Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns

Background: Nowadays the food production, supply and consumption chain representa major cause of ecological pressure on the natural environment, and diet linksworldwide human health with environmental sustainability. Food policy, dietary guidelines and food security strategies need to evolve from the limited historical approach,mainly focused on nutrients and health, to a new one considering the environmental,socio-economic and cultural impact—and thus the sustainability—of diets. Objective: To present an updated version of the Mediterranean Diet Pyramid (MDP)to reflect multiple environmental concerns.Methods: We performed a revision and restructuring of theMDP to incorporatemore recent findings on the sustainability and environmental impact of the Mediterranean Diet pattern,as well as its associations with nutrition and health. For each level of the MDP we provided a third dimension featuring the corresponding environmental aspects related to it. Conclusions: The new environmental dimension of the MDP enhances food intake recommendations addressing both health and environmental issues Compared tothe previous 2011 version, it emphasizes more strongly a lower consumption of red meat and bovine dairy products, and a higherconsumption of legumes and locally grown eco-friendly plant foods as much as possible.