Mediterranean Culinary Medicine: An Integrative Approach to Diet, Culinary Practices, and Health

The Mediterranean diet is widely recognized as one of the most robust dietary patterns for the prevention of chronic diseases, yet its health effects cannot be fully understood without considering the culinary practices and cultural contexts that shape food preparation and consumption. In this context, we propose the concept of Mediterranean Culinary Medicine, defined as the application of culinary medicine principles within the Mediterranean dietary model, integrating evidence-based nutrition with traditional ingredients, cooking techniques, and meal patterns. This narrative review synthesizes evidence from epidemiological, experimental, and clinical studies to examine how culinary practices may influence the nutritional quality, bioavailability of bioactive compounds, and overall health effects of the Mediterranean diet, although the strength of evidence varies across domains, with particular attention to home cooking, traditional cooking techniques, and extra virgin olive oil. We also explore the biological pathways, suggested by a combination of experimental findings and observational evidence, through which culinary practices may modulate metabolic health, including inflammation, glycemic response, and gut microbiota, as well as their potential application in addressing disease-related eating limitations such as sensory alterations, dysphagia, malnutrition, and food allergies, for example, through texture modification or flavor enhancement strategies. Finally, we highlight the social, cultural, and environmental dimensions of Mediterranean Culinary Medicine, emphasizing its role as a holistic and culturally grounded approach that facilitates the translation of Mediterranean dietary principles into sustainable and practical dietary behaviors. Overall, available evidence suggests that culinary practices are a relevant but still underexplored component of the Mediterranean diet, with the potential to improve dietary adherence and nutritional quality. However, current evidence remains heterogeneous and largely based on experimental and observational studies, highlighting the need for longitudinal and intervention studies to clarify their long-term health impact.