Paralelamente ao estudo praticou desporto: hóquei em patins na equipa do Centro Universitário do Porto; ténis, no Ermesinde Ténis Club; montanhismo, no Club Nacional de Montanhismo. Integrou, também, o Orfeão Universitário do Porto, experimentou o jornalismo e, quando frequentava o terceiro ano do curso, passou a trabalhar como delegado de informação médica.

O seu apego à cultura levou-o a participar na fundação da Universidade Popular do Porto (UPP), uma associação cultural sem fins lucrativos e de utilidade pública, com Rui Luís Gomes, Óscar Lopes e Armando de Castro, instituição que abriu portas no dia 25 de Junho de 1979, nas comemorações do 30º aniversário da morte de Bento Jesus Caraça.

Esteve igualmente ligado à Fundação Maria isabel Guerra Junqueiro e Luís Pinto de Mesquita Carvalho, instituída após a morte da filha do poeta transmontano. Foi consultor da Enciclopédia Verbo, militante do PCP e vice-presidente da secção Regional da Ordem dos Médicos (1973-1975).

Para além de uma vida cheia, vale a pena ler a sua escrita, misto de ciência, humor e cultura que não deixava ninguém indiferente. Para quem considera a sopa portuguesa um dos nossos expoentes gastronómicos vale a pena ler o “O elogio da Sopa” publicado na Revista Alimentação Humana.

“…Para os estudiosos da nutrição a sopa é exemplo excelente para demonstrar que a soma aritmética dos teores nutricionais dos constituintes de um cozinhado, tomados um a um, de uma tabela de composição de alimentos, não traduz nem explica o valor nutritivo e alimentar deste cozinhado…”

“A nutritiva, biorreguladora, gastronómica e hedonista sopa é comida autêntica, alimentadora, apelativa e aprazível. satisfaz corpo alma.”

“A contrastar, fast-food é alimentação sumária, deglutição de crise, medicamento para matar a fome. Se não fosse a arquitectura, o colorido e a doçura, repugnaria”

Leitura boa, de Verão, que vale a penar sorver e salivar do princípio ao fim. Boas leituras!

Imagine that one day the European Union took the decision to allocate a simplified label to the books we buy. A green color for books to absolutely read. A yellow color for moderately interesting books and a red color for books with poor literary quality. The attribution of these colors would be based on criteria previously defined by a group of experts in literature and publicly disclosed. The use of this algorithm and the mention of this label and its color would not be mandatory, but publishers or authors would be able to use it if they intend to use it. The great advantage of using this nomenclature would be to facilitate the choice at the time of purchase, preventing many poor-quality books from being purchased (In fact, we buy many books due to the aesthetics of the cover, as well as considering a literary critic, whose “algorithm” we do not know, or by mentioning any prize whose criteria are also unknown). On average, our bookshelves would be filled with books of higher quality and books marked in red would tend to reduce their sales, not least because any self-respecting bookstores would not place them for sale. On the other hand, publishers and writers would be tempted to identify what makes a book worthy of showing a green color and would try to create works that followed the established algorithm, realigning their production according to the criteria previously advertised for the construction of the algorithm such as, for example, creativity/imagination/innovation or the coherence and cohesion of the text or even obedience to the characteristics of the genre in question. In this sense, new or old books should include these ingredients in the appropriate doses so that the book, submitted to an algorithmic test, could bear the mention of “absolutely reading” and have its green dot on the cover. In the long run, most of the books on sale would have a green mention or, quite simply, would have no symbol at all, as some authors or publishers would not adhere to this voluntary scheme to improve “literary quality”.

We now leave the fantasized world of literature (where reading a bad book does not, in principle, cause serious health problems) to the real world of “supermarket foods”, where up to 18,000 food products are stacked to be chosen and bought any weekend, in a short time that goes from one to two hours. Unhealthy diet or inadequate food choices every weekend are the main determinants of the years of healthy life lost by the Portuguese. In this very short time frame, the quality of life we want to have in the medium term is decided. The high intake of salt, sugar and saturated fat, the deficiency of dietary fiber or the absence of fruit, vegetables or pulses are examples of consumption that can “kill us early” or, on the opposite way, can give us more years of healthy life or greater resilience to disease.

And how do we choose? How do we make the decision to buy the most nutritionally appropriate foods? The reading of labels has been consistently pointed out by experts as a good way for consumers to inform themselves about the foods’ nutritional composition and to make more informed choices (we know, however, that other factors as price, convenience, flavor… must also be placed in this equation that determine food choices). Despite the importance of reading food labels, when analyzing the nutritional declaration, mandatory at European level and currently present in all packaged foods, we easily concluded that it is very difficult to read and understand by a common consumer who buys large quantities of food in a short time. In addition, it requires great mathematical literacy to convert, for example, quantities of salt per 100g of food to the weight of the portion you buy and to the individual daily limit of 5g. This calculation is almost impossible to achieve at the time of buying and, even more, it is a factor that contributes to health inequalities. In fact, the majority of the Portuguese population, who are older and have lower levels of education, have greater difficulties in understanding and using this information. In other words, the population that already has greater difficulty in accessing health care, which generally has a higher proportion of chronic diseases, who has to spend proportionally more on the disease control and on food, is also the one with the greatest difficulty in understanding information central to preventing the disease or its progression.

To overcome this challenge and create a front-of-pack nutrition labeling, which everyone can easily understand, regardless of their social condition, a nutritional algorithm has been proposed and is already being used in several countries such as France, Belgium and more recently Spain. This algorithm, when applied to packaged foods it allows to assign a color that ranges from green (food product considered to have better overall nutritional profile) to red (for food products considered to have a worse overall nutritional profile). Actually, it is a rectangular logo to be placed on the front of the packaging, divided into five colors (green, light green, yellow, orange and red), linked, in turn, to the letters A to E. This scale is intended to briefly describe the overall nutritional quality of food and, at the same time, encourage an easy and quick interpretation by consumers. Multinational companies such as Nestlé, Danone, Auschan, Leclerc, Intermarché, Bonduelle or McCain support this information model and are already labeling and advertising the food they produce with these symbols. According to those responsible, in the medium term, most of the food products sold by these companies will be reformulated and will show significant nutritional improvements. From cookies to breakfast cereals and even chocolate products. Many packaged foods may have a green color or close to it. A large part of the processed products sold by these multinationals will be easily reformulated – just remove or sparingly add 3 or 4 nutrients and they will bear a label that will not be red, certainly. Other companies or producers that do not want to join, not least because they can sell fresh products without the right to a label or others that have a reduced capacity for reformulation should not want to join this voluntary scheme to improve nutritional quality through these good practices of “food literacy”.

The process is ongoing and in the near future, supermarket shelves may increasingly have foods packaged with colorful labeling, making consumer choices easier on a daily basis, regardless of their social status. This will be one of the gains of this information model. Most likely, the availability of foods packaged with lower amounts of salt and sugar and more fiber and protein will increase. However, if there is no careful monitoring of these processes, the consumption of many food products that do not fit the nutritional profile model recommended by nutritionists may be encouraged, as we will see below:

1. The current nutritional labeling, which in recent years has been intensively studied in the Portuguese population, thanks to the efforts of the Directorate-General for Health and PNPAS, does not seem to fulfill the role of helping consumers to make the right decisions. Thus, the studies carried out suggest the need to adopt front-of-pack nutrition labelling such as those already adopted in Australia, Chile and other countries. The work carried out for the Portuguese population does not highlight any front-of-pack nutrition labelling scheme. All the models studied seem to have a good performance compared to the existing one (mandatory nutritional declaration).

2. In the case of Nutriscore, which we have analyzed in greater detail here, as it is the model suggested to be adopted in the European Union, the attribution of a position from A (green) to E (red) to a food depends on an algorithm, that is, of a mathematical calculation, where the presence or absence of certain nutrients has implications for the final color to be assigned. In this way, adding fiber and removing fat makes it possible to add value to a food, even if it contains considerable amounts of sugar. This is true, for example, of yogurts and breakfast cereals. The same can happen with salt or other nutrients. In this context, one of the questions to be considered is whether we currently have sufficient evidence to define complex nutritional profile models that allow us to classify the overall nutritional quality of foods, without incurring great risks. We have scientific evidence to support that a food product with 29g of sugar and 7g of fiber per 100g classified with the letter C (yellow) can be classified with the letter B (green) after being removed 4g of sugar and increased 1g of fiber, per 100g? This question certainly deserves reflection by professionals.

3. Another question that is closely related to the previous point is considered to the impact of this FOP nutrition labeling model on consumer perception, regardless of any food education campaigns that may be carried out. In other words, the process will improve the general quality of many packaged foods, but it can give a misleading indication, since a food classified with a green color will be perceived by consumers as a healthy food, encouraging its consumption. For example, for some food categories, the line that separates a C (yellow) product from a B (green) one, can be a very thin line in terms of the food nutritional quality, while the impact on consumer perception may surely be significant. In this regard, it would be interesting to carry out a “risk-benefit” analysis.

4. Unfortunately, these imperfections identified in the Nutriscore algorithm are more common in the categories of yogurts and breakfast cereals. Categories that are mostly aimed at children and that are often advertised using nutrition claims. Evidence has shown us that parents of young children are particularly susceptible to the nutrition-related claims on food labels or advertising, as they are often motivated to ensure a healthy diet for their children.

5. It will also be important to analyze the reasons that have led big food companies to adopt this model, after some initial resistance. Certainly, for the corporate social responsibility, changing the nutritional composition to improve many foods, which is great. On the other hand, the process will allow, with minor changes in the composition of 3 or 4 ingredients, to rewrite the nutritional history of foods and the public perception of it, transforming products previously perceived as bad nutritional choices into good nutritional quality foods. This is a subject that should deserve the attention of Nutritionists. We will be able to find on supermarket shelves minimally processed cereals such as oat flakes with the same simplified nutritional classification of highly industrially processed cereals due to the intense manipulation of their ingredients and certainly with a nutritional profile that is not the same (with about 24x more sugar for example). That is, chocolate-flavored cereals with the same classification as oat flakes. This creates a great opportunity for the marketing strategies of these companies. The experience of Australia and New Zealand, which have already implemented FOP nutrition labeling models that have some similarities to Nutriscore, has shown just that. These models have frequently inadvertently contradicting dietary recommendations and can promote the marketing of these foods that may not fit a healthy eating pattern. And with that, there will be another great challenge for those who are trying to increase nutrition education and for educators in general and that should deserve attention.

6. An analysis carried out by us on December 17, 2020, in a sample of 91 food products available on the Portuguese market already labeled with Nutriscore, shows that 57% are classified with letter A or B (“green”). If we look specifically at the two most critical food categories, where we consider Nutriscore to perform less efficiently, this percentage rises to 80% and 87% for yogurts and breakfast cereals, respectively. For breakfast cereals, food products labeled A or B have an average sugar content of 17.3g (min = 9g and max = 27g). And for yogurts, products labeled with A and B have an average sugar content of 7.1g (min = 0.7g and max = 13g).

7. These reflections become even more relevant if we consider that, in parallel to the discussion on the adoption of Nutriscore within the EU, the possibility of establishing a common nutritional profile model for the regulation of food advertising to children is also discussed. The nutrition profile model based on the Nutriscore algorithm could expose many food products, whose advertising is currently banned according to the World Health Organization’s nutrient profile criteria.

FOP nutrition labeling is a public health measure that can represent very important gains for the literacy and populations’ health, and we have always favored its implementation in Portugal (including the Nutriscore option). However, these tools need improvements in the algorithm and constant reflection by nutritionists, so that we can guarantee, one of the basic principles of the implementation of any public health measure – “first do no harm”. Our value as professionals also depends on the ability to contribute to an in-depth discussion based on quality scientific evidence, on these and other topics.

Authors – Pedro Graça and Maria João Gregório

P.S. The authors declare that they have no conflict of interest in this matter. Maria João Gregório is Director of the National Program for the Promotion of Healthy Eating (PNPAS) of the Directorate-General for Health and Pedro Graça is an independent consultant for PNPAS.

Το πολιτιστικό υπόδειγμα της Μεσογειακής Διατροφής (MΔ), το οποίο παρατηρείτε σε δημοφιλείς εορτασμούς τροφίμων, αναγνωρίστηκε από την UNESCO ως Άυλη Πολιτιστική Κληρονομιά της Ανθρωπότητας. Ως εκ τούτου, αναγνωρίζεται ως πολιτιστική κληρονομιά που πρέπει να προστατεύεται και να διατηρείται, δεδομένης της ευθραυστότητάς της και της συνεχιζόμενης διάβρωσής της στις σημερινές μεσογειακές κοινωνίες.

Η διατήρηση της MΔ απαιτεί ενεργή διακρατική και πολυτομεακή στήριξη και συμμετοχή των κυβερνήσεων, των τομέων του πολιτισμού, της γεωργίας και της υγείας, αλλά και των πολιτών, ώστε να διασφαλιστεί η διατήρηση του πολιτιστικού πλούτου και της βιοποικιλότητας, η προστασία της ευφορίας και της ικανότητας αναγέννησης των εδαφών, καθώς και η υγεία και ευημερία των ανθρώπων και των κοινοτήτων. Εκτός από αυτήν την ομοφωνία, θα πρέπει να είμαστε φιλόδοξοι και να επισημανουμε τους τομείς εκείνους στους οποίους μπορούμε να παρέμβουμε και να κάνουμε τη διαφορά. Παρακάτω η συμβολή μας σε μια κρίσιμη συζήτηση:

1) Ο όρος «δίαιτα» προέρχεται από τα αρχαία ελληνικά και σημαίνει «τρόπος ζωής». Στη Μεσόγειο, που απετέλεσε ένα σημαντικό δίαυλο επικοινωνίας και εμπορίου στην ιστορία της ανθρωπότητας, αυτός ο τρόπος ζωής εξελίσσεται, αναπτύσσεται και διαμορφώνεται συνεχώς τα τελευταία 8000 χρόνια. Τα κύρια χαρακτηριστικά της MΔ είναι, επομένως, η ικανότητα προσαρμογής στο κλίμα, στα νέα φυτά, στις νέες γνώσεις και στις διαπολιτισμικές επιρροές, καθώς και η ποικιλομορφία της. Επομένως, διατήρηση της MΔ σημαίνει και διατήρηση της βιολογικής και πολιτισμικής ποικιλομορφίας.

2) Ως συνέπεια των μικροκλιμάτων, των πολιτιστικών, θρησκευτικών και υγειονομικών συνθηκών, υπάρχουν τοπικές παραλλαγές της ΜΔ. Σε όλες αυτές τις πτυχές, συνυπάρχει μια λεπτή και εμπεριστατωμένη μαγειρική γνώση, που αναγνωρίζει τη σημασία των γευμάτων, εκείνων που μαγειρεύουν και τη συντροφικότητα των ανθρώπων όταν μαζεύονται γύρω από το τραπέζι για να μοιραστούν ένα γεύμα. Επομένως, ο χρόνος που παίρνετε για να καθίσετε γύρω από ένα τραπέζι δεν είναι χαμένος χρόνος. Για τη διατήρηση της MΔ είναι σημαντικό να διατίθεται χρόνος ώστε όλα τα μέλη της οικογένειας να συμβάλουν στην παραγωγή, αγορά και μαγειρική των τροφίμων, και να τρώνε μαζί.

3) Η MΔ έχει μια ουσιαστική σχέση με τους αστρικούς και αγροτικούς κύκλους. Η MΔ προσαρμόζεται στο κλίμα. Είναι θεμελιωδώς εποχιακή, αλλάζοντας με τις εποχές ώστε να προσφέρει φρέσκα τοπικά προϊόντα. Η διατήρηση της MΔ περιλαμβάνει τη διατήρηση της ικανότητας παραγωγής τροφής κοντά στα σπίτια μας και της δίκαιης αγοράς από τους γείτονές μας που θα μπορούσαν να την παράγουν. Η διατήρηση της MΔ προστατεύει εκείνους που παράγουν τοπικά και ενισχύει τις τοπικές και περιφερειακές οικονομίες.

4) Η MΔ αναγνωρίζεται ως υγιής, λόγω των συστατικών που συνδυάζει (δηλ. ελαιόλαδο, δημητριακά, όσπρια, φρούτα …) και της παρασκευής τους, αλλά ουσιαστικά για τη λιτότητά της. Αυτό σημαίνει κατανάλωση σύμφωνα με τις ενεργειακές ανάγκες ενός ατόμου και με έμφαση στην ποιότητα και όχι στην ποσότητα. Αυτό μπορεί να βοηθήσει στην πρόληψη της ανάπτυξης μη μεταδοτικών ασθενειών, όπως η παχυσαρκία ή ο διαβήτης. Διατήρηση της MΔ σημαίνει να εκτιμάς τη ποιότητα των διατροφικών προϊόντων αντί της υπερβολικής κατανάλωσης.

5) Η MΔ περιλαμβάνει μικρές μερίδες κρέατος και ψαριών, αλλά ουσιαστικά βασίζεται στα λαχανικά. Η MΔ στην Πορτογαλία χαρακτηρίζεται από την υψηλότερη κατανάλωση ψαριών, ζωμών και μαγειρευτών πιάτων. Η διατήρηση της MΔ σημαίνει να αναγνωρίζεται η σημασία αυτών των γεύσεων και να ενσωματώνεται η γνώση αυτή σε μικρή ηλικία, όπως στη πρωτοβάθμια εκπαίδευση, όπου ο μεσογειακός τρόπος διατροφής και μαγειρέματος μπορεί να αποτελέσει μέρος της καθημερινής ζωής και των μαθησιακών στόχων.

6) Ιστορικά, η ΜΔ έχει εκθρέψει την εκτεταμένη οικογένεια και τις κοινότητες, τόσο στα χωριά όσο και στις πυκνοκατοικημένες πόλεις, και αναγνωριζόταν και εφαρμοζόταν από όλες τις κοινωνικές ομάδες. Η ΜΔ δεν είναι μια “γκουρμέ”, ακριβή διατροφή που μπορεί να υιοθετηθεί μόνο από λίγους προνομιούχους. Η διαφύλαξη της ΜΔ περιλαμβάνει την εξασφάλιση πρόσβασης σε όλους, ανεξάρτητα από την οικονομική τους κατάσταση.

7) Η ΜΔ περιλάμβανε το καλαμπόκι, τις πατάτες και τις τομάτες τον 16ο και τον 17ο αιώνα, καθώς και την ψυχρή συντήρηση του 20ού αιώνα, γεγονός που επέτρεψε τη μείωση του αλατιού. Στον 20ο και τον 21ο αιώνα, χαιρετίζει την μεγαλύτερη συμμετοχή των ανδρών στην αγορά και την προετοιμασία των τροφίμων, ρόλο που παραδοσιακά κατείχαν οι γυναίκες στις μεσογειακές κοινωνίες. Διαφύλαξη της MΔ είναι να αναγνωρίζεις τη σημασία των γυναικών ως φύλακες της υγιεινής διατροφής της οικογένειας, της κληρονομιάς και της μετάδοσης γνώσεων και μαγειρικών μυστικών από το παρελθόν, αλλά και τη συμμετοχή των ανδρών στις οικιακές εργασίες, όπως είναι η προετοιμασία του φαγητού.

8) Η MΔ έχει τεράστιο αντίκτυπο στην υγεία των ανθρώπων και το χαρακτηριστικό αυτό εξακολουθεί να αποτιμάται σήμερα από την κοινωνία. Επιπλέον, οι διαθέσιμες επιστημονικές πληροφορίες, οι οποίες συνδέουν την ΜΔ με τα οφέλη για την υγεία, ενισχύουν τη δημιουργία συνεκτικών κατευθυντήριων γραμμών που διευκολύνουν την παρέμβαση και την αξιολόγηση των επιπτώσεών της. Η διατήρηση της MΔ απαιτεί τη συμμετοχή και την ενδυνάμωση του τομέα της υγείας, της κοινωνίας και των πολιτών της σε αυτό το πλαίσιο.

9) Οι κλιματικές αλλαγές, δηλαδή η αύξηση της θερμοκρασίας, η μείωση των βροχοπτώσεων, η δημογραφία και η ερημοποίηση, θα θέσουν την πρόσβαση στο νερό, την παραγωγή τροφίμων και τις ανθρώπινες σχέσεις υπό έντονη πίεση. Η MΔ αναγνωρίζεται ως τρόπος οικολογικής κατανάλωσης. Μέσω μιας πιο οικολογικής κατανάλωσης τροφίμων μπορούμε να κάνουμε τη διαφορά στον πλανήτη. Η διατήρηση της ΜΔ ενσωματώνει έναν τρόπο διατήρησης του πλανήτη, όπου ο περιβαλλοντικός τομέας θα έχει καθοριστικό ρόλο.

10) Η MΔ προέρχεται από τη σταθερή αλληλεπίδραση μεταξύ ανθρώπου και φύσης, έχει διαμορφώσει κοινωνικά και πολιτιστικά όλες τις μεσογειακές κοινωνίες (π.χ. Νότια Ευρώπη, Βόρειο Αφρική και Μέση Ανατολή), ενώ επίσης επηρέασε και άλλες παγκόσμιες περιοχές. Η διατήρηση της ΜΔ είναι η διατήρηση της κοινωνικής και διατροφικής καλλιέργειας μέσα και από τις μεσογειακές κοινωνίες, όπου ο πολιτιστικός τομέας διαδραματίζει κεντρικό ρόλο.

Note: Translated from English version by Konstantinos Mine, student of Biology
Σημείωση: Μετάφραση από την Αγγλική από τον Κωνσταντίνο Μινέ, φοιτητή Βιολογίας.

The cultural model of the Mediterranean Diet (MD), noticeable in popular food celebrations and festivities, was recognized by UNESCO as an Intangible Cultural Heritage of Humanity. As such, it is recognized as a cultural patrimony that should be cherished and protected, given its fragility, and continued erosion in today’s Mediterranean societies.

The preservation of the MD requires active transnational and multi-sectoral support and participation, by governments, the cultural, agricultural and health sectors, and citizens, to ensure the preservation of cultural wealth and biodiversity, the protection of the fertility and regenerative capacity of the soils, as well as the health and well-being of people and communities. In addition to this unanimity, we need to be ambitious and recognize the sectors and areas where we can intervene and make a difference. This is our contribution to a crucial discussion:

1) Diet means a way of living, originating from the term “daiata” used by the Ancient Greeks. In the Mediterranean, an influential channel of communication and trade in the history of mankind, this lifestyle has been continuously evolving, expanding and shaping over the last 8000 years. The main features of the MD are, therefore, the ability to adapt and its diversity; the ability to adapt to the climate, new plants, new knowledge and cross-cultural influences. Therefore, to preserve the MD is to preserve biological and cultural diversity.

2) As a consequence of microclimates, cultural, religious and health conditions, there are regional variations of the MD. Within all of these aspects, coexists a delicate and thorough culinary knowledge, recognizing the importance of meals, of those who cook and the conviviality when sitting around the table to share a meal. Taking the time to sit around the table is therefore not time wasted. The preservation of the MD is the preservation of the families’ time to produce, to buy, to cook and to eat together.

3) The MD has a meaningful relationship with astral and agrarian cycles. The MD adapts to the climate. It is fundamentally seasonal, changing with the seasons to provide fresh local products. The preservation of the MD includes the preservation of the ability to produce food near our homes and to buy fairly from our neighbors who might produce it. To preserve MD is to protect those who produce locally and to strengthen the local and regional economies.

4) The MD is recognized as being healthy, due to the ingredients it combines (i.e. olive oil, cereals, pulses, fruit…) and their preparation, but essentially for its frugality. Frugality means eating according to one’s energy needs, and with an emphasis on quality rather than quantity. This can assist to prevent the development of non-communicable diseases, such as obesity or diabetes. To preserve MD means to value quality food products rather than its excessive consumption.

5) The MD includes small portions of meat and fish, but it is essentially vegetable-based. The MD in Portugal is characterized by the highest amount of fish, soups and pot cooked dishes. The preservation of MD means recognizing the importance of these flavors and incorporating this knowledge into early-life and learning settings, such as in school, where the Mediterranean way of eating and cooking can form part of everyday life and ones learning objectives.

6) The MD, historically, has nurtured the extended family and the communities, both in villages and in dense cities, being recognized and practiced by all social groups. The MD is not a gourmet, expensive diet, attainable only by a privileged few. The preservation of the MD includes ensuring that everyone has access to it, regardless of their economic status.

7) The MD, being adaptive encompassed corn, potatoes and tomatoes in the 16th and 17th centuries, as well as cold preservation in the 20th century, which allowed for the reduction of salt. In the 20th – 21st century, it is welcoming a greater involvement of men in the purchase and preparation of food, which has traditional been the role of women in Mediterranean societies. To preserve MD is to recognize the work of women as guardians of the family’s healthy diet, the heritage and transmission of knowledge and culinary secrets from the past, but also the participation of men in sharing domestic tasks, for example around food preparation.

8) The MD has an enormous impact on people’s health and this feature is still highly valued by society today. In addition, the scientific information now available, that links the MD with health benefits, reinforces the creation of coherent guidelines that facilitate the intervention and assessment of its impact. The preservation of MD requires the involvement and empowerment of the health sector, society and its citizens in this regard.

9) The climate changes, namely the rising temperatures, the reduction of precipitation, the demography and the desertification, will put the access to water, the food production and human relationships under severe pressure. The MD is recognized as a mode of ecological consumption. Through a more environmentally conscious food consumption we can make a difference to the planet. The preservation of MD incorporates a way of preserving the planet where the environmental sector will have a key role.

10) The MD results from the steady interaction between man and nature, it has socially and culturally shaped all Mediterranean societies (e.g. Southern Europe, North Africa and the Middle East), as well as influenced other global regions. The preservation of the MD is the preservation of social and dietary culture in and from Mediterranean societies, where the cultural sector plays a central role in.

Note: Translated from Portuguese version by
Luis Guedes, MD, MSc European Public Health, Public Health Medical Resident
Lucinda Cash-Gibson, BScHons, MSc, MRes, PhD Candidate, Universitat Pompeu Fabra, Spain.