29th June 2017

The Pioppi diet book purports to promote the principles of the Mediterranean diet for weight loss and the reduction of type 2 diabetes risk.

The Mediterranean diet has long been recognised as a healthy dietary pattern that can help to reduce the risk of cardiovascular disease.

There is no one definition of the Mediterranean diet and it varies by region, but it is an eating pattern largely based on vegetables, fruits, nuts, beans, cereal grains, olive oil and fish with smaller amounts of meat and low consumption of foods high in saturated fat, salt and free sugars.

This Mediterranean diet approach is consistent with the UK’s healthy eating guidelines, which are summarised in the form of the Eatwell Guide, and also with other evidence based healthy eating guidelines in Europe and internationally such as World Health Organisation. These dietary patterns  all encourage a  higher consumption of vegetables, fruit, wholegrains, low-fat dairy foods, seafood, nuts, seeds, legumes and lower intakes of fatty/processed meat, refined grains, sugar-sweetened foods and beverages, as well as a lower salt, lower saturated fat intake compared to the typical UK diet.

These healthy eating patterns are remarkably consistent in their association with lower risk of chronic disease. So following such patterns could lead to an improvement in the health of our nation.

The advice to cut out starchy carbohydrates such as bread pasta and rice is inconsistent with a Mediterranean dietary pattern, which typically includes these foods (mostly wholegrains) at every meal. For more information see http://mediterradiet.org/nutrition/mediterranean_diet_pyramid

It is also important to note that the Scientific Advisory Committee on Nutrition (SACN) reviewed the available evidence and did not find an association between total carbohydrate intake and type 2 diabetes and obesity, Rather they found that dietary fibre – which wholegrains make an important contribution to in our diet – is associated with lower risk of type 2 diabetes.

The Mediterranean diet is low in saturated fat – typically around 9% of energy – lower than current UK intakes (12.7% in adults). So it’s unclear why the press materials for the book appear to be promoting the idea that people can eat as much saturated fat as they like.

The Eatwell Guide, the UK’s guide to healthy eating, does not advocate diets high in refined carbohydrates/sugars, neither is it specifically low fat – as a population, we are currently meeting the recommendation on total fat consumption of 35% of energy intake from food, which is a moderate level, and is similar to a Mediterranean diet ( around 37% fat). Rather it focusses on the quality of the  diet, with appropriate choices of fat, replacing saturated fat with some unsaturated fat (like olive or rapeseedoil) and choosing wholegrain versions of carbohydrates

The issue is not that healthy eating dietary guidelines are wrong but that people are not following them, so we need to encourage people to choose better quality diets including some aspects mentioned in the Pioppi diet – such as increasing intake of fruit and vegetables and decreasing intake of free sugars.

Following a Mediterranean-style eating pattern is one way to have a healthy diet, but it is not the only one. People can use the healthy eating principles, as shown in the Eatwell Guide, to find a healthy eating pattern that works for them.