There is clear evidence that populations living in Mediterranean countries enjoy a longer life expectancy than Northern Europeans. Genetic or racial factors do not explain these societal differences as revealed by migrant studies. The major causes of death in affluent societies, cardiovascular disease, cancers and digestive disorders, show markedly different incidence rates in different European countries. These differences seem to depend on the varied dietary patterns in Europe but the classic lipid hypothesis alone fails to explain the differing rates of coronary heart disease. Limiting the free radical damage to cholesterol thereby reducing the induction of atherosclerosis is a plausible explanation for the finding that some countries, e.g. France as well as Mediterranean countries with their high fruit and vegetable consumption, are well protected against coronary heart disease. The Mediterranean diet is low in saturated fat content but contains either a high or low content of starch and total fat. A high fat diet reveals the genetically determined individual propensity to obesity, e.g. in Greece, but does not predispose to cardiovascular disease or mitigate against the cancer protective properties derived from the vegetable component of the Greek diet. Studies in the Mediterranean area highlight the considerable dietary diversity which is possible for achieving longevity.