting, energy balance and associated health outcomes in adults : Study protocol for a randomised controlled trial
Templeman, Iain, Thompson, Dylan, Gonzalez, Javier T., Walhin, Jean-Philippe, Reeves, Sue, Rogers, Phoebe, Brunstrom, Jeffrey M., Karagounis, Leonidas, Tsintzas, Kostas and Betts, James A.. (2018). Intermittent fasting, energy balance and associated health outcomes in adults : Study protocol for a randomised controlled trial. Trials. 19(1), pp. 1-11. https://doi.org/10.1186/s13063-018-2451-8
Post-game high protein intake may improve recovery of football-specific performance during a congested game fixture : Results from the PRO-FOOTBALL study
Poulios, Athanasios, Fatouros, Ioannis G., Mohr, Magni, Draganidis, Dimitrios, Deli, Chariklia K., Papanikolaou, Konstantinos, Sovatzidis, Apostolos, Nakopoulou, Theofano, Ermidis, Georgios, Tzatzakis, Theofanis, Laschou, Vasiliki C., Georgakouli, Kalliopi, Koulouris, Agisilaos, Tsimeas, Panagiotis, Chatzinikolaou, Athanasios, Karagounis, Leonidas G., Batsilas, Dimitrios, Krustrup, Peter and Jamurtas, Athanasios Z.. (2018). Post-game high protein intake may improve recovery of football-specific performance during a congested game fixture : Results from the PRO-FOOTBALL study. Nutrients. 10(4), p. Article 494. https://doi.org/10.3390/nu10040494
Dietary protein intake in school-age children and detailed measures of body composition : The Generation R Study
Jen, Vincent, Karagounis, Leonidas G., Jaddoe, Vincent W. V., Franco, Oscar H. and Voortman, Trudy. (2018). Dietary protein intake in school-age children and detailed measures of body composition : The Generation R Study. International Journal of Obesity. 42(10), pp. 1715-1723. https://doi.org/10.1038/s41366-018-0098-x
Disparate habitual physical activity and dietary intake profiles of elderly men with low and elevated systemic inflammation
Draganidis, Dimitrios, Jamurtas, A, Stampoulis, Theodoros, Laschou, Vasiliki C., Deli, Chariklia K., Georgakouli, Kalliopi, Papanikolaou, Konstantinos, Chatzinikolaou, A, Michalopoulou, Maria, Papadopoulos, Constantinos, Tsimeas, Panagiotis, Chondrogianni, Niki, Koutedakis, Yiannis, Karagounis, Leonidas and Fatouros, i. (2018). Disparate habitual physical activity and dietary intake profiles of elderly men with low and elevated systemic inflammation. Nutrients. 10(5), p. Article 566. https://doi.org/10.3390/nu10050566
Protein intake at breakfast promotes a positive whole-body protein balance in a dose-response manner in healthy children : A randomized trial
Karagounis, Leonidas G., Volterman, Kimberly A., Breuillé, Denis, Offord, Elizabeth A., Emady-Azar, Shahram and Moore, Daniel R.. (2018). Protein intake at breakfast promotes a positive whole-body protein balance in a dose-response manner in healthy children : A randomized trial. The Journal of Nutrition. 148(5), pp. 729-737. https://doi.org/10.1093/jn/nxy026
Timing and pattern of postexercise protein ingestion affects whole-body protein balance in healthy children : A randomized trial
Volterman, Kimberly A., Moore, Daniel R., Breithaupt, Peter, Grathwohl, Dominik, Offord, Elizabeth A., Karagounis, Leonidas G. and Timmons, Brian W.. (2017). Timing and pattern of postexercise protein ingestion affects whole-body protein balance in healthy children : A randomized trial. Applied Physiology, Nutrition and Metabolism. 42(11), pp. 1142-1148. https://doi.org/10.1139/apnm-2017-0185
Protein ingestion preserves proteasome activity during intense aseptic inflammation and facilitates skeletal muscle recovery in humans
Draganidis, Dimitrios, Chondrogianni, Niki, Chatzinikolaou, Athanasios, Terzis, Gerasimos, Karagounis, Leonidas G., Sovatzidis, Apostolos, Avloniti, Alexandra, Lefaki, Maria, Protopapa, Maria, Deli, Chariklia K., Papanikolaou, Konstantinos, Jamurtas, Athanasios Z. and Fatouros, Ioannis G.. (2017). Protein ingestion preserves proteasome activity during intense aseptic inflammation and facilitates skeletal muscle recovery in humans. British Journal of Nutrition. 118(3), pp. 189-200. https://doi.org/10.1017/S0007114517001829
Amino acid composition of breast milk from urban Chinese mothers
Garcia-Rodenas, Clara L., Affolter, Michael, Vinyes-Parès, Gerard, De Castro, Carlos A., Karagounis, Leonidas G., Zhang, Yumei, Wang, Peiyu and Thakkar, Sagar K.. (2016). Amino acid composition of breast milk from urban Chinese mothers. Nutrients. 8(10), p. Article 606. https://doi.org/10.3390/nu8100606
Inflammaging and skeletal muscle : Can protein intake make a difference?
Draganidis, Dimitrios, Karagounis, Leonidas G., Athanailidis, Ioannis, Chatzinikolaou, Athanasios, Jamurtas, Athanasios Z. and Fatouros, Ioannis G.. (2016). Inflammaging and skeletal muscle : Can protein intake make a difference? The Journal of Nutrition. 146(10), pp. 1940-1952. https://doi.org/10.3945/jn.116.230912