* Department of Experimental Medicine, RU of Food Science and Human Nutrition, Sapienza University of Rome, Italy ** aut—aut-architettura urbe territorio; Rome, Italy Ann Ig 2016; 28: 179-186 doi:10.7416/ai.2016.2096 The New Modern Mediterranean Diet Italian Pyramid V. Vitiello B.Sc*, A. Germani* B.Sc, E. Capuzzo Dolcetta** B.Arch, L.M. Donini* MD, V. del Balzo* B.Sc Key words: Pyramid, Mediterranean Diet, sustainability, tradition, adherence Parole chiave: Piramide, Dieta Mediterranea, Sostenibilità, tradizione, aderenza Abstract Background. Epidemiological studies have established the health benefits associated with the adherence to the MD (Mediterranean Diet), mainly in relation to reducing the risk of developing the non communicable diseases. The MD is a sustainable diet model that respects the environment, promotes the bio-diversity, the local cultural heritages, the social interaction and economic aspects. Methods. The pyramid is a graphical representation designed to represent the frequencies of consumption and portion sizes of each food according to the Mediterranean model and tradition. The pyramid was deve- loped taking into account the LARN (Reference Intake of nutrients and energy for Italian Population) and the Italian Guidelines for a healthy diet. Results. The frequency of consumption and the portion size recommended are located at the different level of the pyramid. At the base of the pyramid there are the foods that should be consumed every meal and some concepts typical of the Mediterranean culture. In the middle there are foods that should be consumed daily and at the top of the pyramid the foods consumed on a weekly basis. Conclusions. The new modern MD Italian Pyramid is an important tool to promote the MD and improve the adherence to the MD dietary pattern Introduction Since the first studies in 1970s (Seven Countries Studies), the Mediterranean Diet (MD) has been recognized as a dietary pattern associated with decreased all-cause mortality and reduction in the cardiovascular risk factors level. (1). Further recent epidemiological studies have established the health benefits associated with the adherence to the MD, mainly in relation to reducing the risk of developing non communicable diseases such as type 2 diabetes, cardiovascular diseases, some neurodegenerative diseases and cancers (2-5). The MD includes the following dietary factors: a high intake of plant foods comprising mainly fruit and vegetables, cereals and whole grain breads, pulses, nuts and seeds; olive oil as a main source of fat; a moderate amounts of cheese and yogurt; low quantities of red meat and a moderate quantities of fish; a moderate amount of red wine accompanying main meals. The MD is characterized by a high intake b-carotene, group B, C and E vitamins, folic acid, polyphenols and other phytochemicals (6, 7).