The majority of sources of dietary data clearly suggest that there remains considerable room for improvement in the Europeans' diet. As we enter a new millennium weighted with much information, priorities could be set to clarify the objectives of a prudent diet. Are they to prolong life as much as possible, or to maximise quality-adjusted life expectancy? We must also consider externalities that should take into account our cultural heritage, protection of the environment and macroeconomic considerations.
The factors influencing consumer choice are many and varied. It is thus naive to assume that in order to promote healthy eating it is sufficient to tell consumers what constitutes a healthy diet. An effective strategy to improve nutritional health must address a wide range of conceptions, misconceptions and perceptions, concerning diet and its effects on health and disease.
The Mediterranean diet has been identified as 'the most realistic alternative, open to people long-used to Western type of diet' (Trichopoulou and Lagiou, 1997a). Furthermore, four studies have been published, evaluating the role of the Mediterranean diet, as operationally defined through the following eight components:
• high monounsaturated-to-saturated lipid ratio (mainly olive oil),
• moderate ethanol consumption,
• high consumption of legumes,
• high consumption of cereals (including bread),
• high consumption of fruits,
• high consumption of vegetables,
• low consumption of meat and meat products,
• moderate consumption of milk and dairy products.
The first of these studies was conducted in Greece (Trichopoulou et al, 1995), the second in Denmark (Osler and Schroll, 1997), the third in Australia (Kouris-Blazos et al, 1999) and the fourth in Spain (Lasheras et al, 2000). All have shown that the Mediterranean diet has beneficial, substantial and statistically significant effects on longevity.
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