Chinyere, I would consider a qualitative study using medical clinics or offices. You can interview physicians and patients as to what helps them follow the diet and what makes it difficult to follow the diet. This is the type of study that is specific to your population. The Mediterranean diet would be easier to follow for people who grew up eating that way. In the UK the diet is vastly different from the Mediterranean diet. Not being use to or familiar with the foods could be a major barrier.

It is an important question. we give some ideas in our book "The Mediterranean diet Health and science" following some of the recommendations are easily attainable : eat a lot of vegetables (I mean all vegetables: cabbages, beets, turnips, carrots), leaks, whole grains, nuts, moderate amount of wine; more difficult but  most important olive oil; besides no snacking, no fast-food type , physical activity, no smoking, no sodas and keep away from overweight. Those are the principles but as you said eating patterns are important having a healthy lunch , according to the Med Diet, should be provides by hospital ,restaurants and agencies  and a light vegetarian dinner should be recommended. With the food recommendation instruction for food preparation should be given. You ca contact Richard Hoffman at the hertfordshire university, [email protected], we work together on this problem.

it is an honor getting an answer from you Mariette. I have been reading up on most of your papers on the Med. diet. I will take your advice into consideration and if i have any other queries, i will contact you. Thanks.

And thank you Joan for your suggestions too. 

Mariette,

Excellent response! I forgot that the main idea is the science of lifestyle change - toward more vegetables, healthy oils and away from processed foods, soda, and added sugar. if hospitals in the UK set the trends it would make it easier for the public to follow. Perhaps the greatest barrier to following the Med diet is lack of knowledge as to how it could be adjusted to UK foods.

Importing  more vegetables and fruits, lowering wrecks, and supplement With fish oil, also making advertising campaings

I agree with all of you but the problem is that we use to look at the issue downstream (what appears to our eyes) and not upstream (seeking what there is behind our patients). Diet, like physical activity, no smoking, etc (in one word: lifestyle), is the effect of the psychobehavioral balance that may be disturbed by many factors affecting the relationship with oneself (emotions, pulsions, needs, etc) and the Others (people, things, events, etc). Hence, I am convinced that when we talk about any project of prevention or lifestyle change (in single patient or in more or less large groups) we need to get more and more information on what there is behind our patient's (or population's) behaviour. I agree with Joan when she says that we need to interview physicians and patients: this is the first important step to have information on the real situation. In my experience,  we used to do with our CV patients as follows: look at behind to help patients to identify disturbing factors unbalancing behavior, help patients to remove them, help patients to reinforce their resilience with the continuosly present objective to reappropriate of themselves and improve their lifestyle. Change is closely related to motivations; change can be easily done but not easily mantained. Therefore, patients need to have knowledge of their unbalanced beviour and unappropriate (medically speaking)  lifestyle, to feel if they want to address their problems, to understand what they are willing to invest in improving their lifestyle; doctors need to explain why it is advicable to change, to understand if the patients want really to change, to share with the patients the most appropriate way to help them.

Sorry for the length but the topic is exciting and it is impossible not to remember Hyppocrates's writings: "....it is not possible to practice medicine if we do not know who is man and how he is made....with his thoughts, his feelings, ........"

mediterranean diet is not medicine it s lifestyle to be recommended at the population level; we don't speak here at the individual level

It could be; but in my opinion all what is related to health (or disease) is medicine. Regarding lifestyle recommendation, I am convinced that it is important to know individual and population profile and share with them the project.