The Northern Italian Diet Compared to the Mediterranean Diet: Prevalence Rates of Obesity and Diabetes

I am writing in response to your recent articles on the conference proceedings of the World Congress on Nutrition and obesity prevention. I wish to call attention to the data on the prevalence of obesity in Italy, which are some of the lowest in the Western world, and which seem to be relatively stable [1]. The table 1 below shows that the northern part of Italy had significantly lower prevalence of overweight and obesity in 2007 than the southern part of Italy [2]. The Northern Italian diet differs significantly from the Mediterranean diet of the southern part of Italy, being richer in calories, animal fats and meat products than the typical Mediterranean diet. It also uses butter more often than olive oil as a condiment. For years the Mediterranean diet has been portrayed as one of the healthiest. The concept of the Mediterranean diet reflected “food patterns typical of Crete, much of the rest of Greece, and Southern Italy in the early 1960s” [3]. American biochemist Ancel Keys had first originated the concept of the Mediterranean diet after discovering a high proportion of centenarians in the Cilento area of Southern Italy [4]. However, according to the World Health Organization, Greece only ranked 24th among world countries in 2015 with respect to life expectancy with an average life expectancy for men of 78.3 years and for women of 83.6 years, behind Germany and the United Kingdom. Like many Western countries, Greece is also experiencing an obesity epidemic [5]. With particular regards to type 2 diabetes mellitus, Northern Italy has a very low prevalence of the condition (3.2%), lower than that of Southern Italy (6.3%) [6]. The Mediterranean diet has even been proclaimed an intangible cultural heritage by Unesco in 2013 (Inscription: 8.COM 8.10), supposedly for its great health benefits. The American College of Cardiology promotes the Mediterranean diet on its website claiming that it lowers the risk of diabetes. However, analysis of the available data does not support this conclusion. The table 2 below lists the diabetes type 2 prevalence rates of several countries and of Northern and Southern Italy: as it will be apparent some “Mediterranean” countries (including Greece) have higher prevalence rates than the United States. I therefore feel that we are giving the wrong advice to the public: to follow a “Mediterranean” diet