2025 National Guidelines on the Mediterranean Diet: Executive Summary of a Joint Report by Italian Scientific Societies and the National Institute of Health Task Force on Clinical Practice Guidelines
Nicola Veronese, Vincenza Gianfredi, Massimo Volpe, Michela Zanetti, G. Onder, Marco Silano, Daniele Nucci, Luigi Fontana, Alessandro Laviano, C. Sieber, Stefania Maggi, Italian Mediterranean Guideline Group, Stefania Maggi, Massimo Volpe, Michela Zanetti, G. Onder, Nicola Veronese, Vincenza Gianfredi, Daniele Nucci, Marco Silano, Laura Rossi, Antonella Brunello, Caffarra Paolo, Cotroneo Antonio Maria, Ciccone Marco Matteo, Desideri Giovambattista, Galletti Ferruccio, G. Emilia, Antonella Lezo, L. Francesco, Macchia Francesco, Maiorino Maria Ida, Medea Gerardo, P L Barbara, Rogoli Domenico, Scarpato Elena, Sciretti Massimiliano, Spagnuolo Maria Immacolata, Troiano Ersilia, Ungar Andrea, Roberto Volpe, Z. Giovanni, Alonzo Elena, Aversano Fiorella, B. Letizia, Barbarano Federico, Alberto Benussi, Burgio Marianna Ilarj, Buscemi Carola, Camastra Stefania, Cappiello Ilaria, C. Massimiliano, Caruso Irene, C. N. Amanda, Ceriani Elisa, Chernykh Anastasia, C Martina, Chiriacò Martina, Cicero Giuseppe, Cilona Laura, Cintoni Marco, C. De Stefano, Crudele Lucilla, D’Eusebio Chiara, Deledda Andrea, D M Francesco, Espa Lorenzo, Fadda Maurizio, Favaro Enrica, F. Benedict Martina, F. Armando, G E Lucía, G Cristina, Greatti Alessandro, G. D. Paola, Limongi Federica, Lisso Fabrizia, Mazza Elisa, Misotti Alessandro, Mollica Maria Pina, Morlando Alessia, Morsella Alisha, Giovanna Muscogiuri, Pala Barbara, Paolillo Stefania, P C Damiano, Patti Maria Cristina, Pira Costanza, Ragusa Francesco Saverio, Randazzo Cristiana, Raffaele De Francesco, Salatto Alessia, Schirò Piero, S. Sara, Testa Giuseppe Dario, Trestini Ilaria, Valoriani Filippo, Velluzzi Fernanda, Zimmitti Salvatore, Alisha Morsella
Abstract
CONTEXT: Chronic non-communicable diseases (NCDs) are the leading global causes of morbidity, mortality, and escalating health care costs, driven largely by unhealthy lifestyles in an aging population. OBJECTIVE: The Mediterranean Diet (MD), traditionally associated with healthy longevity, is increasingly recognized for its preventative and therapeutic benefits across many NCDs. DATA SOURCES: Using the NUTRIGRADE methodology, a multidisciplinary panel of clinical, methodological, and public health experts conducted a comprehensive systematic review across 9 health domains and one economic domain. DATA EXTRACTION: Data were extracted from multiple databases without date restrictions, assessing outcomes such as disease incidence and prevalence, mortality rates of nutrition-related NCDs, quality of life indicators, and relevant biochemical markers. Evidence was critically appraised and synthesized to formulate evidence-based recommendations. DATA ANALYSIS: A total of 84 evidence-based recommendations were developed. The MD was found to significantly reduce all-cause mortality in the general population and cardiovascular morbidity and mortality, particularly in high-risk individuals. High-quality evidence supports the protective role of the MD against myocardial infarction, stroke, atrial fibrillation, and peripheral arterial disease. In oncological evidence, MD adherence has been found to be linked to a lower incidence of several cancer types and improved survival outcomes. Additional benefits include reduced incidence and progression of cognitive decline, type 2 diabetes, metabolic syndrome, and obesity, and improved pregnancy outcomes. The strength of recommendations varied by outcome and target population, with many supported by robust evidence. CONCLUSIONS: The MD is a scientifically supported dietary intervention with broad preventive and therapeutic benefits. Its integration into clinical practice, public health strategies, and policy initiatives is strongly recommended to promote health and reduce the global health care burden.