Mainstream medicine has adopted the notion that diet and health are inseparably intertwined through substantial research on dietary approaches like the Mediterranean diet, representing a dietary pattern of persons residing around the Mediterranean Sea. [1,2] The diet is primarily a plant-based eating plan that includes daily intake of whole grains, olive oil, fruits, vegetables, beans and other legumes, nuts, herbs, and spices. [1,2] Other foods like animal proteins are eaten in smaller quantities, with the preferred animal protein being fish and seafood. [1,2] The Mediterranean Diet had a unique and important impact on bringing light to the concept of predominantly plant-based eating patterns, healthy fats, and small, well-sourced animal protein servings. [1,2,3]
Interestingly, there is still a high prevalence of chronic disease in populations surrounding the Mediterranean sea, as not all people choose or are able to follow a healthy diet consisting of food from the region. However, some regions in the Mediterranean have uniquely healthy populations with longer than average lifespans. For example, the Greek Island of Ikaria is considered a Blue Zone, referring to its significantly higher than average prevalence of centerian inhabitants, i.e., persons who are 100 or more years old. [3,4] Inhabitants of the island, along with adhering to a local, healthy Mediterranean diet, as described above, also benefit from a number of other factors that contribute to their health. 
Nine characteristics have been identified to contribute to the health of their inhabitants, and only one of those characteristics involves following a diet similar to the Mediterranean diet (e.g., a balanced and moderate plant based, whole food, low meat diet).  The other eight characteristics include moving naturally (e.g., walking daily), a sense of purpose, low stress, eating to 80% of feeling full (“20% rule”), moderate wine consumption (one small serving daily), prioritizing family, and being a part of a community that supports wholesome living.  While addressing diet is a clear step in the right direction toward reducing chronic disease prevalence, there may be great benefit to integrating research across the other eight factors and implementing them through population health programs.
1. Sofi, F., Cesari, F., Abbate, R., Gensini, G. F., & Casini, A. (2008). Adherence to Mediterranean diet and health status: meta-analysis. Bmj, 337, a1344.
2. Couto, E., Boffetta, P., Lagiou, P., Ferrari, P., Buckland, G., Overvad, K., … & Boutron-Ruault, M. C. (2011). Mediterranean dietary pattern and cancer risk in the EPIC cohort. British journal of cancer, 104(9), 1493.
3. Buettner, D. (2012). The island where people forget to die. The New York Times.
4. Buettner, D. (2012). The blue zones: 9 lessons for living longer from the people who’ve lived the longest. National Geographic Books.