We present a food pyramid that reflects Mediterranean dietary traditions, which historically have been associated with good health. This Mediterranean diet pyramid is based on food patterns typical of Crete, much of the rest of Greece, and southern Italy in the early 1960s, where adult life expectancy was among the highest in the world and rates of coronary heart disease, certain cancers, and other diet-related chronic diseases were among the lowest. Work in the field or kitchen resulted in a lifestyle that included regular physical activity and was associated with low rates of obesity. The diet is characterized by abundant plant foods (fruit, vegetables, breads, other forms of cereals, potatoes, beans, nuts, and seeds), fresh fruit as the typical daily dessert, olive oil as the principal source of fat, dairy products (principally cheese and yogurt), and fish and poultry consumed in low to moderate amounts, zero to four eggs consumed weekly, red meat consumed in low amounts, and wine consumed in low to moderate amounts, normally with meals. This diet is low in saturated fat (< or = 7-8% of energy), with total fat ranging from < 25% to > 35% of energy throughout the region. The pyramid describes a dietary pattern that is attractive for its famous palatability as well as for its health benefits.

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Moderate wine consumption is reputed to exert a protective effect against coronary heart disease (CHD). The nature of the protective compounds is unclear and the mechanisms are incompletely understood. We studied whether the nonalcoholic component of wine increases plasma antioxidant capacity measured as total radical-trapping antioxidant parameter (TRAP), and whether such an effect is associated with the presence of phenolic compounds in plasma. The TRAP and plasma levels of phenolic compounds were measured in 10 healthy subjects after the ingestion of 113 mL of tap water (control) and alcohol-free red and white wine at 1-wk intervals. Both alcohol-free wines possessed an in vitro dose-dependent peroxyl-radical activity, but red wine, with a polyphenol concentration of 363 +/- 48.0 mg/L quercetin equivalent (QE), was 20 times more active (40.0 +/- 0.1 mmol/L) than white wine (1.9 +/- 0.1 mmol/L), which has a polyphenol concentration of 31 +/- 1 mg QE/L. The ingestion of alcohol-free red wine caused significant increases in plasma TRAP values and polyphenol concentrations 50 min after ingestion. Alcohol-free white wine and water had no effects on either of the plasma values. The parallel and prompt increase of antioxidant status and of circulating levels of polyphenols in fasting subjects after bolus ingestion of a moderate amount of alcohol-free red wine suggests that polyphenols are absorbed in the upper gastrointestinal tract and might be directly involved in the in vivo antioxidant defenses.

A pilot study was conducted of males 40-45 years old from rural areas of three countries to study the long-term effects of dietary fats on the lipids of plasma, red blood cells (RBCs), and platelets. Differences were observed in cholesterol and phospholipid levels of plasma. Total phospholipids of RBCs and platelets were similar in all three countries. The pattern of individual phospholipids of RBCs in the Finnish and Italian samples differed from the American samples. In all plasma and RBC glycerolphospholipids, the monounsaturated fatty acids were highest in the Italian and the saturated fatty acids were highest in the Finnish samples; PUFAs were highest in the USA samples. Platelet glycerolphospholipids followed similar fatty acid patterns. We concluded that the fatty acid compositions of the glycerolphospholipids of plasma, RBCs, and platelets reflect the major dietary fatty acids.

The current view of dietary carbohydrates as simply providing us with energy is outdated. Because of their varied chemistry and physical form the rate and extent to which the different types are digested in and absorbed from the small intestine varies. This in turn leads to affects on satiety, blood glucose and insulin, protein glycosylation, lipids and bile acids. Some carbohydrates reach the colon where they are fermented and affect many aspects of large bowel function, colonocyte and hepatic metabolism.A new framework for classifying and measuring food carbohydrates is needed to allow a greater understanding of the role of individual species in health and to inform the public of their importance. A classi®cation based primarily on molecular size (degree of polymerisation) into sugars, oligosaccharides and polysaccharides, is suggested, with sub-groups identi®ed by the nature of the monosaccharides. Greater knowledge of the chemical and physical properties of carbohydrates allow a more precise relation with physiology and health to be drawn.The Carbohydrate Group met in Paris in December 1995 at the invitation of Gerard Pascal, Director of CNERNA. Financial support for the meeting was provided by CNERNA.

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Objective: To examine critically the published results of dietary surveys on the fat content of the Greek diet, and to assess its evolution and its relationship to the health of the Greeks. To consider the implications of these findings for current views on the nature and health implications of the traditional Mediterranean diet and how best to define it for use in modern policy making. Design: A systematic review of the literature on food consumption in Greece. Setting: Greece. Results: The first fully published data on the fat content of the Greek diet -the Seven Countries Survey -relates only to a small number of adult males in Crete and Corfu; the legitimacy of extrapolating these results to the rest of Greece is questioned. Earlier studies and chemical validation of intakes point to a lower fat content of the traditional diet than that inferred for Crete. Nearly all later surveys relate only to urban groups in Athens (mostly case -control hospital-based samples) and a variety of nonrepresentative Cretan groups. Only two studies are larger and more representative, but one uses FAO food balance-sheets to reflect the national diet, and the other surveyed school-age children in three out of the 52 Greek counties. Unfortunately recent dietary studies have proved unreliable, given the continuing lack of national food composition tables with survey methods which proved inaccurate for dietary fat content. A progressive upward trend in total and saturated fat intake appears to have occurred with all health indicators in relation to fat indicating remarkable increases in adult and childhood obesity with attendant progressive deterioration in cardiovascular mortality and its risk factors, ie hypertension and diabetes. These data emphasise the need to alter current nutritional advice in Greece, particularly when it focuses on the promotion of olive oil and a high-fat diet. Conclusions: The findings reaffirm low -moderate fat policies for optimum health, within which olive oil can be an important component of the diet.

Many substances in the plant kingdom and in man's diet occur as glycosides. Recent studies have indicated that many glycosides that are not mutagenic in tests such as the Salmonella test become mutagenic upon hydrolysis of the glycosidic linkages. The Salmonella test utilizes a liver homogenate to approximate mammalian metabolism but does not provide a source of the enzymes present in intestinal bacterial flora that hydrolyze the wide variety of glycosides present in nature. We describe a stable cell-free extract of human feces, fecalase, which is shown to contain various glycosidases that allow the in vitro activation of many natural glycosides to mutagens in the Salmonella/liver homogenate test. Many beverages, such as red wine (but apparently not white wine) and tea, contain glycosides of the mutagen quercetin. Red wine, red grape juice, and tea were mutagenic in the test when fecalase was added, and red wine contained considerable direct mutagenic activity in the absence of fecalase. The implications of quercetin mutagenicity and carcinogenicity are discussed.Damage to DNA by environmental mutagens, both natural and man-made, is likely to be a major cause of cancer and other diseases (1, 2). The Salmonella test (3), along with other short-term tests (4), is being used to survey a wide variety of substances in our environment for mutagenicity. The test measures back mutation in several specially constructed mutants of Salmonella bacteria. A homogenate of rat liver (or other mammalian liver) is added to the (Salmonella) test as an approximation of mammalian metabolism (3). By using this system, approximately 85% 1 5% of the organic carcinogens tested have been detected as mutagens (5-9).Recent studies indicate that many naturally occurring glycosides of mutagenic aglycones are not mutagenic in the Salmonella test (10-23). These glycosides are hydrolyzed by the bacteria in the human intestine where the mutagen is liberated. They are not cleaved by the liver or by liver homogenates used in the Salmonella test. For example, cycasin, a f3-D-glucoside of the mutagen methylazoxymethanol, is not mutagenic in the Salmonella test unless 3-glucosidase is added to the standard test (20,21). Cycasin is a carcinogen in rats but is not a carcinogen when tested with germ-free rats (24, 25), which lack the microorganisms that cleave the sugar from the mutagenic moiety.An enormous variety of substances are present as glycosides in the plant kingdom (10-27). It is desirable to have an enzyme preparation for use in mutagenicity tests that will hydrolyze the hundreds of sugars in these glycosides. have developed a cell-free extract of rat cecal bacteria, cecalase, for use in mutagenicity testing. 22) have used hesperidinase, a mold enzyme preparation, for this pur-The publication costs of this article were defrayed in part by page charge payment. This article must therefore be hereby marked "advertisement" in accordance with 18 U. S.