ABSTRACTIntroductionThe term “Mediterranean lifestyle” has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the “traditional Mediterranean lifestyle (tMedL),” referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term “traditional Mediterranean lifestyle.”MethodsMajor medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the “traditional Mediterranean lifestyle.”ResultsThis proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. “The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life.”ConclusionsThis definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well‐being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development.

British Journal of NursingVol. 32, No. 5 RegularsLifestyle medicine: a modern medical discipline full of optimismEllen Fallows, Alex Maxwell, Rob LawsonEllen FallowsE-mail Address: [email protected]GP and Vice-President, British Society of Lifestyle MedicineSearch for more papers by this author, Alex MaxwellGP and President, British Society of Lifestyle MedicineSearch for more papers by this author, Rob LawsonChair, British Society of Lifestyle MedicineSearch for more papers by this authorEllen Fallows; Alex Maxwell; Rob LawsonPublished Online:13 Mar 2023https://doi.org/10.12968/bjon.2023.32.5.268AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Alegría-Torres JA, Baccarelli A, Bollati V. Epigenetics and lifestyle. Epigenomics. 2011;3(3):267-77. https://doi.org/10.2217/epi.11.22 Crossref, Medline, Google ScholarEgger GBinns ARössner SSagner M (eds). Lifestyle medicine: lifestyle, the environment and preventive medicine in health and disease paperback. London: Academic Press; 2017 Google ScholarFurman D, Campisi J, Verdin E et al.. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. https://doi.org/10.1038/s41591-019-0675-0 Crossref, Medline, Google ScholarJacka FN, O’Neil A, Opie R et al.. A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Med. 2017;15(1):23. https://doi.org/10.1186/s12916-017-0791-y Crossref, Medline, Google ScholarJarbøl DE, Larsen PV, Gyrd-Hansen D et al.. Determinants of preferences for lifestyle changes versus medication and beliefs in ability to maintain lifestyle changes. A population-based survey. Prev Med Rep. 2017;6:66–73. https://doi.org/10.1016/j.pmedr.2017.02.010 Crossref, Medline, Google ScholarLean ME, Leslie WS, Barnes AC et al.. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541-551. https://doi.org/10.1016/S0140-6736(17)33102-1 Crossref, Medline, Google ScholarOrnish D. Avoiding revascularization with lifestyle changes: The Multicenter Lifestyle Demonstration Project. Am J Cardiol. 1998;82(10B):72T-76T. https://doi.org/10.1016/s0002-9149(98)00744-9 Crossref, Medline, Google ScholarRidge K (chair). Good for you, good for us, good for everybody. A plan to reduce overprescribing to make patient care better and safer, support the NHS, and reduce carbon emissions. (The report of the National Overprescrining Rreview.) 2021. https://tinyurl.com/3drvj7hu (accessed 1 March 2023) Google ScholarRodriguez-Castaño GP, Caro-Quintero A, Reyes A, Lizcano F. Advances in gut microbiome research, opening new strategies to cope with a western lifestyle. Front Genet. 2017;7:224. https://doi.org/10.3389/fgene.2016.00224 Crossref, Medline, Google ScholarSaneei P, Salehi-Abargouei A, Esmaillzadeh A, Azadbakht L. Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: a systematic review and meta-analysis on randomized controlled trials. Nutr Metab Cardiovasc Dis. 2014;24(12):1253-1261. https://doi.org/10.1016/j.numecd.2014.06.008 Crossref, Medline, Google ScholarSrour B, Kordahi MC, Bonazzi E, Deschasaux-Tanguy M, Touvier M, Chassaing B. Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights. Lancet Gastroenterol Hepatol. 2022;7(12):1128-1140. https://doi.org/10.1016/S2468-1253(22)00169-8 Crossref, Medline, Google ScholarTreadwell JS, Wong G, Milburn-Curtis C, Feakins B, Greenhalgh T. GPs’ understanding of the benefits and harms of treatments for long-term conditions: an online survey. BJGP Open. 2020;4(1):bjgpopen20X101016. https://doi.org/10.3399/bjgpopen20X101016 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetails 9 March 2023Volume 32Issue 5ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 13 March 2023 Published in print 9 March 2023 Information© MA Healthcare LimitedPDF download

Covid-19 has led to virtual care (mainly telephone consultations) becoming a default worldwide, despite well-documented shortcomings. Published evidence on virtual group consultations is limited, although interest and front-line experience have grown substantially since pandemic onset. Unpublished data are summarised showing feasibility of transitioning care to this model across different countries, care settings and conditions. An international webinar series has supported development and sharing of best practice and representative data on spread and utilisation of virtual groups. This model of care creates time and space for more questions and answers, so once engaged patients become staunch advocates. Group care supports personalised care and lifestyle medicine, which is growing very rapidly. In the current context, even healthcare providers under pressure can implement virtual group consultations. Most virtual group consultations have a facilitator, so this allows roles to be extended and support education of both students and new team members. These can confer greater access, continuity of care, peer support and timely information about Covid-19 and may result in better health outcomes. Given the rapid and widespread implementation of virtual care during this pandemic, data should be shared effectively and methodologically sound observational studies and clinical trials to test safety and effectiveness should be promoted now.