Population level divergence from the Mediterranean diet and the risk of cancer and metabolic disease

The Mediterranean diet (MeD) is recognized as a traditional dietary pattern with strong health associations. It has long been studied by nutritionists who have associated adherence to the MeD with reduced risk of chronic non-communicable diseases, not least cardiovascular and related diseases and cancer. Although possessing unique features and associated with broader lifestyle factors which may also impact on health, many of the foods thought to mediate these health effects, or at least their molecular constituents are shared with other traditional diets. Indeed, it is interesting to note, that wherever populations have moved away from these traditional diets and taken on the high-fat, high-animal-protein, high-refined-carbohydrate and sugar Western-style diet, increased incidence of obesity, type 2 diabetes, autoimmune diseases, cancer and dementia follow. Of these traditional diets, the MeD is probably the dietary pattern with the strongest evidence from scientific research for its health promoting ability. The level of divergence from the MeD has been associated with increased risk of cardio-metabolic disease and cancer through different pathophysiological mechanisms. Recent interest has arisen regarding the effects of food group consumption included in the Mediterranean pattern on human gut microbiota. With this chapter, we made an attempt to present MeD from an historical perspective because of its recognition by UNESCO, to define scientifically this way of eating and living, to describe recent research evidence associated to the level of divergence and to conclude whether the impact of MeD food on human gut microbiota could provide a biological model of health prevention