This supplement contains selected contributions to the Scientific Programme of the VI International Congress of the Mediterranean Diet, held in Barcelona, Spain on 8–9, March 2006. In 2006, we celebrated the tenth anniversary of the Foundation of the Mediterranean Diet, a celebration that was dedicated to Ancel Keys, who passed away in 2004 at the age of 100 and whose life was dedicated to physiology and public health nutrition research and especially to the Mediterranean diet.
In 1995, a group of companies from the agro-food sector located in the Barcelona area identified the need to alert the general public of the risks that resulted from abandoning healthy eating patterns, especially in children. Therefore, they decided to create the Association for the Advancement of the Mediterranean Diet, with the aim of promoting traditional products of the Mediterranean basin. To endorse the scientific knowledge that verifies the virtues of this eating pattern, they, along with The Barcelona City Hall, the Government of Catalonia and other institutions, created the Mediterranean Diet Foundation (FDM) in 1996. Recently, the foundation has expanded with the inclusion of the Spanish Ministry of Agriculture and as such, a Spanish Minister and a Catalan Minister of Agriculture now take part in the periodic meetings of the Foundation's Board of Directors.
The FDM is an independent non-profit organisation whose mission is to promote investigation of the health, historical, cultural and gastronomical aspects of the Mediterranean diet. Furthermore, another objective is the dissemination of scientific findings and the promotion of health benefits of the Mediterranean diet among different population groups. Children and adolescents are of particular interest because they constitute a segment of the population that is most rapidly abandoning healthy eating habits. The FDM is honoured with the ability to count on the support of an International Scientific Committee that consists of 23 recognised international investigators. Thus, the FDM provides scientific support and advice not only for the stakeholders but also for the general population.
Since its creation, the FDM has been involved in a wide variety of activities to meet its established goals, such as the organisation of International Conferences, creation and granting of the Grande Covián Award and Honorary Diplomas, establishing the Mediterranean Diet Surveillance System—Observatory, correspondence courses, numerous conferences and workshops (for adults and schoolchildren) and the launching of an internet site (www.dietamediterranea.com) dedicated to this dietary pattern and lifestyle. The FDM has also been active in various forms of media, as well as in renowned scientific journals and health promotion campaigns, and has published numerous books as well as educational materials in Spain and in other countries.
Ancel Keys (1904–2004) is one of the individuals who has contributed much to the development of nutrition and public health in general, and to the Mediterranean diet in particular. And the multiple awards he has received (in which, unfortunately, the Nobel Prize is not included) do not do service to his eminent achievements and scientific contributions. All of us working in the area of the Mediterranean diet know his major studies and accomplishments. I cite them every year when teaching or giving conferences in which I describe the benefits of the Mediterranean diet or when presenting on how the advancement of research influences the advancement of knowledge. The action of different types of dietary fat on serum cholesterol brought Profs Keys and Grande-Covian to the conclusion that seed oils had hypercholesterolaemic effects not observed with olive oil. Several years had to pass before it was discovered that distinct lipoproteins transported cholesterol, and the same investigators, repeating the experiments in human subjects, described the beneficial effect of olive oil on HDL-cholesterol that seed oils did not possess. They were marking the physiology of modern nutrition, the history of the Mediterranean diet.
It had to be a really unique person who, at the beginning of the 1950s, launched a multicentre study, the Seven Countries Study, with a budget of more than 200 000 $ per year. And already by the beginning of the 1960s, Keys denounced the excess of calories and fat found in the average American diet. He called obesity malnutrition, an immoral disease in contrast to the problems with the undernutrition seen in developing countries.
But today we know that obesity and undernutrition can be found together within the context of poverty and lack of development. Keys' studies on the energy intake, energy expenditure and the basal metabolic rate were pioneers at that time. As Henry Blackburn recalls, (1), this shed the light on the fact that the most common diseases were the result of a population's lifestyle and behaviour, and that as physicians and nutritionists, we had the social responsibility to combat these health challenges within our environment. Defending the Mediterranean diet is our obligation and our responsibility. It's worth noting that already in 1961, Time Magazine featured Ancel Keys on its cover and in an extensive article encompassing his life and scientific accomplishments.
Yet Ancel Keys was not only a renowned investigator, who directed important nutritional studies on cardiovascular disease. From the beginning, he conceived his life as an ongoing experience on the subject of good eating. In fact, his books are filled with recipes that he prepared alongside his wife Margaret, whom he met in 1940 while working at Mayo Clinic, and with whom he carried out one of his favourite hobbies—collecting recipes in a variety of Mediterranean countries where he had a multitude of friends.
An early bird and tireless worker he ate with meticulousness and care, and knew how to bring together gastronomy and health. He wrote three books, bestsellers of their time, that combined science and culinary arts, which allowed them, due to their royalties, to build a house near Naples where they would spend long periods of time, as recalled by Jane Brody of the New York Times after Keys passed away.
Prof. Keys is an example to follow. It is the way of guaranteeing the Mediterranean diet. Nowadays, there are so many who fraudulently use the term Mediterranean diet or who invent diets without sound scientific evidence. We can say that Ancel Keys provided us with our scientific base. And we should respect the same Mediterranean diet out of respect for Keys himself.
I met him in 1994, in the Conference on Mediterranean Diets organised by Harvard University, Oldways and the World Health Organisation (6). I was completely impressed. In 1998, he visited us in Barcelona with the motive of receiving the second edition of the Grande Covian Award, alongside with Prof. Flaminio Fidanza.
I remember that we went to the Valls region to eat a traditional meal, la calçotada, in the company of Dr Antonia Trichopoulou, Dr Anna Ferro-Luzzi, Dr Rafael Carmena and Dr Flaminio Fidanza, among many others. He ate more than a dozen calçots (a type of local specialty green onion) that he dipped meticulously in the Romescu sauce and ate without difficulty. He was 94-year old and would live another 6 years longer.
At that time, we talked about his research, his doctoral programmes—in biology at Berkeley and Physiology at Kings College of Cambridge. We spoke of Paco Grande. And what needed to be done in the future. Subsequently in 2002, the above-mentioned Antonia Trichopoulou would receive the highest award of our foundation along with Dimitrius Trichopoulou, followed by the 2004 recipient, Walter Willett.
This monograph of Public Health Nutrition is a compilation of the sessions presented in VI International Congress of the Mediterranean Diet. The FDM wanted to celebrate our 10-year anniversary dedicating this publication to Prof. Keys and to render our modest homage to his memory. All tributes and homages to Dr Keys would fall short. We must not forget that because of him, at present we are still making reference to the same Mediterranean diet. And without a doubt, even this Foundation would not exist today had it not been for his fundamental contributions to science.
