Mediterranean Diet as a Nutraceutical and Sustainable Model for Health and Environmental Wellbeing

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The paper "Mediterranean Diet as a Nutraceutical and Sustainable Model for Health and Environmental Wellbeing" is a comprehensive and complete study of the historical evolution and nutritional profile of the so-called Mediterranean diet (MD). Particular attention is paid to the bioactive components and nutraceuticals contained in the MD and to the evidence from epidemiological studies on the benefits of the MD for human health. For me personally, the parallel that the authors draw between human well-being and the ecological balance in nature was also very interesting. Their point, which I agree with, is that a significant advantage of MD is the lower ecological footprint compared to other dietary patterns, thus being consistent with the principles of a sustainable food system. The reason is that MD is characterized by a predominantly plant-based composition, using many seasonal and locally produced foods and fewer products of animal origin, which leads to a significant reduction in the consumption of energy, water and other resources and limits food waste.

The article is impressive for its in-depth study and systematization of the bioactive components characteristic of the Mediterranean diet and the foods that contain them. On this basis, the authors suggest a reconceptualization of the traditional nutritional pyramid.

 I believe that the proposed review article is well written, complete and suitable for publication in Gastronomy without change.

Author Response

We thank the reviewer for the kind comments and encouragement. Please note that the current revision of the manuscript reflects the comments and suggestions of the other reviewers (colour highlighted).

Changes in text position and/or extensive revisions are highlight in yellow (rev2), blue (rev3) and green (rev4).

We are truly grateful for the recommendation for publication without changes, and we appreciate the time and expertise the reviewer has invested in evaluating our work.

 

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscript addresses the complex and topical issue of the mediterranean diet, emphasizing its nutraceutical benefits, sustainability, and cultural significance.

The article provides an overview of bioactive substances, environmental arguments for the Mediterranean diet, and proposes a new nutritional pyramid based on biologically active substances. The new pyramid design emphasizing bioactive components is innovative and can serve as an educational tool.

Several parts of the article are repetitive (e.g., bioactive compounds are described again in multiple sections). Chapters 3.1, 4.1, and 4.3 partially overlap. I suggest merging the sections on bioactive substances and keeping only one systematic part, perhaps with a table or diagram for greater clarity.

There is no discussion of the limitations of the studies. The extent to which the relationship between the mediterranean diet and health benefits has actually been proven, and the extent to which it is influenced by lifestyle, is not addressed.

The manuscript is rich and includes an attempt to present the mediterranean diet as a nutritionally and environmentally sustainable model of eating. 

Author Response

We would like to thank the reviewer for this insightful and constructive feedback on the proposed bioactive based pyramid and its potential as an educational tool.

Extensive revision regarding text conciseness and clarity was performed. Changes in text position and/or extensive revisions are highlight in yellow (rev2), blue (rev3) and green (rev4).

Comment: “Several parts of the article are repetitive (e.g., bioactive compounds are described again in multiple sections). Chapters 3.1, 4.1, and 4.3 partially overlap. I suggest merging the sections on bioactive substances and keeping only one systematic part, perhaps with a table or diagram for greater clarity.”

R: We have revised the manuscript according to both your suggestions as well as reviewer 4, that raised the same point.

Yellow highlight: lines 147-157, lines 212-231, lines 255-260, lines 285-293 (document without track changes); Green highlight: lines 351-379 (document without track changes).

Comment: “There is no discussion of the limitations of the studies. The extent to which the relationship between the mediterranean diet and health benefits has actually been proven, and the extent to which it is influenced by lifestyle, is not addressed.”:

R: We have now included a discussion of the limitations of the current body of evidence regarding the health benefits of the Mediterranean diet (yellow highlight, lines 255-260, document without track changes).

We are grateful for the reviewer’s valuable suggestions, which have significantly improved the clarity and scientific rigour of the manuscript.

 

 

Reviewer 3 Report

Comments and Suggestions for Authors

The proposal: Mediterranean Diet as a Nutraceutical and Sustainable Model 2 for Health and Environmental Wellbeing, is good, however, many topics are covered without going into depth, except for section 4.2. Mediterranean Diet Health Benefits, which describes some of the mechanisms by which different compounds in the Mediterranean diet modulate health. In addition, there are already many articles that discuss the benefits of this diet, so I would encourage the authors to look for a different approach or to choose one of the topics, for example, Dietary Choices and Sustainability, and discuss it in depth, also considering social factors. 

Author Response

We thank the reviewer for the constructive feedback and opportunity to strengthen the clarity, coherence, and scientific value of the manuscript.

Extensive revision regarding text conciseness and clarity was performed. Changes in text position and/or extensive revisions are highlight in yellow (rev2), blue (rev3) and green (rev4).

Comment: "many topics are covered without going into depth, except for section 4.2. Mediterranean Diet Health Benefits, which describes some of the mechanisms by which different compounds in the Mediterranean diet modulate health."

R: As pointed out in the review, there are several revision papers on the subject. We now acknowledged it and refer to some of them (lines 267-272, version without track changes, blue highlight).

Comment: “In addition, there are already many articles that discuss the benefits of this diet, so I would encourage the authors to look for a different approach or to choose one of the topics, for example, Dietary Choices and Sustainability, and discuss it in depth, also considering social factors.”

R: The rational to submit this revision was to offer a distinct perspective by integrating health, environmental sustainability and sociocultural aspects. In the new version of the manuscript it is highlighted the multidisciplinary approach linking topics such as bioactive compounds and disease prevention with underrepresented themes like food systems and ecological impact.

We are grateful for the reviewer’s input, which has helped us.

 

Reviewer 4 Report

Comments and Suggestions for Authors

The submitted manuscript analyzes the Mediterranean diet (MD) from both nutritional and sustainability perspectives. Although the topic is highly relevant and the authors demonstrate their familiarity with the literature, the manuscript in its current form lacks the scientific rigour, focus, and originality expected of a review article. Considerable revision is required before publication can be considered.

1. Lack of clear novelty and scientific contribution:

The main weakness of the manuscript is that it does not clearly express what is new compared to the existing literature. The authors mention a “reconceptualisation of the MD pyramid", but this is not sufficiently justified or elaborated. A scientifically sound review must present a critical analysis and provide new insights, not just a descriptive summary.

2. Superficial critical analysis of the literature:

The manuscript cites numerous studies demonstrating the benefits of MD, but lacks a more in-depth comparative assessment, discussion of limitations or contradictory evidence. There is no table or synthesis of data from key interventional or observational studies to support claims. A summarising table comparing key findings from recent clinical trials/studies is strongly recommended.

3. Figures and visual representations:

Several figures appear to have been taken from existing sources or directly modified. Figures should be original, schematic and created by the authors. In addition all figure and table titles should be concise and informative. Avoid general or vague labelling such as "adapted from [16]"

4. Structure and redundancy:

The manuscript is excessively long and contains considerable repetition, particularly in the discussion of polyphenols, cardiovascular disease, and diet comparisons. It should be shortened and reorganised to avoid narrative drift and ensure clarity.

5. Keywords:

Review the word chronic diseases, why this particular disease?

6. References and formatting:

Reference [16] is over-cited as it is unrelated to the content.

 

Author Response

Comment: "The submitted manuscript analyzes the Mediterranean diet (MD) from both nutritional and sustainability perspectives. Although the topic is highly relevant and the authors demonstrate their familiarity with the literature, the manuscript in its current form lacks the scientific rigour, focus, and originality expected of a review article. Considerable revision is required before publication can be considered."

R: We would like to thank the reviewer for the possibility to increase the relevance and focus of our manuscript. The current version incorporates suggestions of the other reviewers. Extensive revision regarding text conciseness and clarity was performed. Changes in text position and/or extensive revisions are highlight in yellow (rev2), blue (rev3) and green (rev4).

Comment: "Lack of clear novelty and scientific contribution: The main weakness of the manuscript is that it does not clearly express what is new compared to the existing literature. The authors mention a “reconceptualisation of the MD pyramid", but this is not sufficiently justified or elaborated. A scientifically sound review must present a critical analysis and provide new insights, not just a descriptive summary."

R: We appreciate the concern regarding the novelty of the manuscript. We consider that the main contribution of our review lies in its integrative approach, which brings together the bioactive compounds of the Mediterranean Diet (MD), its relationship with sustainability, and the reinterpretation of the traditional food pyramid. By focusing on the bioactive components, we propose a version of the pyramid that can be more widely applied and that helps to highlight, for example, the prebiotic potential of the MD (an aspect often overlooked in existing literature). This is included in the ms (lines 351-379, version without track changes, green highlight).

Comment: "Superficial critical analysis of the literature: The manuscript cites numerous studies demonstrating the benefits of MD, but lacks a more in-depth comparative assessment, discussion of limitations or contradictory evidence. There is no table or synthesis of data from key interventional or observational studies to support claims. A summarising table comparing key findings from recent clinical trials/studies is strongly recommended."

R: In the new version, and given our intended multidisciplinary approach to interconnect topics such as bioactive compounds and disease prevention with underrepresented themes like food systems and ecological impact, we adapted Table 1 and we specifically acknowledged that several revision papers on the subject (strengths and limitations of dietary influence on health) are available (lines 191-196, green highlight; lines 237-242, blue highlight - version without track changes). In our view, the newly added revision papers [Definition of the Mediterranean Diet: A Literature Review (https://www.mdpi.com/2072-6643/7/11/9139); Mediterranean diet and metabolic syndrome: An updated systematic review (https://link.springer.com/article/10.1007/s11154-013-9253-9)] in-depth discuss the subject and provided the tables referred by the reviewer.

Comment: "Figures and visual representations: Several figures appear to have been taken from existing sources or directly modified. Figures should be original, schematic and created by the authors. In addition all figure and table titles should be concise and informative. Avoid general or vague labelling such as "adapted from [16]". 

R: Thanks for raising this point. Originally created by one of the authors as part of their master’s thesis, they have since been significantly modified to ensure originality and appropriateness for this manuscript.

In this new version of the manuscript, we have improved figures and revised all figure captions to enhance clarity and precision, avoiding vague or overly general labelling. The number of figures was reduced from five to three, arrange in a more concise way to avoid repetition. Green highlights.

Comment: "Structure and redundancy: The manuscript is excessively long and contains considerable repetition, particularly in the discussion of polyphenols, cardiovascular disease, and diet comparisons. It should be shortened and reorganised to avoid narrative drift and ensure clarity."

R: Also raised by rev 2. We have revised the manuscript to improve clarity and coherence, and to eliminate unnecessary repetition-particularly in the sections addressing polyphenols, cardiovascular disease and dietary comparisons.

Several blocks of text were removed (see document with track changes) and/or rewritten and rearranged. Yellow highlight: lines 147-157, lines 212-231, lines 255-260, lines 285-293 (document without track changes); Green highlight: lines 351-379 (document without track changes).

Comment: "Keywords: Review the word chronic diseases, why this particular disease?"

R: Thanks, it should be “non-communicable diseases” as more accurately reflects the preventive potential of the MD in relation to this category of illness. (green highlight).

Comment: "References and formatting: Reference [16] is over-cited as it is unrelated to the content."

R: Reference [16] in the original version refers to a master’s thesis authored by one of the contributors and served as the conceptual foundation for this manuscript. We have carefully reviewed its citation.

Once again, we are grateful for your thorough and thoughtful review, which has significantly contributed to the improvement of our work.

 

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

The authors have satisfactorily addressed the corrections

Author Response

We greatly appreciate the Reviewer’s time and effort in improving the quality of our work.

Reviewer 4 Report

Comments and Suggestions for Authors

The manuscript has been substantially improved in clarity, structure, and integration of nutritional, functional, and sustainability aspects of the Mediterranean Diet. The expanded section on bioactive compounds and the functional pyramid enhance its scientific and educational value.
Minor issues remain: some sentences are too long, captions for Figures 1 and 3 and Table 1 are overly long—titles should be concise with detailed explanations moved to the legend.

Author Response

As indicated, we carefully revised the text to shorten overly long sentences, ensuring greater clarity and readability.

The captions of Figures 1 and 3 and Table 1 were restructured: the titles are now concise, while detailed explanations have been moved to the legends.

These changes have been implemented in the resubmitted Word document.

We greatly appreciate the Reviewer’s time and effort in improving the quality of our work.