02130nas a2200157   4500000000100000008004100001100002000042700002100062700001300083700001300096245004800109300001000157490000600167520178500173022001401958       2016                            d1 aS. Radd-Vagenas1 aA. Kouris-Blazos1 aM. Singh1 aV. Flood00aWhat is the traditional Mediterranean diet?  a45-450 v43 aBackground/Aims. The Mediterranean diet is important for health and used in research and clinical practice. However, a range of definitions exist for this dietary pattern. The purpose of this study is to describe the "traditional" Mediterranean diet and identify additional elements not covered by most educational and index tools, including that used in the PREDIMED trial. Methods. We conducted a literature review of Mediterranean diet definitions, including those used in educational and index tools. Nine databases were searched from inception to July 2015. Results. Definitions in the literature vary and mostly focus on the proportion of key foods. The traditional Mediterranean diet is described as high in plant foods (fruits, vegetables, cereals, legumes, nuts/seeds and extra virgin olive oil), moderate in fish/shellfish and red wine and low in meat, dairy, eggs and animal fats. In 2010, the United Nations Educational, Scientific and Cultural Organization (UNESCO) recognised the Mediterranean diet as an Intangible Cultural Heritage. Yet the definition accepted by UNESCO encompasses broader lifestyle aspects related to culinary and consumption habits. Additional elements of the traditional Mediterranean diet, not well documented in previous tools, include the intake of home cooked meals, cooking styles, frequency of eating in company, fasting practice, ownership of a kitchen garden and napping after the midday meal. Conclusions. Scope exists for improved educational and index tools for use by researchers and clinicians. Existing tools should be reviewed to incorporate broader elements of the Mediterranean "way of life" that may influence dietary adherence and/or provide independent health effects. Funding source(s). N/A. All rights reserved, Elsevier.  a2352-3859