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Cardiovascular risk factors begin in childhood and track into adulthood, increasing the possibility of impaired cardiometabolic health. Adopting healthy dietary patterns can help curb childhood obesity, a worrisome epidemic problem at present. In the era of personalized nutrition, dietary recommendations should be adapted to different stages of life, including children (older than 3 years) and adolescents. Hereby, we present an updated version of the Mediterranean Lifestyle Pyramid addressed to children and adolescents, wihich may be used as a prevention tool by health professionals, teachers, and stakeholders. This pyramid arises from a consensus position between participants in a forum on Mediterranean Food Cultures with international experts. During this meeting, after reviewing all literature published, a consensus was reached on the new Medieterranean Lifestyle Pyramid for kids including details such as labels of the pyramid, position of foods, servings, type of foods, and healthy lifestyle habits. All components of the pyramid are supported by the most recent scientifically sound research and are based upon top-level evidence in nutritional sciences. Fruit, vegetables, legumes, nuts, wholegrains, and EVOO continue to be at the basis of the pyramid, but the importance of an adequate intake of fish, dairy products, and meat during these particular ages, when body and brain development occurs, is also considered. The promotion of physical activity, adequate sleep and good emotional health are emphasized, as well as the consumption of seasonal and local products, and overall sustainability. Improving dietary habits in early stages of life should increase health in adulthood and reduce future incidence of non-communicable chronic diseases. The Mediterranean Diet and its graphic representation in the Lifestyle Pyramid should be a health-fostering tool not only for adults and children, but also for the entire planet because it promotes the diversity of species, respect for the earth, and the local economy. CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE WHERE IT WAS OBTAINED: Not applicable STATEMENT OF SIGNIFICANCE: A new Mediterranean lifestyle pyramid is addressed to children and adolescents, as well as health professionals, teachers, and stakeholders. Fruit, vegetables, legumes, nuts, wholegrain cereals, and extra-virgin olive oil continue to be a crucial part of the pyramid, but the importance of adequate intake of fish, dairy products, and meat in these early ages, when body and brain development occurs, is also emphasized., Competing Interests: Declaration of Competing Interest ☒ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Emilio Ros reports a relationship with Alexion Pharmaceuticals Inc that includes: speaking and lecture fees and travel reimbursement. Emilio Ros reports a relationship with California Walnuts that includes: travel reimbursement. Emilio Ros reports a relationship with Spanish Arteriosclerotic Society that includes: speaking and lecture fees. Emilio Ros reports a relationship with International Nut and Dried Fruit Council that includes: travel reimbursement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Ramon Estruch reports administrative support was provided by Fundacion Dieta Mediterranea, Barcelona (Spain). Ramon Estruch reports a relationship with Carlos III Health Institute that includes: funding grants. Ramon Estruch reports a relationship with European Comission, Brussells, Belgium that includes: funding grants. Ramon Estruch reports a relationship with National Institute of Health, Bethesda, USA that includes: funding grants. Ramon Estruch reports a relationship with Cerveza y Salud, Madrid, Spain that includes: consulting or advisory. Ramon Estruch reports a relationship with Dallant Laboratories, Spain that includes: consulting or advisory. Ramon Estruch reports a relationship with Wine and Culinary International Forum, Barcelona (Spain) that includes: speaking and lecture fees. Ramon Estruch reports a relationship with Grand-Fountain Laboratories, Spain that includes: funding grants. Ramon Estruch reports a relationship with Karolinska Institute, Menarini Laboratories, Sweeden that includes: travel reimbursement. Ramon Estruch reports a relationship with Iberoamerican Foundation for Nutrition that includes: travel reimbursement. Ramon Estruch reports a relationship with Italian Pavilion, EXPO DUBAI 2020 that includes: travel reimbursement. Ramon Estruch reports a relationship with Vatican City that includes: travel reimbursement. Ramon Estruch reports a relationship with Fundacion de Investigación sobre Vino y Nutricion, Vilafranca (Spain)pain) that includes: funding grants and travel reimbursement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Rosa M Lamuela-Raventos reports a relationship with Carlos III Health Institute that includes: funding grants. Rosa M Lamuela-Raventos reports a relationship with European Comission, Brussells, Belgium that includes: funding grants. Rosa M Lamuela-Raventos reports a relationship with National Institute of Health, Bethesda, USA that includes: funding grants. Rosa M Lamuela-Raventos reports a relationship with Ecoveritas SA, Spain that includes: non-financial support. Rosa M Lamuela-Raventos reports a relationship with Cerveza y Salud, Madrid, Spain that includes: funding grants. Rosa M Lamuela-Raventos reports a relationship with UNIDECO SA that includes: consulting or advisory. Rosa M Lamuela-Raventos reports a relationship with Wine in Moderation, Brussels that includes: travel reimbursement. Rosa M Lamuela-Raventos reports a relationship with ADVENTIA SA, Spain that includes: travel reimbursement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Andrea Vania reports a relationship with Italian Society of Human Nutrition that includes: travel reimbursement. Javier Fontecha reports a relationship with Spanish Ministry of Science, Innovation and Universities that includes: funding grants. Sara Castro-Barquero reports a relationship with Alfonso Martín Escudero Foundation that includes: employment. Ana Maria Ruiz-Leon reports a relationship with Fundacion Dieta Mediterranean, Barcelona, Spain that includes: paid expert testimony. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.)