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  • Letter to the Editor
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The Florence diet is not Mediterranean. Really?

European Journal of Clinical Nutrition volume 60, pages 440–441 (2006)Cite this article

In their study that evaluated dietary habits and lifestyle of 520 men and women living in Florence area of Italy, Sofi et al. (2005) concluded that the dietary habits of this population did not mirror the features of the Mediterranean diet. I believe that this conclusion is not supported by the data presented.

The authors justified their conclusion, firstly, on the high total fat consumption; secondly, on the high saturated fat consumption; thirdly, on the low polyunsaturated fat consumption; and, finally, on the high prevalence of participants not meeting the recommended intake of several nutrients. Trichopoulou et al. (1995) proposed a composed dietary score to rank individuals according to their adherence to the traditional Mediterranean diet. The main characteristics of this dietary pattern consist of a high consumption of plant-based foods and a low and high intake of meat and fish, respectively. However, Sofi et al. (2005) did not report food intake. They reported a total fat consumption of 33.3%. How could this be considered high for a Mediterranean country (Linseisen et al., 2002; Pala et al., 2003; Schroder et al., 2004)? High consumption of nuts and olive oil, both characteristic components of the Mediterranean diet, implies high fat intake. Furthermore, one has to underline that there are no established cutoffs for fat (or any other nutrient) intake that characterize a diet being Mediterranean or not. Kafatos et al. (2000) have calculated the nutritional composition of the traditional Cretan Mediterranean diet. They reported a contribution of 123 g of fat corresponding to 42% of total energy intake. Surprisingly, Sofi et al. (2005) considered the reported average saturated fat intake of 9.8% also as being high (‘… as clearly seen by high contribution of from total fats with its type saturated…’). It is frequent to observe a considerable difference between total fat consumption and the sum of the individual fat subclasses. This is mainly due to incompleteness of data concerning foods in nutrient databases that are used for the calculation of the nutrient composition of a diet. The difference in the data of Sofi et al. (2005) was 7.7% (33.3% for total fat intake and 25.6% for fat subclasses). One cannot assume that this difference is equally distributed among saturated, monounsaturated, and polyunsaturated fat. One can argue that the low polyunsaturated fat intake might be due to incomplete data of foods rich in this nutrient. As this possibility cannot be discarded any interpretation of this data should be taken with caution.

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  1. Lipids & Cardiovascular Epidemiology Unit, IMIM, Barcelona, 8003, Barcelona, Spain

    H Schröder

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Schröder, H. The Florence diet is not Mediterranean. Really?. Eur J Clin Nutr 60, 440–441 (2006). https://doi.org/10.1038/sj.ejcn.1602326

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