The purpose of this article is to review the historical development of the healthy food model of the Mediterranean Diet and related scientific knowledge from the early 1960s to the present time. The review presents the origins of the first pyramid of the traditional Mediterranean Diet in 1993 and how it has been revised to produce, in 2010, a new updated Mediterranean Diet pyramid. What emerges over the years is the evolution of the Mediter -ranean Diet from a range of specific foods to a comprehensive Mediterranean lifestyle in which food, health, culture, people, and sustainability all interact, even if its practice in the Mediterranean is diminishing. The food transition in Mediterranean countries and the emerging issues of overweight and obesity are also highlighted in the article. The present-day lifestyle is characterised by a wide availability of food and an ever-increasing rate of physical inactivity leading to a situation of apparent psycho-physical well-being, which, however, often does not correspond with the real state of health. The typical eating habits of the Mediterranean populations have been progressively enriched