The innovative Mediterranean Pyramid

Luis Serra Majem has made a loto of studies on the innovative Mediterranean Pyramid and “Spain is leading the research on the Mediterranean diet and olive oil in the world”
Last July international scientists gathered at the Palazzo Lombardia in Milan as part of the first world conference on the Mediterranean Diet, where they defined the future of this healthy and sustainable food model.
In this meeting, organized by the International Foundation of the Mediterranean Diet (IFMeD, for its acronym in English), the new pyramid of the Mediterranean diet, whose innovative approach is to connect health with socio-cultural dimensions, has been presented as a proposal for economic and environmental sustainability. The physician, professor and researcher Lluis Serra Majem, president of this entity, reveals the main innovations of the pyramid and the role it plays as olive oil. Here’s an excerpt of the interview in MERCACEI Magazine 89.

What are the main novelties of the innovative Mediterranean Pyramid?

The new pyramid aims to highlight the benefits for public health in the Mediterranean diet that, in addition to being one of the more healthy eating habits throughout the world, is also highly sustainable, unlike other with the ambient atmosphere. The Pyramid of the food should preferably be produced locally, because they retain their nutritional, organoleptic and culinary properties, reduce the environmental impact on transport and reactivate the local economy. Fruits and vegetables grown on land close to the consumer respect the seasonality and require less management processes for storage and all this allows us to better maintain their properties, both nutritional and organoleptic. The same applies to fishery products or livestock.
Also noteworthy is the importance of legumes as a source of vegetable protein and good quality fats. It recommends a daily intake of pasta, rice, potatoes or bread; although this does not mean that should be consumed daily.

What role does the olive oil in this pyramid?

Olive oil has been, is and will be the key feature of the Mediterranean diet. All Mediterranean countries use it as their main dietary fat. The novelty in the consumption of olive oil comes from several studies that confirm that their regular consumption is associated with better physical and mental health. The greatest benefits are obtained from extra virgin olive oil, real nutritional liquid gold.

Le principali innovazioni della piramide

What advice for its consumption?

The olive oil should be the main dietary fat, both for cooking and salad dressings. All meals should include olive oil, the oil must be extra virgin, and for cooking and frying can be refined. This is due to the polyphenols content in raw extra virgin olive oil that maintains all of its properties and that, however, when heated loses them, at least partially.
We should not limit the consumption of olive oil, because many years ago I demonstrated that when we limit the consumption of salads, vegetables and fish increase other unhealthy fats. Reduce the consumption of virgin olive oil does not bring any benefit, even if there should logically be a balance between calories consumed and expended through exercise, which is an important fact as the food.
This is one of the foods that gives identity to the Mediterranean diet …
No doubt. Of course, the olive tree is characteristic of the Mediterranean area, is part of the landscape. Spain has more than 300 million olive trees spread across 34 provinces and is the largest producer and exporter of olive oil in the world, with over 45% of its production. The Mediterranean countries are the main consumers of olive oil, in particular Greece, Spain and Italy, but since many countries are increasing consumption of our oil (USA, Australia, China …) although at the moment they use only the highest socio-cultural levels.

What is its composition and effects on health?

98% of the olive oil composition is fat. The remaining 2% of the nutritional components of olive oil are polyphenols which have anti-inflammatory and antioxidants features . Among the most characteristic polyphenols are the derivatives of cinnamic acid as caffeic acid; the secoiridoide glycated: oleuropein; and derived from hydrolysis, phenols: tyrosol and hydroxytyrosol.
The type of fat found in oil is what gives some of its beneficial properties.
Between 70 and 80% of this fat is oleic acid, a type of fat healthy for the heart. The regular consumption of olive oil acts on the prevention of these diseases, reducing the risk of hypertension, diabetes, cholesterol levels and obesity. It also reduces the complications of cardiovascular disease. It was also shown that olive oil has beneficial effects on the health of digestion, has a protective effect against some types of cancer, and reduces the risk of dementia and Alzheimer. And some studies also show a protection against osteoporosis. The advantages are always higher with the extra virgin olive oil, refined olive oil.

How do you think that has evolved for the extra virgin olive oil consumption in recent years?

In recent years there has been an increase in the extra virgin olive oil consumption, according to the expenditure data for the purchase that gathers every year the Ministry of Agriculture, Food and Environment. There has been a slow but steady increase over recent years, and this is because the surveys have been published and disseminated in recent decades.
In evidence, for example, PREDIMED … Undoubtedly, studies like PREDIMED help spread the benefits of olive oil, not only among the general population, but also among health care.
His role in promoting the Mediterranean diet is essential and the population gives much value to the advice they receive from their doctors, nurses and when they are a team of dietitians nutritionists.
The PREDIMED and now the PREDIMED Ciber plus Study of Obesity and Nutrition Institute of Health Carlos III are an example of the collaborative research quality and today Spain is leading the research on the Mediterranean diet and olive oil in the world.


The PREDIMED (PREvención con DIeta MEDiterránea) multicenter, randomized, primary prevention trial assessed the long-term effects of the Mediterranean diet (MeDiet) on clinical events of cardiovascular disease (CVD). We randomized 7447 men and women at high CVD risk into three diets: MeDiet supplemented with extra-virgin olive oil (EVOO), MeDiet supplemented with nuts, and control diet (advice on a low-fat diet). No energy restriction and no special intervention on physical activity were applied. We observed 288 CVD events (a composite of myocardial infarction, stroke or CVD death) during a median time of 4.8years; hazard ratios were 0.70 (95% CI, 0.53-0.91) for the MeDiet+EVOO and 0.70 (CI, 0.53-0.94) for the MeDiet+nuts compared to the control group. Respective hazard ratios for incident diabetes (273 cases) among 3541 non-diabetic participants were 0.60 (0.43-0.85) and 0.82 (0.61-1.10) for MeDiet+EVOO and MeDiet+nuts, respectively versus control. Significant improvements in classical and emerging CVD risk factors also supported a favorable effect of both MeDiets on blood pressure, insulin sensitivity, lipid profiles, lipoprotein particles, inflammation, oxidative stress, and carotid atherosclerosis. In nutrigenomic studies beneficial effects of the intervention with MedDiets showed interactions with several genetic variants (TCF7L2, APOA2, MLXIPL, LPL, FTO, M4CR, COX-2, GCKR and SERPINE1) with respect to intermediate and final phenotypes. Thus, the PREDIMED trial provided strong evidence that a vegetable-based MeDiet rich in unsaturated fat and polyphenols can be a sustainable and ideal model for CVD prevention.



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