Symposium chair : Prof. Jacques Delarue

Event date : Tuesday 26th August 2025 from 8:00 to 9:30

Room : 341

Whose suggestion was it to lead this code of conduct and which stakeholders are involved in its development?

The Mediterranean diet is a widely accepted healthy diet supported by scientific evidence from epidemiology and clinical trials, including randomized control trials, and systematic reviews and meta-analyses. The Mediterranean diet is the most studied dietary pattern with proven health benefits, especially regarding the prevention of non-communicable diseases at a time when their incidence is increasing worldwide. Throughout the Mediterranean region, the adherence to the Mediterranean diet is decreasing especially among young people, with proliferation of ultraprocessed foods and negative accompanying effects on human health. The Mediterranean diet has also been recognized as a sustainable diet model with multiple interdependent benefits on health and nutrition, social and cultural, environmental and economic dimensions.

Despite all its well documented benefits, the Mediterranean diet is almost abandoned in most Mediterranean countries. Scientific evidence shows a tendency of Mediterranean populations to change their dietary patterns in favor of unhealthy dietary patterns, and mainly among the young generation. Some Southern and Eastern Mediterranean countries are still experiencing the “nutritional transition”, in which problems of under-nutrition coexist with overweight, obesity and diet-related chronic diseases. 

The traditional ways of consuming and producing food in the Mediterranean area have changed considerably, due to economic, social, cultural, demographic and technological trends, increasing globalization, urbanization, and shifting lifestyles with increased sedentary daily life. The erosion of the Mediterranean diet heritage is alarming, as it has undesirable impacts not only on health and nutrition, but also on social, cultural, economic and environmental sustainability dimensions in Mediterranean countries.

Faced with this challenge, within the continuation of previous consensus process started in 2016, a Joint Med Diet Task Force was formed in 2023 by the Task Force of Mediterranean Networking of FENS, the Sustainable Diets Task Force of IUNS and the CIHEAM Bari, to set the path for reversing its erosion by promoting its multiple benefits as a sustainable healthy lifestyle, a way of living as defined in 2010 by UNESCO in its inscription in the list of the Intangible Cultural Heritage of Humanity.  

This has sharpened the focus on setting a “voluntary code” for increasing its adherence among Mediterranean populations, as a sustainable healthy diet model, within the context of a sustainable food systems transformation in the region, with recommendations for different sectors (primary producers, food industry, health, environment, food service and consumers, etc.), using a rights-based approach, grounded in tradition, respectful of biodiversity and ecosystems, and consistent with Sustainable Development Goals, and addressed to all interested stakeholders and rights holders, linking food consumption and production, toward sustainable food systems transformation in the Mediterranean and beyond.

What does this code of conduct include?

The aim of the voluntary code of conduct is to serve as a resource on the Mediterranean diet for public and private policy makers, scientists and all other food system stakeholders, to improve the adherence and sustainability of the Mediterranean diet model.

This voluntary code of conduct incorporates the common principles of the Mediterranean diet, such as: 

• Variety and balanced food combination: Different food, with more fruits and vegetables of diverse colors;

• Seasonality: Fresh foods, minimally processed;

• Traditional, local food products, biodiversity, agro-eco-friendliness: Territorial linkages –sustainable rural development;

• Culinary activities: Preservation and transmission of food knowledge, skills, practices and heritage and pleasure of eating;

• Conviviality: Pleasure of eating together – dialogues between people and cultures;

• Frugality and moderation: Small portion sizes – major public health challenge of obesity – food has value, do not waste;

• Active living: Physical activity – non-sedentary lifestyle.

In this Voluntary code of conduct, the basic unit of nutrition, would not be individual nutrients, nor would it be food per se. It would have to be ‘diet’ and it would have to be addressed through an ecosystem approach to ensure nutrition and sustainability. It will address cross-cutting domains, related to the Mediterranean diet, as a sustainable healthy diet model, as well as, a Mediterranean life-style, such as: a) Nutrition and health, b) Sustainable diets, c) Sustainable food systems, d) Environment, e) Agriculture, f) Fisheries and aquacultures, g) Food industries, h) Retail distribution, i) Food services, catering, restaurants, j) Food environment and consumer science, k) Food Loss and waste, l) Economics, m) research, innovation, capacity building, n) Education and training, o) Media, p) Digital technologies and artificial intelligence, q) Implementation science.

Where can this model be applied ? Only in Mediterranean countries or further?

The Mediterranean diet as a sustainable diet model is context specific, with Med country variations. But, this voluntary code of conduct on the Mediterranean diet, as an expression of the interconnections between different physical and cultural systems, such as the Mediterranean context, can provide useful recommendations for more in-depth observations and analyses also for other territorial diets, in different agroecological zones with similarconstraints.

When do you think we will be able to assess the impacts of this code on dietary behaviour?

The proposed code of conduct aims to be pragmatic. The next step of its time framework for being able to assess impacts will be the continuation of a broader consensus process to bring these propositions to all the stakeholders and policy makers who have the power to help operationalize them within the proposed voluntary code of conduct. The dedicated symposium at the IUNS/ICN 2025 conference has the aim, by further debating it with the audience, to foster a broader consensus towards the code development as a collaborative effort.

How do you think we can balance respect for cultural food traditions with sustainable goals (environment)?

In the Mediterranean, there is spreading awareness of the social and cultural dimension of “food”, shared by all Mediterranean people in which “food” is an integral part of their identityand their history. The Mediterranean diet is an expression of their way of life expressed by their ancient food cultures and traditions. Therefore, it is a concept that goes far beyond just the food. It is rather a lifestyle based on tradition, sustainability and well-being. Thus, the consumption of local seasonal products, the preparation of dishes following traditional recipes and respect for the biodiversity and the environment are the pillars of such a varied diet, recognized as one of the healthiest in the world, that ensures the conservation of the territory and the development of traditional activities characteristic of each community. 

The Mediterranean diet has been defined by the UNESCO in its 2010 inscription to the list of the Intangible Cultural Heritage of Humanity, as “a set of skills, knowledge, practices and traditions ranging from the landscape to the table, including the crops, harvesting, fishing, conservation, processing, preparation and, particularly, consumption of food. However, the Mediterranean diet (from the Greek ‘diaita’, or way of life) encompasses more than just food”.

The Mediterranean diet, as a model of a sustainable diet, has been characterized by four interrelated sustainable benefits on nutrition and health, environment, local economy, society and culture, closed linked to the three intertwined pillars, environmental, economic and social,that include health and culture, through which the sustainability is defined and interconnected to sustainable goals.  Cultural identity and family traditions play key roles in the Mediterranean diet heritage by shaping food choices, guiding individuals toward healthier, more sustainable practices, mixed with the “modern” facets of social media, environmental consciousness, stigma and responsibility, coolness, perceived status, and satisfaction in the act of eating, especially in the company of family, friends and colleagues.  Taste and emotions aroused by “traditional” foods can be a compelling starting point for revitalizing the Mediterranean diet. Many lifestyle choices that resonate with aspects of individual responsibility, such as the protection of nature and the environment, fairness in work, animal welfare, etc., can find common ground on promoting the Mediterranean diet. 

In this case, promoting the adherence to the Mediterranean Diet model requires highly to consider the history of the Mediterranean. In many communities, introducing dietary changes without respecting existing cultural practices can encounter resistance and fail to achieve public health goals. Therefore, it is essential that the voluntary code development include the participation of local communities in its development.

Why did you choose a voluntary code instead of a more regulatory approach?

Within the United Nations system and its member states, regulatory approaches are notoriously difficult to usher through, particularly when they require involvement of multiple sectors and disciplines for coping with interdependent barriers facing the sustainable healthy diets transformation. However, for a voluntary code, as in this case for the Mediterranean diet, by considering that it is voluntary and non-mandatory, with a potential wide cross-cutting multistakeholder interest on it, the process may be simpler than a more regulatory approach such as food-based dietary guidelines or nutrition recommendations, very sectorial with alsolimitations of scientific research and methodological factors. The proliferation of ultra-processed foods, and the accompanying effects on human and planetary health, have sharpened the focus on the imperative for a “code” for a restoration of the Mediterranean diet, as a sustainable diet model for Mediterranean populations, in the context of the sustainable food systems transformation in the region. By incorporating the principles of the Mediterranean diet as a sustainable healthy life-style with multiple benefits a broaderconsensus process for the development of this voluntary code of conduct could facilitate, through various sectors and channels, its operationalization. The code development will require a transdisciplinary food system approach, linking sustainable food consumption and production and overcoming silos of specialization, and fragmented sectoral approaches.