Adaptability of the Mediterranean Diet to Indonesian Culinary Traditions for Reducing Noncommunicable Disease Risk

Authors

  • Diyah Eka Andayani Universitas Indonesia , Department of Nutrition, Faculty of Medicine, Universitas Indonesia- dr Cipto Mangunkusumo Hospital, Jakarta Pusat, 10430, Indonesia , Division of Clinical Nutrition, dr Cipto Mangunkusumo Hospital, Central Jakarta, 10430, Indonesia
  • Vitia Ajeng Nur Linda Islamic University of Indonesia image/svg+xml
  • Bernadina Chyntia Carsantiningrum St. Carolus Hospital, Central Jakarta, 10440, Indonesia
  • Fadilah University of Indonesia image/svg+xml , Bioinformatics Core Facilities, IMERI, Faculty of Medicine, Universitas Indonesia- dr Cipto Mangunkusumo Hospital, Central Jakarta, 10430, Indonesia , Department of Medical Chemistry, Faculty of Medicine, Universitas Indonesia- dr Cipto Mangunkusumo Hospital, Central Jakarta, 10430, Indonesia
  • Diana Sunardi University of Indonesia image/svg+xml , Department of Nutrition, Faculty of Medicine, Universitas Indonesia- dr Cipto Mangunkusumo Hospital, Jakarta Pusat, 10430, Indonesia , Division of Clinical Nutrition, dr Cipto Mangunkusumo Hospital, Central Jakarta, 10430, Indonesia

Keywords:

Mediterranean diet, noncommunicable diseases, nutrition therapy

Abstract

Noncommunicable diseases (NCDs) remain a significant global public health concern, with a particularly high burden in Indonesia. The Mediterranean diet has been associated with a reduced risk of major chronic diseases and lower mortality rates. Despite its well-documented health benefits, the adoption of the Mediterranean dietary pattern in Asian populations, especially in Indonesia, poses a multifaceted challenge that necessitates a comprehensive and context-specific approach. This literature review aims to assess the feasibility of adapting the Mediterranean diet in Indonesia to help lower NCDs rates. Key dietary modifications involve substituting traditional Mediterranean staples with regionally appropriate Asian alternatives. The long-term sustainability of this dietary pattern depends on promoting local food production, minimizing environmental impact, and ensuring affordability and cultural acceptability.

Downloads

Download data is not yet available.

References

1. World Health Organization. Noncommunicable diseases [Internet]. Geneva. 2025 [cited 2026 Jan 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

2. Arifin H, Chou KR, Ibrahim K, Fitri SUR, Pradipta RO, Rias YA, et al. Analysis of Modifiable, Non-Modifiable, and Physiological Risk Factors of Non-Communicable Diseases in Indonesia: Evidence from the 2018 Indonesian Basic Health Research. J Multidiscip Healthc. 2022;15:2203–21.

3. Dominguez LJ, Bella G Di, Veronese N, Barbagallo M. Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity. Nutrients. 2021;13:1–32.

4. Al-Jawaldeh A, Abbass MMS. Unhealthy Dietary Habits and Obesity: The Major Risk Factors Beyond Non-Communicable Diseases in the Eastern Mediterranean Region. Front Nutr. 2022;9:1–21.

5. Martínez-González MA, Gea A, Ruiz-Canela M. The Mediterranean Diet and Cardiovascular Health: A Critical Review. Circ Res. 2019;124:779–98.

6. Galbete C, Schwingshackl L, Schwedhelm C, Boeing H, Schulze MB. Evaluating Mediterranean diet and risk of chronic disease in cohort studies: an umbrella review of meta-analyses. Eur J Epidemiol [Internet]. 2018;33:909–31. Available from: https://doi.org/10.1007/s10654-018-0427-3

7. Rai A, Misra R, Khan H, Shukla S, Patel DC, Brown A. Systematic review of the barriers and facilitators to dietary modification in people living with type 2 diabetes and pre-diabetes from South Asian ethnic populations. Diabet Med. 2023;40:1–14.

8. Gioxari A, Grammatikopoulou MG, Katsarou C, Panagiotakos DB, Toutouza M, Kavouras SA, et al. A Modified Mediterranean Diet Improves Fasting and Postprandial Glucoregulation in Adults with Overweight and Obesity: A Pilot Study. Int J Environ Res Public Health. 2022;19:1–15.

9. Martínez-González MÁ, Hershey MS, Zazpe I, Trichopoulou A. Transferability of the Mediterranean diet to non-Mediterranean countries. What is and what is not the Mediterranean diet. Nutrients. 2017;9:1–14.

10. Ogce F, Ceber E, Ekti R, Oran NT. Comparison of Mediterranean, Western and Japanese diets and some recommendations. Asian Pacific J Cancer Prev. 2008;9:351–6.

11. Todea DA, Rosca LE, Coman AC, Suatean I, Herescu AC. Benefits of the mediterranean diet in the prevention of Non-communicable diseases as the epidemic of the 21st century. Not Bot Horti Agrobot Cluj-Napoca. 2013;41:21–5.

12. Salas-Salvadó J, Papandreou C. The Mediterranean diet: History, concepts and elements [Internet]. Second Edi. The Mediterranean Diet: An Evidence-Based Approach. Elsevier Inc.; 2020. 3–11 p. Available from: https://doi.org/10.1016/B978-0-12-818649-7.00001-1

13. Menotti A, Puddu PE. Ancel Keys, the Mediterranean Diet, and the Seven Countries Study: A Review. J Cardiovasc Dev Dis. 2025;12:1–10.

14. Doggui R, Al-jawaldeh H, Ati J El, Barham R, Nasreddine L, Alqaoud N, et al. Meta-Analysis and Systematic Review of Micro- and Macro-Nutrient Intakes and Trajectories of Macro-Nutrient Supply in the Eastern Mediterranean Region. Nutrients. 2021;(Ci):1–5.

15. Mazzocchi A, Leone L, Agostoni C, Pali-Schöll I. The Secrets of the Mediterranean Diet. Does [Only] Olive Oil Matter? Nutrients. 2019;11:1–14.

16. Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011;14:2274–84.

17. Bower A, Marquez S, de Mejia EG. The Health Benefits of Selected Culinary Herbs and Spices Found in the Traditional Mediterranean Diet. Crit Rev Food Sci Nutr. 2016;56:2728–46.

18. Serra-Majem L, Tomaino L, Dernini S, Berry EM, Lairon D, de la Cruz JN, et al. Updating the mediterranean diet pyramid towards sustainability: Focus on environmental concerns. Int J Environ Res Public Health. 2020;17:1–20.

19. Khan HTA, Addo KM, Findlay H. Public Health Challenges and Responses to the Growing Ageing Populations. Public Heal Challenges. 2024;3:1–9.

20. Luo Y, Wang J, Sun L, Gu W, Zong G, Song B, et al. Isocaloric-restricted Mediterranean Diet and Chinese Diets High or Low in Plants in Adults With Prediabetes. J Clin Endocrinol Metab. 2022;107(8):2216–27.

21. Son DH, Kwon YJ, Lee HS, Kim HM, Lee JW. Effects of a calorie-restricted mediterranean-style diet on plasma lipids in hypercholesterolemic South Korean patients. Nutrients. 2021;13(10):1–14.

22. Jin SM, Ahn J, Park J, Hur KY, Kim JH, Lee MK. East Asian diet-mimicking diet plan based on the Mediterranean diet and the Dietary Approaches to Stop Hypertension diet in adults with type 2 diabetes: A randomized controlled trial. J Diabetes Investig. 2021;12(3):357–64.

23. Chooi YC, Zhang QA, Magkos F, Ng M, Michael N, Wu X, et al. Effect of an Asian-adapted Mediterranean diet and pentadecanoic acid on fatty liver disease: the TANGO randomized controlled trial. Am J Clin Nutr [Internet]. 2024;119(3):788–99. Available from: https://doi.org/10.1016/j.ajcnut.2023.11.013

24. Rosato V, Temple NJ, La Vecchia C, Castellan G, Tavani A, Guercio V. Mediterranean diet and cardiovascular disease: a systematic review and meta-analysis of observational studies. Eur J Nutr [Internet]. 2019;58:173–91. Available from: http://dx.doi.org/10.1007/s00394-017-1582-0

25. Georgoulis M, Kontogianni MD, Yiannakouris N. Mediterranean diet and diabetes: Prevention and treatment. Nutrients. 2014;6:1406–23.

26. Koloverou E, Esposito K, Giugliano D, Panagiotakos D. The effect of Mediterranean diet on the development of type 2 diabetes mellitus: A meta-analysis of 10 prospective studies and 136,846 participants. Metabolism [Internet]. 2014;63(7):903–11. Available from: http://dx.doi.org/10.1016/j.metabol.2014.04.010

27. Ramesh S KK. The burden of non-communicable diseases: A scoping review focus on the context of India. J Educ Health Promot [Internet]. 2023;12:1–6. Available from: https://journals.lww.com/jehp/fulltext/2023/02280/the_burden_of_non_communicable_diseases__a_scoping.41.aspx

28. Mirabelli M, Chiefari E, Arcidiacono B, Corigliano DM, Brunetti FS, Maggisano V, et al. Mediterranean Diet Nutrients to Turn the Tide against Insulin Resistance and Related Diseases. Nutrients. 2020;12:1–37.

29. Trajkovska Petkoska A, Ognenoska V, Trajkovska-Broach A. Mediterranean Diet: From Ancient Traditions to Modern Science—A Sustainable Way Towards Better Health, Wellness, Longevity, and Personalized Nutrition. Sustain. 2025;17:1–19.

30. Caprara G. Mediterranean-type dietary pattern and physical activity: The winning combination to counteract the rising burden of non-communicable diseases (NCDS). Nutrients. 2021;13:1–36.

31. Estruch R, Ros E. The role of the Mediterranean diet on weight loss and obesity-related diseases. Rev Endocr Metab Disord. 2020;21:315–27.

32. Mentella MC, Scaldaferri F, Ricci C, Gasbarrini A, Miggiano GAD. Cancer and mediterranean diet: A review. Nutrients. 2019;11:1–25.

33. Bazzano LA, Green T, Harrison TN, Reynolds K. Dietary approaches to prevent hypertension. Curr Hypertens Rep. 2013;15:694–702.

34. Quattrini S, Pampaloni B, Gronchi G, Giusti F, Brandi ML. The mediterranean diet in osteoporosis prevention: An insight in a peri-and post-menopausal population. Nutrients. 2021;13:1–10.

35. Alahmari LA. Dietary fiber influence on overall health, with an emphasis on CVD, diabetes, obesity, colon cancer, and inflammation. Front Nutr. 2024;11:1–13.

36. Romagnolo DF, Selmin OI. Mediterranean Diet and Prevention of Chronic Diseases. Nutr Today. 2017;52:208–22.

37. Zhao S, Zhong J, Sun C, Zhang J. Effects of aerobic exercise on TC, HDL-C, LDL-C and TG in patients with hyperlipidemia. Medicine (Baltimore). 2021;100:1–4.

38. Yu D, Shu XO, Rivera ES, Zhang X, Cai Q, Calcutt MW, et al. Urinary levels of trimethylamine-N-oxide and incident coronary heart disease: A prospective investigation among urban Chinese adults. J Am Heart Assoc. 2019;8(1):1–14.

39. Levantesi G, Marfisi R, Mozaffarian D, Franzosi MG, Maggioni A, Nicolosi GL, et al. Wine consumption and risk of cardiovascular events after myocardial infarction: Results from the GISSI-Prevenzione trial. Int J Cardiol. 2013;163:282–7.

40. Spadaccini D, Chandran A, Gonçalves Correia FP, Janji H, Ciamparini C, Tini S, et al. South Asia-specific adaptation of Mediterranean diet principles: a mixed-methods review for practical and sustainable dietary habits. Front Nutr. 2025;12:1–18.

41. Hoffman R, Gerber M. Evaluating and adapting the Mediterranean diet for non-Mediterranean populations: A critical appraisal. Nutr Rev. 2013;71(9):573–84.

42. Radd-Vagenas S, Kouris-Blazos A, Singh MF, Flood VM. Evolution of Mediterranean diets and cuisine: Concepts and definitions. Asia Pac J Clin Nutr. 2017;26:749–63.

43. Singh RB, Fedacko J, Fatima G, Magamedova A, Watanabe S, Elkilany G. Why and How the Indo-Mediterranean Diet May Be Superior to Other Diets: The Role of Antioxidants in the Diet. Nutrients. 2022;14:1–11.

44. Kankanamge R, Jeewanthi C. Modifications of nutritional , structural , and sensory characteristics of non-dairy soy cheese analogs to improve their quality attributes. J Food Sci Technol [Internet]. 2018;55:4384–94. Available from: https://doi.org/10.1007/s13197-018-3408-3

45. Woodside J, Young IS, McKinley MC. Culturally adapting the Mediterranean Diet pattern - a way of promoting more “sustainable” dietary change? Br J Nutr. 2022;128:693–703.

46. Lakshmipriya N, Gayathri R, Praseena K, Vijayalakshmi P, Geetha G, Sudha V, et al. Type of vegetable oils used in cooking and risk of metabolic syndrome among Asian Indians. 2013;64:131–9.

47. Mannucci PM, Jolliet O, Meijaard E, Slavin J, Rasetti M, Aleta A, et al. Sustainable nutrition and the case of vegetable oils to match present and future dietary needs. Front Public Heal. 2023;11:1–6.

48. Wijaya S. Indonesian food culture mapping: A starter contribution to promote Indonesian culinary tourism. J Ethn Foods. 2019;6:1–10.

49. Berry EM. Sustainable food systems and the mediterranean diet. Nutrients. 2019;11:1–9.

50. Harmayani E, Anal AK, Wichienchot S, Bhat R, Gardjito M, Santoso U, et al. Healthy food traditions of Asia: Exploratory case studies from Indonesia, Thailand, Malaysia, and Nepal. J Ethn Foods. 2019;6:1–18.

51. Antonia Trichopoulou, Miguel A Martínez-González, Tammy YN Tong, Nita G Forouhi, Shweta Khandelwal, Dorairaj Prabhakaran, et al. Definitions and potential health benefits of the Mediterranean diet: views from expers around the world. BMC Med. 2014;12:1–16.

52. Micha R, Khatibzadeh S, Shi P, Andrews KG, Engell RE, Mozaffarian D. Global, regional and national consumption of major food groups in 1990 and 2010: A systematic analysis including 266 country-specific nutrition surveys worldwide. BMJ Open. 2015;5:1–23.

53. Franchi C, Orsini F, Cantelli F, Ardoino I, Piscitelli P, Shaji S, et al. “Planeterranean” diet: the new proposal for the Mediterranean-based food pyramid for Asia. J Transl Med [Internet]. 2024;22:1–10. Available from: https://doi.org/10.1186/s12967-024-05491-2

Published

2026-10-01

Issue

Section

Review Papers

How to Cite

1.
Andayani DE, Vitia Ajeng Nur Linda, Bernadina Chyntia Carsantiningrum, Fadilah, Diana Sunardi. Adaptability of the Mediterranean Diet to Indonesian Culinary Traditions for Reducing Noncommunicable Disease Risk. JMS [Internet]. 2026 Oct. 1 [cited 2026 Oct. 1];95(3):e1657. Available from: https://jms.ump.edu.pl/index.php/JMS/article/view/1657