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Evaluations of the environmental sustainability of lifestyles and consumption practices have been taking centre stage in European research projects in recent years. Considerable work has been undertaken on the environmental assessment of food consumption patterns, and several analytical tools and methodologies have been proposed to quantify the environmental burden of production and consumption. Claims have been made in several international reports that the Mediterranean diet offers the best consumption pattern in terms of both the environment and health, but there has never been a specific assessment of the Mediterranean diet in comparison with other food consumption behaviours. This paper explores the environmental burdens of the Mediterranean diet applied in the Italian context. The environmental performance of this diet is compared to the national average diet in Italy, as well as to two empirical scenarios of healthy and vegetarian food consumption patterns. The environmental burdens of the different diets are assessed in terms of their energy consumption and their carbon footprint using a hybrid IOA-LCA method. This method considers the positive aspects of both bottom-up methodologies (e.g. life cycle assessment – LCA) and top-down methodologies (e.g. input–output analysis – IOA). The results allow several comparisons to be made between the different diets. When compared with the national average diet, the Mediterranean diet reveals an improvement in environmental performance of 95.75 MJ (2.44%) and 27.46 kg CO 2 equivalent (6.81%) per family. The best overall environmental performance can be found with the vegetarian diet in which energy consumption is 3.14% lower and the carbon footprint 12.7% lower than the national average diet. [ABSTRACT FROM AUTHOR]