The mediterranean diet in a world context.

Objective: To put the debate on the Mediterranean diet in context by highlighting historical and prospective changes in the level and composition of food consumption in the world and key Mediterranean countries.

Design: Data from FAO's food balance sheets are used to illustrate historical evolution. Projections to 2030 are presented from FAO's recent and ongoing work on exploring world food and agriculture futures.Setting: International.

Results and conclusions: Many developing countries are undergoing diet transitions bringing them closer to the diets prevalent in the richer countries, i.e. with more energy-dense foods. There follows an increase in the incidence of diet-related non-communicable diseases, which are superimposed on the health problems related to undernutrition that still afflict them. In parallel, many low-income countries are making little progress towards raising food consumption levels necessary for good nutrition and food security. Wider adoption of food consumption patterns akin to those of the Mediterranean diet hold promise of contributing to mitigate adverse effects of such diet transitions. However, the evolution of food consumption in the Mediterranean countries themselves is not encouraging, as these countries have also followed the trend towards higher shares of energy-dense foods. Possible policy responses to these problems include measures to raise awareness of the benefits of healthier diets and/or to change relative food prices in favour of such diets (by taxing fattening foods) or, at the extreme, making individuals who follow 'bad' diets, and thus are prone to associated diseases, bear a higher part of the consequent costs borne by the public health systems (tax fat people).