Nurturing health, embracing conviviality: Sharing meals along the lifespan in the Mediterranean region

Since its inception on the UNESCO Representative List of the Intangible Cultural Heritage of Humanity in 2010, the Mediterranean Diet (MeD) has gained recognition as an eating pattern to be emulated and promoted, not only for its health value, but also for its sustainability and socio-cultural value. The preventive and therapeutic benefits of consuming a MeD for a host of health problems and conditions, ranging from cardiovascular disease, to cancer, diabetes, metabolic syndrome, obesity, neurodegenerative diseases and frailty, amongst others, have continued to be proven ever since Professor Ancel Keys globally publicized the positive link between the MeD and cardiovascular health in the 1960s and 1970s. However, proponents of the lifestyle concept of the MeD, which started to be emphasized over recent decades and which stems from the Greek meaning of the word 'diaita' (way of life), are now highlighting even more strongly conviviality - or pleasure around meal sharing - as an integral component of the MeD, providing additional benefits for wellbeing throughout the lifecycle. Indeed, the national dietary guidelines of a number of different countries have referred to the importance of meal sharing, indicating that there is evidence to justify such a recommendation. More specifically, in graphical food guides based on the MeD eating pattern developed in the past two decades, the requisite characteristic of conviviality involving shared food consumption and sometimes also food preparation is always portrayed. Yet whilst several studies have shown that eating with others, particularly family, is associated with healthier dietary outcomes across the lifespan, the prevalence of meal sharing and the relationship between this traditional cultural practice and physical, mental and social wellbeing for different population groups in the Mediterranean region is still an emerging area of research. Nonetheless, although research is somewhat scarce on frequency of family meals at different lifestages in Mediterranean countries, some studies have shown that sharing breakfast or family meals is a predictor for higher adherence to MeD consumption among children and adolescents in particular. Other studies have shown that high adherence to the MeD was associated with better Health-Related Quality of Life (HRQOL) and more subjective happiness among adolescents, and that, similarly, the number of meals per day consumed with the family was significantly positively associated w