Mediterranean diet and coronary heart disease.

The traditional Mediterranean diet is the diet that prevailed in the olive tree-growing areas of the Mediterranean basin up to the early 1960s, before globalization invaded the local food culture. The seminal studies by Keys and his colleagues brought the concept of the Mediterranean diet into the mainstream of the science focusing on the relation between nutrition and health. The interest in the diet has resurged in recent years with further studies indicating lower incidence of coronary heart disease and reduced mortality in those adhering to this traditional dietary pattern. The traditional Mediterranean diet is the diet that prevailed in the olive treegrowing areas of the Mediterranean basin up to the early 1960s, before globalization invaded the local food culture. During the early post World War II years, the traditional Mediterranean diet attracted the attention of the scientific community, because the health of the Mediterraneans was better than that expected taking into account the modest regional economic development, the suboptimal local health care resources and the high prevalence of smoking in the respective population groups. The insightful, albeit ecological, studies by the legendary A. Keys and his colleagues brought the concept of the Mediterranean diet into the mainstream of the science focusing on the relation between nutrition and health (Keys, 1980). Following the Keys era, three developments, after the late 1980’s, contributed to the resurgence of the traditional Mediterranean diet as a nutritional pattern of major importance for health and wellbeing. A workshop in Delphi, Greece under the auspices of WHO Europe (Helsing and Trichopoulou, 1989), a conference in Boston, USA co-sponsored by the Harvard School of Public Health (Willett et al, 1995) and the publication in the same year of a scale allowing the semi-quantitative assessment of conformity to the traditional Mediterranean diet (Trichopoulou et al, 1995). The development of this scale, and variants of it, underlies the shift from ecological to more reliable analytical epidemiological studies (of casecontrol and particularly cohort design) and the exponential increase of publications in the international scientific literature of studies evaluating the relation of conformity to the traditional Mediterranean diet with health and disease. Several investigations have evaluated conformity to the traditional Mediterranean diet in relation to coronary heart disease (CHD) mortality and/or incidence (Mente et al, 2009). In an early study based on the Greek-EPIC (European Prospective InvestiEDITORIAL Professor of Cancer Prevention and Professor of Epidemiology Harvard School of Public Health, Boston, MA, USA HOSPITAL CHRONICLES 2012, 7(2): 68–69 Address correspondence to: Professor Dimitrios Trichopoulos, Harvard School of Public Health, Boston, MA, USA; e-mail: [email protected] Manuscript received March 3, 2012; Accepted after revision March 16, 2012