The Mediterranean diet is attracting increasing attention internationally not only as a healthy diet but also as a sustainable one. Paradoxically, Mediterranean countries are moving away from this diet towards a situation in which problems of undernutrition coexist with overweight, obesity and chronic food-related diseases. The erosion of the Mediterranean diet heritage not only affects health but also has social, cultural, economic and environmental implications. Based on the outcomes of a workshop, this publication highlights the need to consolidate the Mediterranean diet as a lever to improve the sustainability of food systems and consumption patterns in the Mediterranean region.