There is now a consensus about recommending the Mediterranean diet pattern for the prevention of coronary heart disease (CHD) and cancer. The most important aspect of this treatment decision, in contrast with the pharmacologic prevention of CHD (including cholesterol lowering), is that the Mediterranean diet has a striking effect on survival. The main explanation for this is that the Mediterranean diet is protective not only against CHD and cancers but also against other various chronic diseases. Furthermore, the Mediterranean diet appears to be effective at reducing atherosclerosis and the risk of fatal complications (ie, sudden cardiac death and heart failure) of atherosclerosis. Finally, unlike drug therapies, no harmful side effect has been reported following the adoption of this dietary pattern. Many micro- and macronutrients characteristic of the Mediterranean diet interact in a synergistic way to induce states of resistance to chronic diseases. More research is required to understand these complex interplays.