title: Med Diet 4.0: the Mediterranean diet with four sustainable benefits.
abstract: OBJECTIVE
  To characterize the multiple dimensions and benefits of the Mediterranean diet as a sustainable diet, in order to revitalize this intangible food heritage at the country level; and to develop a multidimensional framework - the Med Diet 4.0 - in which four sustainability benefits of the Mediterranean diet are presented in parallel: major health and nutrition benefits, low environmental impacts and richness in biodiversity, high sociocultural food values, and positive local economic returns.
  
  
  METHODS
  A narrative review was applied at the country level to highlight the multiple sustainable benefits of the Mediterranean diet into a single multidimensional framework: the Med Diet 4.0. Setting/subjects We included studies published in English in peer-reviewed journals that contained data on the characterization of sustainable diets and of the Mediterranean diet. The methodological framework approach was finalized through a series of meetings, workshops and conferences where the framework was presented, discussed and ultimately refined.
  
  
  RESULTS
  The Med Diet 4.0 provides a conceptual multidimensional framework to characterize the Mediterranean diet as a sustainable diet model, by applying principles of sustainability to the Mediterranean diet.
  
  
  CONCLUSIONS
  By providing a broader understanding of the many sustainable benefits of the Mediterranean diet, the Med Diet 4.0 can contribute to the revitalization of the Mediterranean diet by improving its current perception not only as a healthy diet but also a sustainable lifestyle model, with country-specific and culturally appropriate variations. It also takes into account the identity and diversity of food cultures and systems, expressed within the notion of the Mediterranean diet, across the Mediterranean region and in other parts of the world. Further multidisciplinary studies are needed for the assessment of the sustainability of the Mediterranean diet to include these new dimensions.
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: S
authors.initials: S
authors.lastname: Dernini
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: E M
authors.initials: EM
authors.lastname: Berry
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: L
authors.initials: L
authors.lastname: Serra-Majem
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: R
authors.initials: R
authors.lastname: Capone
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: F X
authors.initials: FX
authors.lastname: Medina
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: J
authors.identifier: http://orcid.org/0000-0002-4975-3906
authors.initials: J
authors.lastname: Aranceta-Bartrina
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: R
authors.initials: R
authors.lastname: Belahsen
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: B
authors.initials: B
authors.lastname: Burlingame
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: G
authors.initials: G
authors.lastname: Calabrese
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: D
authors.initials: D
authors.lastname: Corella
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: L M
authors.initials: LM
authors.lastname: Donini
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: D
authors.initials: D
authors.lastname: Lairon
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: A
authors.initials: A
authors.lastname: Meybeck
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: A G
authors.initials: AG
authors.lastname: Pekcan
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: S
authors.initials: S
authors.lastname: Piscopo
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: A
authors.initials: A
authors.lastname: Yngve
authors.affiliation: 1International Foundation of Mediterranean Diet (IFMeD),London,UK.
authors.forename: A
authors.initials: A
authors.lastname: Trichopoulou
mesh_terms: D044822:Biodiversity; D003247:Conservation of Natural Resources / Q000191:economics; D003365:Costs and Cost Analysis; D003469:Culture; D000072001:Diet, Healthy / Q000191:economics; D038441:Diet, Mediterranean / Q000191:economics*; D005523:Food Supply / Q000191:economics; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D018803:Models, Economic; D018673:Nutrition Policy / Q000191:economics
keywords: Food security and nutrition; Mediterranean diet; Public health nutrition; Sustainability; Sustainable diets; Sustainable food systems