Numerous health benefits have been attributed to the ‘Mediterranean diet’ over the last decades. Selecting foods that were common in the Mediterranean regions (especially Crete) in the 1970s, with a frequent and abundant intake of fruit, vegetables, fish, olive oil and perhaps wine, has been reported to be associated with wide-ranging benefits including improved glucose metabolism and decreased risk of type 2 diabetes, obesity and CVD. While the respective contributions of various types of food have been widely investigated, less attention has been paid to other factors, also characteristic of the Mediterranean lifestyle, which may contribute to the health benefits perhaps as much as specific food choices. Traditionally, the Mediterranean diet was consumed in the context of a particular lifestyle, with a fixed number of daily meals, generally consumed at later hours (compared to North of Europe), and some specific meal-related behaviours such as the post-lunch siesta. In addition, the Mediterranean diet and lifestyle that were so beneficial to health, 40 years ago, were considerably different from present-day practices. The changes are particularly clear in younger individuals and countries of the Mediterranean region presently have the highest child overweight rates in Europe. The present paper will address research about meal and satiety patterns and examine how the recent changes from traditional practices are likely to have an impact on health risks and benefits in Mediterranean populations.