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Good For You

The Taste of the Mediterranean
Ten steps to a longer,
healthier and happier life

Dr Simon Poole

Let medicine be thy food,

and food be thy medicine

Dr Simon Poole 2010

Dr Simon Poole retains sole copyright to his contribution to this book
Photography Adam Poole 2010

Publication details
This book is produced on a non-profit, non-commercial, non-sponsored basis in
conjunction with the free resources available at
It is the authors belief that this guidance should be readily available and
accessed as widely as possible, and the contents of this book are therefore also
produced as a free download from the website.
Advice contained within this book is based on current scientific evidence and
theories. It should not replace the guidance or prescribed medication of a
personal physician and in the event of allergies or special prescribed diets,
further medical direction should be sought. Reference to this book should be
made as a guide to making positive changes in diet and lifestyle. Achieving a
balance of calorie intake and exercise is important for maintenance of a state of
health and fitness. If an individual has concerns about his or her capacity to
undertake changes in physical activity or weight loss they should seek medical
advice. Most of the research findings are based on adult populations and may
not be applicable to children or pregnant women.
It is assumed that readers will understand the negative effects of smoking and
obesity. Although significant benefits may be gained from following the
recommendations contained in this volume, it assumes a capability and
willingness to address general health concerns and seek further individual help
where necessary.

About Dr Simon Poole

Simon studied at St Marys Hospital Medical School,
University of London, and has been a Family
Physician since 1992. He is now a partner in a large
medical practice in Cambridge, UK.
His special interest in health promotion, nutrition
and lifestyle manifests in his role in various
organisations including:
Chairman Cambridgeshire Health Promotion Committee 1997- 2002.
Professional Executive Committee Cambridge Primary Care Trust 1999 - 2003.
Clinical Governance Lead South Cambridgeshire Primary Care Trust 1999 - 2003.
Tasked with implementing National Service Frameworks for Coronary Heart
Disease and Cancer.
Chairman Cambridgeshire Medical Committee 2003 - 2011.
Member National General Practitioners Committee since 2005.

STEP 1 A MEDITERRANEAN WEEKLY SHOPPING LIST ................................7
Shop, plan and enjoy your healthy eating
STEP 2 BRINGING COLOUR TO YOUR TABLE ...............................................13
Take advantage of natures colourful gifts of strength
STEP 3 HEALTH GIVING OILS............................................................................17
Bring the ancient powers of oils to your every day
STEP 4 BOWLED OVER BY FRUIT ....................................................................25
Experience fruit at its best and achieve your 5 a day
STEP 5 FABULOUS FAST FOODS ......................................................................27
Healthy snacking in between meals
AND LUSCIOUS LEMONS......................................................................30
Fantastic flavouring and salt substitutes
STEP 7 SEEDS OF LIFE .......................................................................................34
Omega 3s without the bones
STEP 8 WONDERFUL WINE (TEA AND COFFEE).........................................37
Drink yourself healthy (within reason!)
STEP 9 A SECRET CHAPTER FOR CHOCOLATE LOVERS ...........................40
Ssshhhhhhh! its positively good for you
STEP 10 EXERCISE FOR ENERGY......................................................................43
Fitness and health for bodily wealth
APPENDIX ....................................................................................................................48
SOME EXAMPLE RECIPES .........................................................................................58

Doctors learn much from their patients. Some years ago I had the privilege of
meeting Peter. This book is dedicated to Peter and all those who, like him, seek
to enjoy life to the full and who are committed to positive actions to maintain a
healthy body and active mind.
I first met Peter one busy Monday morning. His broad smile contrasted with my
mood. It seemed that all morning I had been lecturing...
...try to avoid eating too much fat ... know your diet is probably affecting your Blood Pressure ...
...I know how hard it is to exercise after a long and tiring day, but your
sedentary lifestyle is really not helping your weight ...
I started to imagine my own blood pressure rising as I suspected the slim notes
in front of me meant that his records had been lost, but soon realised that this
was one of Peters rare visits for medical advice. I cannot recall the reason for
the consultation, but he mentioned that he was flying off to Spain later that day.
Rather enviously I enquired further into his lifestyle. It transpired he had bought
a property in Spain prior to retirement, and spent half of the year there. He
explained with unrestrained enthusiasm how he had undergone a transformation
after his brothers untimely death a few years previously. He had begun by
exercising regularly and soon sensed the reward of feeling the buzz of physical
fitness. A trip to Spain had resulted in a love affair with the Mediterranean
cuisine and way of life, culminating in his moving to set up a home in Barcelona.
Peters dedication to enjoyment of the abundance of life was complete. He
described the olive groves and lemon orchards, the vineyards and the harbour
fish markets. With a smile he recalled his first invitation to a neighbours farm,
where the elderly grandmother had prepared the onions, garlic, peppers, lemon
chicken and tomatoes with the local olive oil and herb marinade. And with a
twinkle in his eye he parted with the conclusion that he was blessed not only by
good health, but that his wife and he were probably closer than they had been
throughout their long marriage...
As time has passed, I have come to appreciate the truth in Peters words. Of
course chance decrees there may always be misfortune and unavoidable illness,
but scientific evidence is increasingly demonstrating the astonishing health
benefits of the Mediterranean diet and lifestyle. The wonderful coincidence is
that this wholesome, tasty and complete way of life can confer extraordinary
health benefits and achieve a longer and healthier experience of being.
Even smiling and laughter have been shown scientifically to have positive
physical effects. So the time has come to celebrate those gifts of nature and the
possibilities in ourselves to welcome simple changes that will be positively good
for us.

Eating to Enjoy
Diet is thought to be a causal or contributing factor in up to half of cancers.
Lifestyle (lack of exercise and dietary habits) is thought to be a direct cause
in over fifty percent of heart attacks.
Diet patterns as recommended in this book have been shown scientifically to
reduce the risk of cardiac events by 76% and to potentially increase life
expectancy free from heart disease by an average of nine years. (ref 1)
In recent years we have become accustomed to negative messages in relation to
what we do and eat. We are constantly reminded of the harm food can do to us,
whether in relation to fat, alcohol, salt or sugar. And indeed studies show trends
of increases not only in calorie intake but also of sugar, salt and saturated fats,
especially with the ready availability of processed foods. Such dietary patterns,
along with a more sedentary lifestyle contribute significantly to the exponential
increase in levels of obesity, with associated diabetes and high blood pressure,
as well as the incidence of heart disease and cancers. There is an over simplistic
response in Government advice. The message to eat a low fat, high
carbohydrate diet has been shown to be flawed since different carbohydrates
and fats have varying effects on blood sugar and lipids, and has been seriously
undermined by fad diets such as those that promote precisely the reverse i.e.
high fat, low carbohydrate consumption.
The evidence that is becoming widely accepted confirms that certain types of fat
are positively good for you, providing protection against heart disease and
many types of cancer. These are the monounsaturated fats contained in olive oil
which may be consumed freely as part of a balanced diet where exercise and
overall calorie intake ensure that weight remains within recommended limits.
Manufacturers of spreads and margarines have made claims about the benefits
of substituting saturated fats with certain polyunsaturated fats in their products
but there is increasing evidence that high levels of these omega 6
polyunsaturated fats decreases the bodys ability to utilise the beneficial
omega 3 polyunsaturated fats found in oily fish, certain nuts and linseed
(flaxseed). Consequently most of the potential benefits of polyunsaturated fats
is dependent on us getting the right balance of fats. In western cultures we
consume a ratio of fats which is unhealthily skewed towards an excess of
saturated and omega -6 polyunsaturated fats.
Not only are we understanding better the roles of fats in the diet, but the last
decade has seen the acceptance of the importance of the glycaemic index of
carbohydrates. The processed and refined carbohydrates so common in our
foods result in quick breakdown and absorption of sugars, which, in
combination with the sugars in drinks and snacks are contributing to the rise in
incidence of both obesity and diabetes. The more natural diet for which our

Positively Good For You

bodies have evolved over millennia comprises of sugars in foods such as honey
and fruits, complemented with low GI foods such as wholegrains, brown
(unmilled) rice, unprocessed cereals and oats. These unrefined, starchy
carbohydrates release sugar loads in a more controlled way and also retain the
fibrous husks, often rich in vitamins and minerals, which contribute to bowel
health and reduce cholesterol absorption It is surely time for educated western
consumers to take charge of our diet and lifestyles.
Governments may nanny or nudge, the food industry may have conflicts of
interest, manufacturers may continue to promote supplements and pills of
dubious benefit, but we alone have the final say in the choices we make.
The environmental impact of our modern system of food production is beyond
the scope of this book, however, the ability to sustain our natural world is
dependent on a more natural approach to diet and lifestyle. The ancient
traditions of farming and husbandry, soil maintenance and patterns of consumer
demand associated with the Mediterranean Diet should enable us to better fulfil
our obligations to maintain a balance which is more healthy for us as individuals
and also for our planet.

Horrible or Healthy?
This confused picture allows retailers to claim health benefits of products where
modest changes to processed foods can permit them to be included in a healthy
eating range when it is merely somewhat reduced in calories or fat.
There are numerous examples where foods are promoted as low in fat to imply a
more healthy choice, where the fats reduced are in fact the healthy good fats, or
when the product has very high levels of sugar. Consumer groups have rightly
demanded clearer food
labelling, to empower the
customer to choose and to
inform of the nutritional
content. Whilst this is limited in
scope as it does not describe
the many positive
micronutrients in foods, if care
is taken to read the small print,
it may be possible to begin to
reverse the trends of
increasingly processed and
unhealthy foods.

To illustrate this point there follows a sample of ingredients as recorded on a

ready made chicken dish , followed by sponge pudding both of which are sold in
the HEALTHY LIVING section of a leading supermarket;
White rice, water, dehydrated chicken (20%), modified maize starch, salt, tomato
ketchup, onion, sugar, red pepper (2%), pasteurised egg, vegetable oil, dried
skimmed milk, potato starch, stabiliser, xantham gum, white pepper, pectin, light
soy sauce, colour (capsanthin), sweetener (aspartame), chicken stock, duck fat,
dextrin, flavourings, chicken skin, maltodextrin, chicken broth, molasses, acidity
regulator, lactic acid, potassium sorbate, pork gelatine and caramelised sugar
And for desert;
Water, raspberries(22%), sugar, wheat flour, pasteurised egg, modified maize
starch, dextrose, humectant, milk protein, whey powder, wheat starch, disodium
diphosphate, calcium phosphate, polyglycerol esters of fatty acids, mono and diglycerides of fatty acids, rice starch, guar gum, xantham gum, salt and citric
Imagine how that compares with the goodness and taste of a freshly prepared
yet simple dish of red onions, yellow peppers, tomatoes, garlic and lemoned
chicken pieces fried in extra virgin olive oil. Tossed in herbs and spices, served
with wholegrain rice and a glass of good red wine. Followed by a mixture of
fresh fruits pieces of oranges, peaches, strawberries, grapes and plums.

Curing Antioxidants, Clogs and Clots

And of course there is so much more to a diet than simply fats, carbs and
proteins. Not only do we know much more about vitamins and minerals, but the
most exciting areas of scientific discovery in the next twenty years will
undoubtedly centre around the micronutrients such as phytochemicals or so
called bioactive compounds. This relates to specific ingredients in foods that
have the capacity to neutralise harmful oxidating compounds called free radicles
that we all produce in our cells and which are believed to be contribute to the
formation of cancers and heart disease as well as other diseases of ageing.
There are a number of contributing factors which play a role in atheroma the
narrowing of arteries associated with heart disease and strokes. This clogging
of blood vessels with fatty plaques is much more likely to occur in a diet high in
saturated fats, but it is the clots which can suddenly break away from these
plaques which can cause the most catastrophic blocking of arteries which
occurs in most strokes and heart attacks. Oxidation and the damage by toxic
free radicles is now believed to play a part in the destabilisation of the fatty
plaques, which perhaps explains the reason why the adoption of a diet rich in
antioxidants and antiinflammatory components can prevent acute events of
illness at almost any stage in life. In short, it is never too late to improve health
through dietary and lifestyle changes!

Positively Good For You

The Mediterranean Diet

For some time it has been recognised that populations in Mediterranean countries
live longer, healthier lives. This has been shown even in areas that are relatively
deprived compared with the wealthier countries of North West Europe. The
benefits can be shown if the dietary principles are adopted by people living outside
the areas where the diet originates, and also that the health of individuals
deteriorates if they stray from their traditional diet and consume processed, high
saturated fat diets of Western Europe.
Perhaps the greatest challenge for health services in the Western World is the
obesity and diabetes time bomb. World Health Organisation figures predict
exponential rises in these conditions and the associated incidence of heart disease
and cancers. Sadly even the governments of those countries in the Mediterranean
are struggling to reverse the decline in adherence to a healthy diet as processed
and high saturated fat produce becomes more readily available in these economies.
Government and National Health Service advice refers directly to the qualities of
the Mediterranean diet, and European Union funding has been allocated to
educational initiatives to promote the diet, now recognised by UNESCO. The
principles of the Mediterranean Diet are not exclusive to a single unique
geographical or cultural area, rather, as researchers have described, the pattern is
becoming a comprehensive popular and successful translational paradigm for the
promotion of healthier lifestyles.
International scientific studies continue to demonstrate the evidence, and are
beginning to explore the components that might contribute to the advantages.
Indeed some producers of vitamins and supplements are already beginning to
market pills that claim to confer the same health gains such as garlic capsules or
concentrated tomato tablets.
But why pop a pill when you can enjoy the beautiful fresh produce itself? AND
BENEFITS THAT ARE CLAIMED. The secret lies in the complexity of combination
of substances in the whole foods.

How to use this book

This book is designed to help you change the way you live in a simple and
accessible way. To celebrate the goodness of what you eat, enjoy physical fitness
and to delight in foods that are positively good for you.
The chapters that follow provide examples of how to apply some whole diet
principles to daily life, and how to incorporate the health advantages in a busy
week. Some authors of dietary books include sophisticated recipes and meal
menus to guide readers. However, experience shows that such complex and
regimental advice is almost impossible to integrate into hectic modern life.

Understanding the balance of foods in a diet is far more important than having
a list of fine cuisine recipes that assumes we have the time and skills to be
celebrity chefs! The Mediterranean diet pyramid and the health benefits of
many beautifully colourful fresh fruits and vegetables may be brought to our
daily lives by simply ensuring that they are included in the weekly shopping
list. The nutritional benefits of these gifts of nature is not dependent on
whether they are prepared in a simple way or used in a sophisticated
combination when there is more time for preparation and reference to cookery
There is also some evidence that certain individual foods possess health giving
qualities. These have usually been shown to contain chemicals called
antioxidants and are often common constituents of the Mediterranean diet
which protects against cancers and heart disease.
Later chapters are dedicated to these positively good for you foods, to
celebrate their wonderful properties and taste. Perhaps most importantly there
are simple suggestions to help bring them into everyday use in an
approachable way.

Ten simple, enjoyable steps to a healthier, longer life. . .

Make an active choice to achieve this!

Positively Good For You

A Mediterranean weekly shopping list
Shop, plan and enjoy your healthy eating
The traditional diet of the peoples of the Mediterranean has been shown to be
the healthiest diet in the World. Scientific study after scientific study has
demonstrated that people who eat such foods in the proportion outlined in the
Mediterranean Diet Pyramid not only live longer, but have significantly lower
risk of heart disease and many cancers, including bowel, prostate and breast
...Mediterranean diet cuts death rate by 50% ...
...The Mediterranean diet is positively associated with healthy longevity...
...The Mediterranean peoples have reduced risks of bowel, breast and prostate
cancer, as well as heart disease, stroke and diabetes...
...The Mediterranean Diet appears to significantly reduce the risk of
suffering from dementia including Alzheimers disease, depression, high blood
pressure, arthritis and asthma ...
(refs 2 -14 )
The diet is high protection/low damage, essentially meaning that there are
relatively small quantities of the undesirable saturated fats, but high amounts of
cancer beating, heart protecting fruits, vegetables, antioxidants, olive oil and
fish oils.
Much of the advice on healthy eating is negative and restrictive. Many diets are
focused exclusively on weight loss and make meal times a miserable experience.
There are even fad diets that are potentially dangerous to long term health and
expose people to increased risk of heart disease and cancer.
The beauty of the ancient diet of the Mediterranean is that it provides a
wonderfully healthy, tasty and complete diet that is centred around fresh, non
processed, readily available natural produce. It is ready made, balanced and
nutrient rich. Low in saturated fats, low in salt, and with a low glycaemic index,
there is evidence that it is a healthier and more successful weight controlling
lifestyle than the low fat, high carbohydrate much promoted in the last few
years. Furthermore, people are more likely to persevere and make long term
changes when they are delighting in a wide variety of enjoyable foods.
We feel how we eat; there is increasing evidence that our diet can affect our
mood and that the Mediterranean Diet may help to maintain a healthy mind. Not
only does the Mediterranean Diet seem to significantly reduce the risk of
Alzheimers Disease and other forms of dementia, but studies also support the
notion that a Mediterranean style diet can protect us from depression. We
intuitively know that an unhealthy lifestyle full of saturated fat and processed

foods reduces our sense of wellbeing, and now scientific research has illustrated
very elegantly that the dietary advice contained in this book can reduce the risk of
depression by as much as thirty percent (ref 18). It is thought that the low
glycaemic index, high vitamin and antioxidant Mediterranean Diet may increase
serotonin levels in our brains. Olive oil, fruit, vegetables and nuts are all likely to
contribute to this effect.
An important analysis of the combined findings of a number of studies in 2008
published in the British Medical Journal recognised the profound impact of the
diet on rates of cardiovascular disease and cancer, presenting the sum of medical
evidence in support of the benefits for individuals and society if there was more
widespread adherence to the principles of the Mediterranean Diet. (ref 16 ).
A further large study demonstrated the advantages of the Mediterranean Diet in
the prevention of metabolic syndrome the description of obesity, high blood
pressure and adverse sugar and fat levels in the blood which can eventually lead
to diabetes (ref 17 ).
In short, the evidence for the benefits of the Mediterranean diet is compelling.
So, now lets enjoy the exquisite taste combinations and fantastic foods which
we know can add up to a healthier and longer life.

So whats the Mediterranean Diet

all about?
In a nutshell:
Lots of fresh beautiful fruit.
Lots of luscious and varied vegetables.
Lots of delicious legumes, beans and high grain/fibre cereal products.
Lots of fine extra virgin olive oil (positively good for you monounsaturated fat).
All frying in olive oil.
Plenty of fresh oily fish (positively good for you omega 3 fats).
Plenty of crunchy natural nuts and seeds (positively good for you omega 3 fats).
Moderate amounts of low fat dairy products for protein strength.
Moderate amounts of wonderful wine, generally with a meal.
Moderate amounts of white meat.
Low consumption of red meat. But hey lets really enjoy the occasional grass
fed, organic fillet steak!
Low consumption of potatoes, white bread, and salt.
Low consumption of biscuits, cakes, margarines and other baked products high
in transfatty acids (positively BAD for you).

Positively Good For You

Plan your weekly shop and meal plans around the Mediterranean Diet Pyramid.
For example, a week may be planned around two fish dishes, two poultry, two
vegetarian based and a single meal with red meat. Clearly, it is sensible to buy
low fat red meat, and to eat modest servings eg 60g per person. Most people can
increase their intake of vegetables and fruit if portions of meat are reduced.
By applying these general principles it is easy to adopt a more balanced and
healthy proportional intake of food and construct a planned weekly menu with
simple or sophisticated recipes to achieve this.
The pattern of eating will result from the pattern of shopping. Many people find
it useful to attach a laminated pyramid illustration to their fridge as a positively
reinforcing message to encourage the right proportion of content of cupboards,
freezes and chillers.
Remembering that the ideal diet is low in saturated fat, salt and sugars, we can
increasingly use the labelling on food products to restrict our intake of often
hidden harmful or inappropriate nutrition and to maximise the benefits of the
calories we absorb.
The importance of a diet balanced in calorie intake and output is an essential
component of the traditional diet and lifestyle of the Mediterranean, where
regular physical activity has been integral to daily life. The dietary pattern is one
associated with maintenance of a healthy weight, and has become accepted as
one of the most successful and sustainable ways to keep within recommended
body mass indices, in combination with an awareness of calorie intake, portion
size, food properties including glycaemic index, and a commitment to regular
physical activity which has benefits of its own.

Mediterranean Diet Pyramid

A contemporary approach to delicious, healthy eating

The Mediterranean Diet pyramid concept illustrated above and reproduced by

kind permission was conceived by nutritionists and epidemiologists from
Oldways working with the World Health Organisation and Harvard School of
Public Health. The aim was to pictorially represent the nutritional balance in the
diet of the areas in the Mediterranean with the lowest recorded rates of chronic
disease and the highest adult life expectancy.


Positively Good For You

Recipes, Food Combinations

and Meal Ideas
The Mediterranean Diet is about day to day simple patterns of eating and
ingredients rather than complex cuisine or time consuming recipes, unless of
course there is special occasion to celebrate.
Referring to the Mediterranean Diet Pyramid, a visit to the supermarket can
ensure stocks of basic ingredients are easily accessible to create a wonderful
food experience. Brown rice, pasta, couscous, other whole grains and potatoes
can form the low GI carbohydrate which combines with vegetables or beans and
perhaps fish, lean white or red meat to create a balanced, nutritious and
complete meal.
Salads are a beautiful accompaniment to fish and meat, in particular combining
the colours of a summer garden at any time of year.
Herbs and spices are
readily available in
packets, dried or fresh
to add flavour and
variety to meals. They
can even be purchased
in convenient plastic
tubes. Alternatively
potted herbs around the
kitchen or patio,
replaced from time to
time, allows fresh leaves
to be always available.


Jazzing up the Carb the lowly potato, so common in Western

European diets can be given the Positively Good for You Mediterranean
treatment. Try baked potatoes seared with fresh rosemary and a little garlic, or
part boiled and sliced potatoes roasted until crisp with a drizzle of olive oil and a
sprinkle of paprika. Why not pour a little passata over the roasting vegetables
and throw some basil leaves on at the time of serving. And what about mash
with a dash mash potato with a dash of olive oil and crushed garlic or chilli.
Similarly brown rice is wholesome simply boiled but can add flavour and
goodness to a meal with fried or raw red or spring onion and herbs sprinkled on
top. Perhaps fry the onion in a little ginger from a bottle or tube.

Salads endless combinations at least once try the super- salad, loaded
with antioxidants and colour, the only challenge will be finding a bowl big
enough. This can be served with grilled lean meat or fish and olive oil roasted
potatoes. Include; lettuce, tomatoes, pitted olives, mixed nuts, red onion,
beetroot, radish, mixed peppers, sun dried tomatoes, finely chopped carrots,
fresh bay leaves, cucumber, red grapes, seeds and a sprinkle of grated cheese or
feta. Perhaps add a little avocado... or even beans!

Dressings, instant marinades, and drizzles to accompany a salad,

to drizzle onto vegetables or to marinate or glaze grilled roast meat and fish,
simply mix up a special olive oil dressing. Again the combination of flavours
from simple and positively good for you ingredients is almost endless. From a
basic mix of extra virgin olive oil with balsamic vinegar or walnut oil, the scope
for dressings is wide and can include many ingredients which combine healthy
antioxidants with fabulous flavours. A dressing might include olive oil, perhaps
combined with some flax oil and proportions to taste of lemon juice, sundried
tomato paste, honey, chopped garlic and herbs. Some chopped chilli or mustard
will add spice and white wine or balsamic vinegar can enhance the rich
peppery experience. If used as a glaze, a little yoghurt can be placed lightly on
top of the meat. The spice route passed through the Mediterranean and the spice
markets of Istanbul combined traditional herbs of the Mediterranean with more
exotic flavours from India and the Far East. Stir frying vegetables with seafood
or meats in olive oil with spices such as, chilli, turmeric, ginger and soy sauce is
a great way to include such produce.

STEP 1: The Bottom Line Plan your meals and shopping

around a well balanced Mediterranean diet.


Positively Good For You

Bringing colour to your table
Take advantage of natures colourful gifts of strength
When shopping, think beautiful natural colour.
Many plants contain compounds that provide significant health benefits, and
many of the bright colours in fruits and vegetables represent these so called
phytochemicals which are believed to have many antioxidant effects. Such
natural chemicals protect the body by neutralising free radicals or unstable
molecules which can damage body tissue and lead to ill health, defending
against cancer, diabetes and heart disease. Colourful foods are frequently rich in
vitamins which are in themselves beneficial and have been known for many
years to prevent ill health.
There are hundreds, perhaps thousands of these substances in our diet, and
study of their effects is in its very early stages. It has long been accepted that the
bright colours in seed containing fruits are an evolutionary means by which a
plant attracts an animal to eat the fruit, and deposit the undigested seeds in a
packet of fertiliser some distance away from its parent. There is a further
suggestion that evolution might have favoured plants that have incorporated
health giving properties into the chemistry of the fruit in addition to the
antioxidant protection conferred by the chemistry to protect itself. After all, the
mutually beneficial relationship between the plant and the animal would be
further enhanced if the colours that attract the animal bestowed not only the gift
of food, but also of medicine, to ensure the healthy survival of the creatures
upon which the plant depends for its successful procreation and evolution.
And colour brings beauty and joy to any dish. Imagine if the food on our plate
was entirely grey. Suppose it tasted the same, but was completely grey. Please
do not hold that thought for long, because we are blessed with an array of
colours that bring visual and tasteful delight to our table.


Shop for red fruits and vegetables. These include;

Red grapes

Red peppers

Red grapefruit



Red apples



Red onions

The specific phytochemicals in many of these products include lycopenes and

anthcyanins. As well as a possible role in heart health, a Harvard study has
suggested possible benefits of lycopenes in prevention of cancer of the prostate.


Positively Good For You

Shop for blue fruits and vegetables. These include;




Purple grapes



Purple cabbage

The specific phytochemicals in these products include anthocyanins and

phenolics. These antioxidants may play a part in the prevention of cancers and
heart disease by reducing cell damage.

Shop for green fruits and vegetables. These include;








Leafy greens

Green apples


Green grapes



Green cabbage


The specific phytochemicals in these products include lutein and indoles. Such
compounds are believed to have anti cancer effects, and their consumption is
considered to be associated with a lower risk of many types of cancers.


Orange and Yellow

Shop for orange and yellow fruits and vegetables. These include;


Yellow peppers




Butternut squash





Yellow pears



The specific phytochemicals in these products include carotenoids and

bioflavanoids. Similar antioxidant properties to reduce risk of heart disease and
cancer may be associated with these compounds.

White and Brown

Other fruits and vegetables are thought to contain bioactive chemicals. For
example ginger contains the antioxidant gingerol, onions and garlic contain
allium which may help fight cancer and improve immunity, and dates are a
particularly concentrated source of antioxidants.

In summary, preparing highly coloured nutritious salads and vegetables

packs a punch of powerful vitamins and phytochemicals for which there
is increasing evidence of possible protection against heart disease and

Next time you prepare a Saturday lunch or take sandwiches into work, spend a
few minutes preparing an accompanying salad consisting of lettuce, tomatoes,
red pepper, yellow pepper, olives, carrot, cucumber, onion, with an olive oil
dressing (see step 3). This provides perhaps hundreds of compounds that
promote health and well being.
What a glorious feast of colour and goodness!

STEP 2: The Bottom line Colourful fruits and

Vegetables are packed with goodies to prevent disease.
Buy more, eat more.


Positively Good For You

Health giving oils
Bring the ancient powers of oils to your every day
Olive oil is the cornerstone of the most healthy diet in the world. It is ubiquitous
and abundant. The proven benefits of the diet are likely to be related to the
enjoyment of olive oil as the principal source of fat. Olive oil contains many
constituents that are considered to confer health both in terms of the type of fat
and also the compounds that have antioxidant properties. There is emerging
evidence that a proportion of the benefits of the Mediterranean diet as a whole
relate to the specific contribution of olive oil itself. A recent study of a
population of more than 8,000 over 65 year olds demonstrated that those
consuming regular amounts of olive oil had significantly reduced risks of stroke.
The risk was reduced on average by 41%, but as much as 78% if those consuming
the highest and lowest quantities of olive oil were compared.
(ref 3 and 14 )
Olive oil is consumed in large quantities in the Mediterranean region. As much
as a litre a week in many households. It is used for frying, to accompany salads
and vegetables, to moisten and soften foods and as the only source of fat in the
traditional diet. Extra virgin olive oil is the most unprocessed oil and is widely
available as the finest and most palatable form of the pressed juice of the olive.

Olive oil in ancient times

The olive tree and its fruit held a special place in antiquity. It was considered to
have healing properties as well as providing nutrition and wealth. The great
civilisations of the ancient Mediterranean were often built on the trading of olive
oil, which was used as food, medicine, balming oil, soap and fuel for lighting.
Indeed such was its importance that the tree was the subject of legend and
poetry. The Goddess Athena bestowed the gift of the first olive tree to the
peoples of Athens and the demigod Hercules carried a club cut from a sacred
tree. The tree was protected by law and later became the subject of frequent
biblical reference including mention of its healing qualities.
These civilisations invented many ideas that have been incorporated into
modern medicine.
The language of medicine and much of science is derived from the doctrines
inherited from the wisdom of those who so valued the olive tree, its fruit and oil.


FATS the Good the Bad and the Ugly

Fat is a vital part of a healthy balanced diet. Fat can be good for you. Fat in the
diet does not necessarily make you fat!
The simplistic message promoted in Western Europe is to reduce fat in the diet
to below 35%. However, the reasons that underlined this advice were based on
the knowledge that populations in Western Europe consumed too much BAD
SATURATED fatty acids. (SFA) that is strongly implicated as a contributing
factor in the development of heart disease and cancers. Such peoples were also
at risk of being overweight or obese.
Western populations also consume TRANSFATTY ACIDS. These are the fats that
occur in biscuits, cakes and the scummy stuff that occurs after frying in butter
or unhealthy oils.
Seriously UGLY fats! Look for partially hydrogenated fats on labels. This is
another term used for these disgusting, artery clogging fats.
In Crete, studies have shown that the inhabitants consumed a diet that is made
of 40% fat and is exercise balanced, and they enjoy the best health and live
longer and healthier lives with a lower risk of obesity.
So why is this?
More than 80% of the fat content of the diet is olive oil. Unlike any other oil or
fat, extra virgin olive oil is comprised almost entirely of MONOUNSATURATED
fatty acids (MUFAs).
MUFAs reduce bad cholesterol.
MUFAs reduce the risk of heart disease and stroke.
MUFAs may play a role in preventing some cancers.
Essentially, as long as there is exercise to match needs to maintain a healthy
weight (BMI), intake of MUFAs (including those of olive oil) need not be
Take, for example, an international rower who needs to eat 6000 calories per day
(compared with the average of 2,500). If he trains and utilises his energy intake,
replacing with foods that are positively good for him such as MUFAs in olive oil,
he can reap the extraordinary benefits of the cardiovascular advantages of
exercise and cholesterol lowering, heart protecting foods.
Clearly we cannot all aspire to be international rowers and eat 6000 calories per
day, but we can certainly aim to increase our fitness and replace burnt calories
within our weight recommendations with foods that contain positive health
So, there is potential to enjoy wonderful heart healthy foods to replace calories
expended on wonderful heart healthy buzzy exercise... (we shall explore more
about exercise buzz in chapter 10).


Positively Good For You

Olive oil for health

Olive oil tastes fantastic and there is increasing evidence to suggest that
The understanding of the mechanisms for the possible effects described above is
Olive oil contains numerous antioxidants and has effects on blood vessel walls
and blood clot formation. It even acts to cleanse the body of bad fats after a
Oleic acid and other compounds in olive oil have been shown to reduce the
action of bad genes in breast cancer, and there are naturally occurring
substances that have chemical structures similar to those used to fight cancers.

Celebrating olive oil

A fine olive oil is comparable to a fine wine with flavour and aroma dependent
on climate, soil and weather. Olive oil connoisseurs can distinguish great variety
in quality, and describe flavours and bouquet that vary with estate and vintage.
It does not take long to become familiar with the various oil producing areas,
and the taste and quality of the harvest.
Although Italy exports a high proportion of olive oil, Italian shippers source
most of the product from Greece and Spain. Probably the most celebrated
examples of finest quality derive from Greek estates, and many specialist
delicatessen outlets stock first class varieties.
The advice regarding blended or olive oils other than extra virgin is quite simply
not to waste money on them. They have reduced benefits and the taste is far


Benefits of olive oil

from theory to practice
Given the opportunities to improve ones health and wellbeing through enjoying
more positively good for you olive oil, it is once again important to translate
these possibilities from theory to practice.

Olive oil can be used in cooking and also for marinades. Any vegetable, fish or
meat can be refrigerated for some hours covered in olive oil and a combination
of favourite flavours. For example spices, chilli, herbs, honey, garlic, tomato
paste, lemon juice etc.
The marinade can be poured into a large pan or wok and used to fry the meal
that will have already tenderised and absorbed the delicious tastes.

A fine oil can be sampled alone, or alternatively wholemeal bread can be dipped
into a small bowl of good quality olive oil. This can be mixed with a little walnut
oil or balsamic vinegar to enhance the flavour.
If dining out, most restaurants will provide this as an alternative to butter to
accompany a meal. In fact, many chefs will delight in sharing their most
precious olive oil with a discerning customer.
Most supermarkets also stock infused or scented oils, though a simple
alternative is to add garlic, fresh herbs, peppers or even cinnamon or citrus
fruits to oil and allow to infuse for a day or two. Olive oil is a natural
preservative and has a long shelf life if stored in a cool dark place.

Oil on the table

To have a beautiful oil bottle adorning the table is a statement of taste and
appreciation of health. Knowing its value in maintaining physical fitness and its
fabulous flavour, it can be added to any meal.
Though mashed potato is not the most nutritious of side dishes, it can be
enhanced beyond measure by the addition of raw olive oil from the table.
Similarly any meal can be accompanied by a simple salad of greens, tomatoes
and peppers bathed in olive oil.


Positively Good For You

Salads can be flavoured with simple oil or infused oils. Alternatively an
antioxidant dressing can be simply prepared.
Adding ingredients such as those described for a marinade can provide flavour
and goodness.
So, for example a dressing may contain approximately 80% olive oil with
tablespoons of balsamic vinegar and walnut oil, honey, a teaspoon of dried
herbs, some lemon juice, a squirt of chilli paste, tomato and garlic paste, and
even a sprinkle of powdered flax seed.
Such a dressing is easy to make in a few minutes and contains a powerful mix of
compounds that are known to have proven or theoretical effects on the body to
lessen the risk of ill health.


Walnut oil
Extra virgin olive oil is the most important oil in terms of health benefits. It is
quite simply the best source of life-giving MUFAs which have such beneficial
effects on cholesterol levels and reducing the risk of heart disease. As we have
seen, there are hundreds of other compounds in olive oil which add to the
experience of fantastic taste and make it positively good for you...
However, there are other plant based oils that are believed have benefits. And
for different reasons. In Step 7 we shall explore the importance of Omega 3
PUFAs. The good fats (MUFAs) the bad fats (SFAs) and the downright ugly
(Transfats) are not the only fatty acids in our diet.
Despite the best efforts of margarine manufacturers, the claim to be high in
polyunsaturates that we have heard over the years, should cause us to be less
than impressed.
Most PUFAs are Omega 6 types and we probably have too many of these in our
diets. BUT there are some PUFAs that are positively good for us the Omega 3s!
Omega 3s are contained in walnut oil, flaxseed oil and rapeseed oil.
Walnut oil is probably the most tasty. It has a fine and subtle flavour that can
enhance olive oil when mixed together in dressings or simply as a dip. Generally
a combination of olive oil to walnut oil mixed in ratio of approximately 5:1
provides a wonderful blend of flavour and nutritional goodness. Available in
most supermarkets, try it!

Hemp oil
Hempseed oil in small quantities can be added to olive oil to provide a nutty
flavour that can enhance dressings. It is a rich source of omega 3s, omega 6s and
MUFAs so is an alternative to walnut oil in its possible health benefits.

STEP 3: The Bottom Line- olive oil has numerous health

giving effects. Make it readily available for cooking,
dressing, splashing and mixing. Get to know it, get to love it.


Bowled over by Fruit
Experience fruit at its best and achieve your 5 a day
We have seen in previous chapters how fruit packs so much goodness into your
diet, and concentrates nutrients, vitamins and antioxidant potential.
Yet despite an abundance of choice and tastes, we still do not maximise the
possibilities of these guardians of health.
There follow a number of ideas to place fruit at the centre of our living, to
ensure that we are surrounded by opportunities to enjoy and gain the most for
our well being and fitness. There is much simplicity in these suggestions for
which I make no apology. We know we generally do not eat enough fruit, and so
we should change our environment to ensure that it is ever present and ever

Your fruit bowl is not big enough!

Treat yourself to a beautiful new fruit bowl. Perhaps wooden or highly
decorative. It needs to be large, overflowing and placed centrally in living areas
or the kitchen. If you fill it each week, the fruit will be eaten. Guaranteed!
You will be aware of the pieces that are ripening, and will snack healthily as you
pass the bowl.

Variety the key to fullest enjoyment

Some fruit is stored at room temperature, and some best refrigerated. Dried
fruits have a long shelf life, and can add more sweetness to mixtures of fruit. So
stock up on dried apricots, stoneless prunes, raisins and other exotic dessicated
fruits as well as the fresh fruit from the supermarket.

Snack opportunities for fruit

At many workplaces there is a member of staff responsible for stocking the
biscuit cupboard. Some years ago at my place of work we opted to buy and
stock a fruit bowl. Now staff members consume fruit through the day as a
healthy alternative to cakes and biscuits.


Meal opportunities for fruit

There is an opportunity to make fruit part of every meal. And for families there
is the practical possibility of sharing, so that a cut up banana, slices of apple and
a peach, a scattering of grapes, segmented citrus fruit and some pieces of dried
fruit can be shared to make a wonderful mix of juicy fruit.
At breakfast time, a piece of fruit mixed with low fat yoghurt is a delight. Or a
handful of dried fruits mixed with cereal or muesli to start the day.
And perhaps the occasional dish of exotic fresh fruit such as papaya with lime,
fresh pineapple, mango or passion fruit can create an ambience of romance and
celebration. Fruit is fantastic fun in bed...

STEP 4: The Bottom Line Indulge a passion for Fruit to

protect from cancer and heart disease. Create opportunities
and variety.


Positively Good For You

Fabulous fast foods
Healthy snacking in between meals
Most of us snack in between meals. Indeed there is something to be said for
grazingon healthy foods within calorie limits. Children in particular are not
designed to have three full meals a day, which is why kids in particular are
susceptible to snacking on unhealthy foods in between meals.
There are wonderful possibilities for snacking healthily, as a way to access the
wonderful nutrients that confer wellbeing. It is important to have easy access to
ready made fast foods either stored in a fridge, or in small decorative bowls in
the kitchen or living areas.
Availability, convenience and flavour are the secret.

Nuts about nuts

(Though not if you are allergic to nuts)
Nuts are a rich source of protein which satisfies
appetite. A bowl of unsalted mixed nuts is a delight to
be grabbed in passing. Nature has blessed us with a
rich variety of nuts, and their consumption is
associated with lower rates of heart disease. The MUFAs in nuts lower
cholesterol and the omega 3 PUFAs in certain types also contributes to health.
People eat fewer nuts in Western Europe perhaps because of concerns about fat
content, but it should be remembered that as long as the calories are burned up
(see chapter 10) and obesity is avoided, the fats in nuts are good fats that
protect the heart.
Peoples in the Mediterranean eat twice the quantity of nuts in comparison with
those living in Western Europe, and this may be another factor which makes the
Mediterranean diet the healthiest in the World. Nuts also contain vitamin E and
antioxidants which may play a part in cancer and heart disease protection.
Brazil nuts are one of the richest known sources of selenium, a trace element
that may play a specific role in prevention of breast cancer.
As we will see in the next chapter, salt is not necessary as a flavour enhancer, so
unsalted nuts are by far the most tasty and healthy option.

A Bowl of Cherry Tomatoes

Tomatoes are a tasty snack. Always have a bowl of cherry tomatoes in the
kitchen readily available. Tomatoes contain not only vitamin C, but also the
substance lycopene. It has been suggested that lycopenes play a role in
prevention of cancer of the prostate. Cherry tomatoes are a rich source of this
substance, and can be consumed in a mouthful!


A Bowl of Fruit
We have already seen how a bowl of fruit readily available can provide a healthy
snack, and how a grabbed handful of delicious dried fruits can give your
morning an antioxidant boost.

A Bowl of Seeds
See step 7.

A Bowl of Dates
Dates are said by some to be quite simply the most concentrated package of
antioxidants on the planet!

Raw Vegetables
Perhaps the most tasty way to snack on raw vegetables is to have a bag of fresh
peeled carrots in the fridge. If a more substantial and filling snack is needed
then simply dip the vegetable in olive oil

Olives are best stored in a bottle of extra virgin olive oil or simply in the fridge.
The olives stored in brine tend to lose their flavour and become too salty. Most
supermarkets sell jars of olives stored in oil or from the delicatessen. These
need to be stored in the fridge and consumed within a few days (no problem!).
The olive bar generally contains a wide range of different varieties, often with
peppers, lemon, or stuffed with a garlic clove.
Become an olive buff! There are so many different types and flavours
Kalamata, gaidourolia, megaritiki, kothreiki, karydolia, throumba to name but a
few. Olives can be consumed as an aperitif, in salads, in main meals, or in
passing! Olives contain the goodness of olive oil and can be consumed as an
ideal snack.

Olive paste
Olive pastes have been consumed in the Mediterranean for thousands of years.
Crushed olives mixed with lemon, herbs, garlic, or tomato. Spread on toast or
bread they can be used as an appetizer or snack. Many are now available in
supermarkets, and usually combined with fruits or herbs that are packed with

STEP 5: The Bottom Line Pick great tasting, antioxidant

snacks. Buy them, Bowl them, Believe in them.


Positively Good For You

Healing herbs, glorious garlic
and luscious lemons
Fantastic flavouring and salt substitutes
Healing Herbs
The wonderful foods that can be so positively good for you have been listed
based on current scientific evidence or theory.
Herbs and spices have played an important role as medicines over the last few
thousand years. So often science reveals the wisdom of folklore, and so it is not
surprising that many herbs are now being increasingly recognised for their
Indeed many herbs and spices contain substances that fight against disease and
infection. Chimpanzees when ill will naturally eat certain wild plants not
dissimilar to the herbs we know. So, nature can teach us to help our health!
Basil, parsley, thyme, oregano, rosemary and other herbs and spices have been
used to flavour and preserve foods as well as for medicinal purposes. Many
bioactive compounds contained in herbs are thought to have beneficial effects,
including phenols and flavonols.
Some herbs such as rosemary contain compounds similar to aspirin which has
been shown to have a protective effect in heart disease.
Hot spices such as cinnamon, mustard and chilli are also rich in antioxidants.
In Mediterranean countries, dishes are flavoured with a variety of herbs. Even a
sprinkle of dry herbs is likely to give some benefit, though fresh herbs now
readily available in supermarkets are a delightful and subtle addition to any dish.
Dry herbs may be available as a salt substitute, producing a more sophisticated
and healthier option as a flavour enhancer. Taste develops tolerance to salt, so
food will lose its natural taste to a heavy salt user. Wean yourself off added salt
gradually (YOU DONT NEED IT!), and introduce herbs... the difference will

Glorious Garlic
Garlic is a common component in Mediterranean diets. It has been known for a
number of years that it has health benefits, and many people buy expensive
supplements or capsules.
The report of the British Nutrition Taskforce confirms the evidence that garlic
has reported benefits in the prevention of heart disease and cancers. It was not
so certain of the evidence base for the warding of vampires!


Positively Good For You

The sulphur containing chemicals may also play a role in prevention of infection.
As with other bioactive substances at least part of the mechanism for prevention
of heart disease lies in its action to inhibit blood clot formation, and reduce
Blood Pressure.
As for bad breath, it is well understood that it is virtually impossible to smell
garlic within a household of garlic eaters. So, the answer is to help friends and
family appreciate that the gorgeous taste and aroma of garlic, coupled with its
health benefits, means that more and more of us should be eating it regularly
and so fewer of us will be aware of the later effects!
Garlic is a member of the onion family, and other varieties of onions also contain
bioactive substances. Though remember to go for colour! Red onions are far
more generously loaded with those gloriously good flavonols!

How to achieve the increase in dietary garlic

Garlic is available in many different forms. A basis for many dishes can be olive
oil fried onions and garlic. Add peppers, tomatoes, herbs and protein (meat or
fish) and you have the beginnings of a great recipe...
The Spaniards spread crushed garlic and tomato on wholemeal bread as a
starter or salad accompaniment.
Garlic pastes are now available and can be added to sauces or dressings.
Raw garlic cloves accompany pitted olives.
Roasted vegetables are an increasingly popular winter side dish. Whole cloves
can be placed alongside other vegetables basted in olive oil.
Lemons are ever present in Mediterranean cuisine. They enhance the flavour of
salads, fish, vegetables, meat and dressings.
Lemon juice is rich in vitamin C, which is fine and dandy, but as explained in the
introduction, few of us are deficient in such vitamins. The likely real benefit of
lemon juice in the diet probably lies in its effect on the GLYCAEMIC INDEX (GI).
Much has been written about the GI Diet, and I do not intend to explore this
area in too much depth. The Mediterranean diet is a ready made low GI diet, so
there is simply no need to bore readers too much! Suffice to say that
carbohydrate slowly absorbed is less likely to give sugar load boosts that
contribute to obesity, diabetes etc. The unprocessed cereal, wholegrain, fibrous
nature of the Mediterranean diet is a low GI diet by definition (so do stick to
WHOLEMEAL UNPROCESSED rice, pasta, bread etc its more flavoursome and
nutty anyway!)


Positively Good For You

Luscious lemons!
Ok, so back to luscious lemons! Research has shown that citrus fruits that are
acidic delay emptying of the stomach. This reduces the Glycaemic Index or Load
of the meal, and so probably reduces risk of obesity, diabetes, heart disease and
certain cancers prevalent in the overweight...
So, not only luscious, but wonderfully tasty and healthy.
Lemons ready to slice in the fruit bowl is great, but if you want quick access,
there are long life lemon juice preparations that can be stored in the fridge and
brought out at every mealtimes for a generous squirt (along with the pinch of
mixed herbs and splash of olive oil!)

STEP 6: The Bottom Line A squirt of lemon, a pinch of

herbs, and garlic everywhere to keep a healthy state.


Seeds of life
Omega 3s without the bones
In chapter 3, we saw that there are some healthy fats that can be positively
good for you. These included the monounsaturated fats (MUFAs) and SOME
polyunsaturated fats (PUFAs), especially the so called omega 3 essential PUFAs.
Omega 3s are substances that stabilise cells and have been shown to very
significantly reduce the risk of heart disease. Cardiac problems are very rare in
Eskimo populations, despite a fat intake of 40% in their diet. This is due to the
fact that much of the fat is derived from fish which contain a high proportion of
the marine omega3 fats. Interestingly, this high fat diet in combination with an
active lifestyle is very comparable to the diet of Crete, though here the fat intake
is primarily derived from good MUFAs (in olive oil) in combination with
relatively high oily fish consumption.

So, reduce the risk of heart disease with an increase in oily

fish in your diet... as described in the Mediterranean diet.
Now, I realise that many people are put off oily fish by the bones. Also the
reports of contaminants such as mercury and PCBs in our seas and oceans.
Certainly the benefits of oily fish undoubtedly outweigh the risks of
contamination, assuming we consume different varieties of fish from different
habitats. To eat fish three times a week for a main meal is good advice, and for
those people who feel that removing the bones is burdensome, there are enough
species of fish that can be served in steak or fillet form for it to be possible
to adapt ones weekly shop to achieve this. Swordfish, salmon, eel, tuna are a
few examples of hassle-free fish.
But there is more to omega3s. They are also freely available in some nuts and
seeds. The chemistry of plant derived omega3s is not exactly the same as the
marine omega3s, but there is widespread scientific consensus that they have
beneficial effects of their own, and a proportion of plant omega3s will be
converted by the body into at least one of the marine omega3s.
Walnuts are a good example of omega3 rich nuts. A handful of walnuts, perhaps
mixed with almonds or brazil nuts scattered on a salad, or walnut oil added to
olive oil and used in dressings can give a wonderful and easy boost to omega3
However, the omega3 treasure is flaxseed. This rather nondescript dark brown
seed that is also known as linseed has received more attention as a preservative
oil for cricket bats than as an extraordinary preserver of good health and


Positively Good For You

Flaxseed, which is available from whole food shops has the highest content of
plant omega3s than any other seed or nut. It is simply way out ahead.
Two tablespoons of ground flaxseed on cereal every morning is a simple, cheap
and incredibly effective way of boosting the omega3 content of the diet. It adds
a subtle, slightly nutty flavour, and is especially complimentary to muesli and
other oat based cereal. Grinding using a blender is advised as the absorption of
the omega3s is considerably higher if the seeds are crushed and powdered.
Seeds are great snacking material. A bowl of mixed seeds available provides
protein, fibre and some essential and good fats, along with other nutrients. Try
pumpkin or sunflower seeds as a crunchy snack, or scattered onto salads or

Lignans the other treasure of flaxseed?

As well as boasting the highest plant content of heart protecting omega 3
essential oils, flaxseed contains chemicals called lignans. These belong to a
group of naturally occurring substances called phytoestrogens, also present in
particularly in high amounts in soya. The role of phytoestrogens in the diet is not
entirely clear, but there are early suggestions that these chemicals may confer
benefits on bone health, reduce the rates of hormone related cancers and reduce
risk of heart disease. However, it must be stressed that such theories are not yet
well established.

STEP 7: The Bottom Line Ground Flaxseed on cereal and

boost your heart.


Positively Good For You

Wonderful wine (tea and coffee)
Drink yourself healthy (within reason!)
In previous chapters we have explored foods that are positively good for you
and can be consumed in almost unlimited quantities, notwithstanding an overall
calorie controlled diet.
This is not the case for wine and coffee. Clearly the benefits are dose
dependent with a moderate intake conferring benefits, but excessive intake
reversing the advantages and indeed risking harm.

Wonderful Wine
Wine shares a place in history with olive oil. Celebrated in ancient
Mediterranean cultures it has long enjoyed associations with leisure and good
health. St Paul was recorded as extolling the benefits of wine.
Moderate regular consumption of wine (1 - 3 glasses per day depending on
gender and build) has been shown to reduce the risk of heart disease in a
dramatic way. It is clear that responsible, enjoyable drinking of wine with fine
food and excellent company is the best way of achieving this blessing. And of
course this is the way that wine can be most pleasurable. As alcohol is a mild
diuretic, always accompany the meal with generous quantities of water to
ensure adequate hydration. With water, good food and in relaxed surroundings,
moderate drinking of wine is unlikely to cause drowsiness or headaches.
There may be some direct effect of alcohol on stress reduction, however, it is
most likely that the bioactive micronutrients are the greatest contributing
factors. If this is the case, then it is certainly true that red wine is better for you
than white. Red wine contains higher concentrations of antioxidants such as
polyphenols and flavanols that have been shown to have anticancer effects, and
also a capacity to reduce cholesterol levels and lower the risk of blood clots that
lead to heart disease, heart attacks and stroke.

Drinking wine is a joy! The fact that such a delightful

pastime promotes health and well being is an added bonus.
Exploring and celebrating wines with other beautiful foods that are positively
good for you is a fundamental of a long and healthy life. In the summer in the
open air, with company or as an aperitif to romance, there is always a place
for wine.


Tea is another drink with a long history and folklore that has described
medicinal qualities. Recent research has suggested a positive effect of tea on
cholesterol levels, blood pressure and probably anti cancer effects. The
antioxidants contained in tea include polyphenols and most specifically
The bioactive chemistry varies between black, green and white tea. Rather than
argue about the most effective tea, the best advice is to enjoy the cup most
preferred. A cupboard with a selection of varieties is likely to create the
opportunity to relax with whichever tea attracts at a particular time. If the
bitterness of green tea is not enjoyed, take advantage of the numerous
combinations with fruits and ginger.
How many cups a day?
Studies that have shown health benefits of tea have reported on populations that
consume, for example 3 cups a day. One large analysis of the studies to date
demonstrated an 11% reduction in risk of heart attack with this average

Antioxidants in coffee have been the subject of research in the last few years.
The picture has been confused however by claims that coffee contains toxins
that are harmful to the heart and might increase the risk of cancer. In addition,
the stimulant effect of caffeine has been reportedly associated with an increased
likelihood of irregularities of rhythm of the heart.
Essentially there is NO convincing evidence of harmful effects of coffee, drunk
in moderation ie 2 - 3 cups per day. Clearly, people who suffer from palpitations,
heart irregularities or adverse effects of caffeine overload should consider
drinking decaffeinated preparations.
The specific antioxidants include polyphenols, but the evidence for beneficial
effects of these compounds is not as compelling as the studies undertaken on tea.

STEP 8: The Bottom Line Celebrate fine wine knowing it is

good for you. Ensure your three cups of tea a day.


A Secret chapter for Chocolate lovers
Ssshhhhhhh! Its positively good for you
During the 1990s there was an important scientific breakthrough demonstrating
the health benefits of wine. After years of negative messages in relation to the
potential harm of foods, this was a breath of fresh air. We could indulge a little,
enjoy, and be fitter and feel better. The joy of a positive dietary experience that
allowed us to experience pleasure in the knowledge that we were gaining health
benefits! And from wine! That which cheers the sad, revives the old, inspires
the young, makes weariness forget his toil, and fear her danger; opens a new
world when this, the present, palls.
The news gets better still with the fantastic taste of colourful fresh fruits,
vegetables and salads covered in olive oil significantly reducing risk of heart
disease and cancers.

And now we are discovering that chocolate is actually good

for you! (as part, of course, of a balanced calorie stable diet);
There is increasing evidence that the cocoa bean, and chocolate made from it,
contains a number of bioactive substances similar to those in tea that have
potential health benefits to prevent illness including cancers and heart disease.
There is also some research to suggest that chocolate has a mood lifting effect.
One recent study showed that regular consumption of small amounts of dark
chocolate might be associated with a 39% reduction of the incidence of heart
attacks and strokes (ref 13).
There are specific bioactive substances such as phenols, polyphenols and other
antioxidants present in chocolate that may have anticancer properties and also
act to prevent clot formation and to relax blood vessels. Dark/plain chocolate
packs more of these powerful antioxidants in a bar, though people often express
a taste preference for milk chocolate as it tends to be less bitter. Just as green
tea is now produced for different tastes, there are combinations of dark
chocolate with almonds, orange and even chilli.


Sure, chocolate is energy dense. As we will explore in chapter 10, it is important
that a stable weight within recommended limits is maintained, but this is best
achieved through regular exercise, portion control, and commitment to a
balanced healthy Mediterranean style diet.
So a little packet of antioxidant rich chocolate to relax those blood vessels and
mop up some of those cancer risking free radicals is a great idea.


Positively Good For You


Sure, there are fats in chocolate. Whilst most saturated fats (including palmate
in chocolate) raise cholesterol levels, chocolate also contains one of the least
harmful combinations of saturated fats since stearate actually has no effect on
cholesterol, and the presence of oleic acid (a GOOD monounsaturated fat)
probably reverses any negative effects of the saturates. It has been shown
scientifically that the main ingredient of chocolate ie cocoa does NOT raise
cholesterol levels due to its balance of saturated and monounsaturated fats!
However, this is an argument for the superiority of dark/plain chocolate over the
more processed milk chocolates, which not only contain less cocoa (as little as
20 % compared with the more usual 70% in good quality dark chocolates) but
also bulks out with ingredients such as vegetable fat or butterfat which add
calories and unhealthy fats.

STEP 9: The Bottom Line Add a little Dark chocolate to

end your Evening Meal.


Exercise for Energy
Fitness and health for bodily wealth
Exercise protects the body from heart disease, some cancers, obesity, diabetes
and stress...
But more than that it gives a sense of well being, fitness and energy.

Exercise is Positively Good for You

Exercise is the answer to tiredness
Exercise is the answer to fatigue
Exercise is the answer to stress
Exercise energises other parts of our life.
Exercise allows you to enjoy all of those really great foods by burning up the
calories to maintain a healthy weight.
For exercise to do all these things, you need to get the BUZZ

The exercise Buzz

Science has long observed the natural high that is experienced by many people
after exercise and there have been a number of theories to explain this.
Naturally occurring substances in the brain such as serotonin, endorphins and
encaphalins may play a part.
It is also known that some people lose the sense of wellbeing if they do not have
the opportunity to exercise it is slightly addictive.
But lets be clear. There is nothing wrong with being addicted to an activity
that promotes a sense of well being, fitness and energy. That reduces stress, risk
of heart disease and cancers. That improves mental functioning and probably
reduces the likelihood of dementia.
Some people exercise without sensing the buzz. Light regular exercise to burn
up calories, maintain a healthy heart and weight is a good thing, but to really get
the best from exercise you need to CATCH THE BUZZ ...

Catching the buzz

Be patient, this may take some time. To feel the sense of joy and energy from
regular exercise may take some working out.
The amount and effort of activity depends on your baseline weight and fitness.
You may wish to achieve weight loss before cardiovascular fitness. There may
need to be a gradual build up towards the minimum average 30 minutes thrice


weekly cardiovascular work and 30 minutes resistance training. If in doubt seek

the advice of a physician or qualified trainer. Ultimately you may choose to tone
muscles rather than build, to exert comfortably in the lower pulse rate zone
rather than catch the real buzz in a true sweat work out.
Exercise may drive up appetite, and what a great opportunity to eat positively
good for you foods. If you are overweight, feed your appetite with low calorie
foods, if you are within limits then you can eat as much olive oil and other
goodies as you wish.
Remember, for any given BMI (body mass index a ratio of weight and height),
a person exercising and eating more is far healthier than a sedentary person
trying to control their intake in dieting.
Different people need different means to catch the buzz. Here are a few tips.
Some or all of them may help;
The right kit. Whilst it is not absolutely necessary, good quality gym equipment
whether for a small room or an area designated a gym is a real motivator.
Regular schedule. A routine is also important. A circuit of activity, different
sports and a set aside time to enjoy the space and freedom of exercise may be
essential. For your fitness be selfish. Make and demand time in your busy
schedule, whether first thing in the day or later at home. It is vital to invest in
your body for your sake and for those you love, and who wish you to live
longer and healthier.
Motivated by machines. Equipment sometimes is available with fitness guides
and pulse meters. A great motivator is the knowledge that you are training
your heart by exercising in a cardiac fitness zone of pulse rate (see opposite)
for sufficient time to be POSITIVELY GOOD FOR YOU. Pulse rate monitors
are inexpensive and easy to use.
Maintaining interest. Some like the solitude of thinking whilst exercising
whilst others appreciate TV or music. Whatever suits.
Personal trainers or joining a gym. Expensive, but the only way to achieve
catching the buzz for some.
Targets and goals. Setting a goal to gradually increase performance or time of
exercising is a means to success for some. Do not over reach or you may give
up. Computer programmes can help to plot fitness, BMI etc over time.
Body image. If you tone muscles with exercise and feel the glow and gentle
throbbing of your body, you will feel taller, stronger, fitter and sexier! Do it for
the feeling.


Positively Good For You

Target HR Zone
50 -75%

Average Maximum Heart Rate


20 years

100-150 beats per minute


25 years

98-146 beats per minute


30 years

95-142 beats per minute


35 years

93-138 beats per minute


40 years

90-135 beats per minute


45 years

88-131 beats per minute


50 years

85-127 beats per minute


55 years

83-123 beats per minute


60 years

80-120 beats per minute


65 years

78-116 beats per minute


70 years

75-113 beats per minute



Your maximum heart rate is approximately 220 minus your age.

The figures above are averages and should be used as general guidelines.

STEP 10: The Bottom Line Exercise for health and joy.
Catch the Buzz.


The Bottom Line Plan your meals and shopping around a well balanced
Mediterranean diet.
The Bottom Line Colourful fruits and Vegetables are packed with goodies to
prevent disease. Buy more, eat more.
The Bottom Line olive oil has numerous health giving effects. Make it readily
available for cooking, dressing, splashing and mixing. Get to know it, get to
love it.
The Bottom Line Indulge a passion for Fruit to protect from cancer and heart
disease. Create opportunities and variety.
The Bottom Line Pick great tasting, antioxidant snacks. Buy them, Bowl them,
Believe in them.
The Bottom Line A squirt of lemon, a pinch of herbs, and garlic everywhere to
keep a healthy state.
The Bottom Line Ground Flaxseed on cereal and boost your heart.
The Bottom Line Celebrate fine wine knowing it is good for you. Ensure your
three cups of tea a day.
The Bottom Line Add a little Dark chocolate to end your Evening Meal.
The Bottom Line Exercise for health and joy. Catch the Buzz.

Ten simple enjoyable steps to a longer and healthier life. Its positively good for
you. ENJOY!


Positively Good For You

References much of this summary is reproduced by kind permission of Oldways, the nonprofit organisation supporting healthy eating;

Ref 1; Eurosciences Communication 2000

Ref 2; see below;
Medical Evidence for the Benefit of the Mediterranean Diet and its Constituents including
Olive Oil
Thousands of scientific studies now provide an overwhelming evidence base to support the health
benefits of the Mediterranean Diet. It is not possible to usefully list all of the references in this
appendix. There is also a body of published data that defines the role of individual components of the
diet, including olive oil, nuts, vegetable and fruits etc.
Examples of excerpts from medical and scientific journals below include review articles which draw
conclusions from numerous published studies. In addition the evidence is cited in documents produced
by organisations such as The American Heart Association, the National Standards Framework for
Cardiovascular Disease and in numerous National Health Service documents.
The following excerpts from medical and scientific journals reveal the depth and breadth of
the evidence for the Gold Standard status of traditional Mediterranean eating patterns.
The Mediterranean Diet ... has been associated with lower risk for several forms of cancer, obesity,
dyslipidemia, hypertension, abnormal glucose metabolism, coronary heart disease, and overall
mortality. In a recent study, we demonstrated that higher adherence to the Mediterranean Diet at
baseline evaluation was associated with lower risk of developing Alzheimers disease during follow-up.
Similarly to our previous findings, in this different Alzheimers disease population we observe that
higher adherence to the Mediterranean Diet is associated with reduced disease odds. Similarly to our
previous report, we note a gradual reduction in Alzheimers disease risk for higher tertiles of
Mediterranean Diet adherence, suggesting a possible doseresponse effect. Additionally, in accordance
with our previous results, the associations between Mediterranean Diet and Alzheimers disease remain
unchanged and significant even when simultaneously adjusting for the most commonly considered
potential confounders for Alzheimers disease, such as age, sex, ethnicity, education, APOE genotype,
caloric intake, and BMI. Higher adherence to Mediterranean Diet reduced risk for probable Alzheimers
disease either with or without coexisting stroke.
Mediterranean Diet, Alzheimer Disease, and Vascular Mediation
Scarmeas, N., Stern, Yaakov., et al. Archives of Neurology 63 (2006)
A systematic review was made and a total of 43 articles corresponding to 35 different experimental
studies were selected. Results were analyzed for the effects of the Mediterranean diet on
lipoproteins, endothelial resistance, diabetes and antioxidative capacity, cardiovascular diseases,
arthritis, cancer, body composition, and psychological function. The Mediterranean diet showed
favourable effects on lipoprotein levels, endothelium vasodilation, insulin resistance, metabolic
syndrome, antioxidant capacity, myocardial and cardiovascular mortality, and cancer incidence in obese
patients and in those with previous myocardial infarction.
Scientific Evidence of Interventions Using the Mediterranean Diet: A Systematic Review
Serra-Majem, Ll., Roman, B., et al. Nutrition Reviews 64(1): 24-47(21) (2006).
The findings support the hypothesis that a Mediterranean diet that emphasizes olive oil, fibre, fruits,
vegetables, fish, and alcohol and reduces meat and meat products can be an effective measure for
reducing the risk of coronary heart disease. The benefits of the Mediterranean diet were significant in
all studies. The reduction in the risk of coronary heart disease varied from study to study, but this also
reflects the different increments used, explicitly or implicitly, in these studies. To our knowledge there
are no studies that have shown a detrimental or non-significant impact of the Mediterranean diet on
cardiovascular disease.
Can a Mediterranean diet moderate the development and clinical
progression of coronary heart disease? A systematic review
Panagiotakos, D.B., Pitsavos, C., et al. Med Sci Monit, 10(8): RA 193-198 (2004)


Positively Good For You

The main finding of this study is that high adherence to the traditional Mediterranean dietary
pattern, characterized by high intakes of vegetables, fruits, legumes, fish, cereals, and nuts and low
and moderate consumption of meat and wine, respectively, is associated with a lower prevalence of
obesity in men and women in this Mediterranean population. This association held even after
controlling for age, leisure time physical activity, educational level, smoking, and alcohol consumption.
Adherence to the Traditional Mediterranean Diet Is Inversely Associated with Body Mass Index and
Obesity in a Spanish Population
Schroeder, H., Marrugat, J., et al. The Journal of Nutrition 134: 3355-3361 (2004)
Recent findings showing that elderly African Americans and Japanese living in the USA have a much
higher prevalence of AD (6.24% and 4.1%, respectively) than those still living in their ethnic homelands
(< 2%) suggest that the prevalence of Alzheimers disease is more strongly influenced by diet and
nutrition, environment and/or lifestyle than by genetics... In conclusion, the Mediterranean diet
pattern based on complex carbohydrates, fibre and non-animal fat appears to protect against agerelated cognitive decline and cognitive decline of vascular or degenerative origin.
Mediterranean diet and cognitive decline
Panza, F., Solfrizzi, V., et al. Public Health Nutrition 7(7): 959-963 (2004)
The present study provides a pathophysiologic explanation to the growing scientific evidence for the
beneficial effect of the Mediterranean diet on human health and, especially, atherosclerotic disease.
We found that greater adherence to this traditional diet was independently associated with a reduction
in the inflammation and coagulation indexes that are believed to have an important role in CVD. The
World Health Organization reports that the three major components involved in preventing
atherosclerotic disease are smoking, physical inactivity, and an unhealthy diet, as they are factors that
can be changed. Our findings emphasize the need for actions from public health care professionals in
order to prevent the development and progression of atherosclerotic diseases through the adoption of
low animal fat diets, like the Mediterranean diet.
Adherence to the Mediterranean diet attenuates inflammation
and coagulation process in healthy adults: the Attica study
Chrysohoou, C., Panagiotakos, D.B., et al. Journal of the American College of Cardiology 44:152-158
Greater adherence to the Mediterranean diet is associated with a significant reduction in total
mortality. A one unit increase in a diet score, devised a priori on the basis of eight key features of the
traditional common diet in the Mediterranean region, was associated with a 17% reduction in overall
Adherence to a Mediterranean diet and Survival in a Greek Population
Trichopoulou A. et al. The New England Journal of Medicine, 348:2599-2608 (2003)
Dietary intervention with the Mediterranean diet and statin treatment improve flow-mediated
vasodilatation in the brachial artery in patients with ischemic heart disease and hyper-cholesterolemia
to a greater degree than statin treatment alone.
Effect of dietary intervention and lipid-lowering treatment on brachial
vasoreactivity in patients with ischemic heart disease and hypercholesterolemia
Sondergaard, E., Moller JE., Egstrup K. American Heart Journal 145(5):E19 (2003)
The results indicate that patients with Rheumatoid arthritis, by adjusting to a Mediterranean diet, did
obtain a reduction in inflammatory activity, an increase in physical function, and improved vitality.
An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis
Skoldstam,L., Hagfors, L., Johansson G. Annals of the Rheumatic Diseases 62(3):208-14 (2003)
Myocardial infarction patients can respond positively to simple dietary advice, and this can be expected
to lead to a substantial reduction in the risk of early death. Regardless of any drug treatment
prescribed, clinicians should routinely advise patients with myocardial infarction to increase their
frequency of consumption of Mediterranean foods.
Mediterranean diet and all-causes mortality after myocardial infarction:
results from the GISSI-Prevenzione trial
Barzi, F. et al. European Journal of Clinical Nutrition 57(4):604-11 (2003).


Efforts to combat nutrient deficiencies have centered on supplemental nutrient administration and
addition of selected nutrients to the food chain in the form of food fortification. In addition to
supplementation or fortification with specific nutrients, the consumption of certain dietary patterns
(such as the Mediterranean diet) is associated with a reduced risk of chronic diseases, particularly
cardiovascular diseases.
Fortification, supplementation, and nutrient balance
Caballero, B. European Journal of Clinical Nutrition 57 1:S76-8, (2003)
Trichopoulou et al. report the results of a population-based study involved 22,043 apparently healthy
adults in Greece, in which adherence to a traditional Mediterranean diet was associated with
significantly lower total mortality, mortality from coronary heart disease, and mortality from cancer. To
measure adherence to this diet, a score was constructed that incorporated relatively high intakes of
vegetables, fruits and nuts, legumes, cereals, fish, and monounsaturated fat; relatively low intakes of
meat, including poultry, and moderate consumption of alcohol. One intriguing aspect of this study is
that despite a robust inverse association between the overall Mediterranean-diet score and mortality, no
appreciable associations were seen for most of the individual dietary components used to construct the
score. One possible explanation is that the effects of single nutrients of foods may be too small to
detect, whereas the cumulative effective of multiple dietary components may be substantial. In
addition, there may be synergistic or interactive effects among nutrients or foods, which the score
automatically takes into account.
The Mediterranean Diet and Mortality Olive Oil and Beyond
Hu, F.B. New England Journal of Medicine 348:26, 2595-2596 (2003)
Until the picture can be clarified, lipid modification with strategies proved to reduce the risk for
coronary events, such as statins or dietary changes in the style of the Mediterranean diet, should be
better implemented in clinical practice.
Antioxidants, statins, and atherosclerosis
Gotto, AM. Journal of American College of Cardiology 41:1205-10 (2003)
In the Lyon Heart Study, higher ALA consumption in the context of a Mediterranean diet dramatically
reduced total and cardiovascular mortality as well as nonfatal MI. These trials strongly support the
protective effects of omega-3 fatty acids, including both ALA and fish oil, in secondary prevention of
CHD. Mediterranean diet enriched with ALA reduced death by more than 70%.
Optimal Diets for Prevention of Coronary Heart Disease
Hu, F.B., Willet, W.C. Journal of the American Medical Association, 288: 2569-2578 (2002)
The traditional Mediterranean diet as outlined in this article is an ideal eating pattern for prevention
of cardiovascular disease. We believe that current understanding and scientific evidence are adequate
to recommend this diet widely as a practical, effective, and enjoyable strategy the new gold
standard in heart disease prevention.
Understanding the Mediterranean Diet: Could This Be the New
Gold Standard for Heart Disease Prevention?
Curtis, B., OKeefe, J., Postgraduate Medicine, 112(2): 35-8. 41-5 (2002)
The Indo-Mediterranean diet is a safe and economical way to improve the health of a non-Western
population over 2 years. A diet enriched with fruit, vegetables, nuts, whole grains, and mustard or soy
bean oil is associated with a pronounced decline in CAD morbidity and mortality, without an increase in
non-cardiac deaths, and in the presence of improved metabolic profiles. The long-term benefits may be
even more substantial.
Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high
risk patients (Indo-Mediterranean Diet Heart Study): a randomized single-blind trial
Singh, R.B., Dubnov, G., et al. The Lancet 360; 1455-1461 (2002)
Our data support the hypothesis that a Mediterranean diet (that emphasizes olive oil, fibre, fruits,
vegetables, fish and alcohol and reduces meat/meat products) can be an effective measure for reducing
the risk of myocardial infarction. However, our results support the exclusion of refined cereals with a
high glycaemic load as healthy elements of this pattern.
Mediterranean diet and reduction in the risk of a first acute myocardial
infarction: an operational healthy dietary score
Martinez-Gonzalez, M.A., Fernandez-Jarne, E., et al.
European Journal of Nutrition 41(4): 153-160 (2002)


Positively Good For You

We studied the acute and longer-term effects of vitamin C compared to a Mediterranean-type diet
on endothelial function in healthy older subjects. A Mediterranean-type diet rich in vitamin C improves
vascular function. Neither acute intra-arterial nor sustained administration of oral vitamin C improves
vascular function in healthy older subjects.
Effects of a healthy diet and of acute and long-term vitamin C
on vascular function in healthy older subjects
Singh, N., Graves, J., et al. Cardiovascular Research. 56(1): 118-25 (2002)
Based on the estimated risk model we found that the Mediterranean type of diet reduces
significantly the risk of developing acute coronary syndromes even in the presence of unfavourable
lifestyle situations, such as sedentary life, smoking habit, as well as hypertension, hypercholesterolemia and diabetes mellitus.
The role of traditional Mediterranean type of diet and lifestyle in the development
of acute coronary syndromes: preliminary results from CARDIO 2000 study
Panagiotakis, D.B., Pitsavos, Ch., et al. Central European Journal of Public Health. 10(1-2): 11-5 (2002)
Long-term success in weight loss with dietary treatment has been elusive. A moderate-fat,
Mediterranean-style diet, controlled in energy, offers an alternative to a low-fat diet with superior
long-term participation and adherence, with consequent improvements in weight loss.
A randomized controlled trial of a moderate-fat, low-energy diet compared
with a low-fat, low-energy diet for weight loss in overweight adults
McManus, K., Antinoro, L., Sacks, F. International Journal of Obesity & Related Metabolic Disorders
25(10):1503-11 (2001).
It would be short-sighted not to recognize the enormous public health benefit that the Mediterraneanstyle diet could confer... there is a pressing need to identify unknown risk Mediterranean diet itself
on CHD. Other characteristics of factors and effective intervention strategies... The findings from the
Lyon Diet Heart Study illustrate the importance of a [Mediterranean] dietary pattern that emphasizes
fruits, vegetables, breads and cereals, and fish, within the context if a Step I diet... to dramatically
lower CVD risk in the population and can be followed by free living people.
Lyon Diet Heart Study: Benefits of a Mediterranean-Style, National Cholesterol Education Program
American Heart Association Step I Dietary Pattern on Cardiovascular Disease
Kris-Etherton, P., et al. Circulation 103: 1823-1825 (2001).
A Mediterranean-style diet demonstrates impressive effects on cardiovascular disease. Early reports
from the Lyon Heart Study caused us to commission this advisory and to examine the current scientific
basis for the effect of such dietary modifications in general; this led to recommendations for the AHA,
practitioners, and the public. Because of the potentially substantial significance of their findings, we
believe an aggressive pursuit of the issues raised in the study and the advisory must be undertaken. It
does seem that substantial enhancement to the effectiveness of our current dietary recommendations
may be provided by integrating the features of the diet used in the Lyon Diet Heart Study with current
AHA guidelines. Studies addressing the issues listed in the scientific advisory will need to be completed
before this conclusion can be drawn. Such studies should be aggressively pursued because of their
major potential and societal impact.
Can a Mediterranean-Style Diet Reduce Heart Disease? Editorial
Robertson, R.M., Smaha, L. Circulation 103: 1821 (2001)
The DART and the Mediterranean diet trials did show significant reduction in coronary heart disease
in comparison with the placebo.
What Role for Statins: A Review and Economic Model [Treatment and Prevention]
Updated 31-05-2001 NHS Centre for Reviews and Dissemination, University of York, U.K. (2001)
The most effective means of reducing the risk of sudden cardiac death (apart from the prophylactic
implantation of a defibrillator) appears to be dietary prevention in the light of animal experiments,
epidemiological studies and four randomized trials... Adoption of a dietary pattern, for instance a
Mediterranean type of diet, seems to be the best way.
Diet and medication for heart protection in secondary prevention
of coronary heart disease. New concepts [Review]
de Lorgeril, M., Salen, P., et al. Nutrition, Metabolism & Cardiovascular Diseases 10(4): 216-22 (2000)


There is increasing scientific evidence of positive health effects from diets which are high in fruits,
vegetables, legumes, and whole grains, and which include fish, nuts and low-fat dairy products. Such
diets need not be restricted in total fat as long as there is not an excess of calories, and emphasize
predominantly vegetable oils that are low in saturated fats and free of partially hydrogenated oils. The
traditional Mediterranean Diet, whose principal source of fat is olive oil, encompasses these dietary
2000 Consensus Statement on Dietary Fat, the Mediterranean Diet
and Lifelong Good Health: Summary Statement
The Mediterranean diet is a centuries-old tradition that contributes to excellent health, provides a
sense of pleasure and well-being, and forms a vital part of the worlds collective cultural heritage. For
Mediterranean peoples, this way of eating describes a traditional diet that can be readily preserved and
revitalized within a modern lifestyle. For Americans, Northern and Eastern Europeans, and other who
wish to improve their diets, the Mediterranean way of eating describes a dietary pattern that is
attractive for its famous palatability as well as for its health benefits, and one that can be adopted in its
entirety or adapted to a Mediterranean-style diet.
From the Scientific Exchange of the 2000 International Conference on the Mediterranean Diet
The Mediterranean diet and moderate consumption of red wine have complementary, mostly
beneficial effects on haemostatic cardiovascular risk factors.
Complementary effects of Mediterranean diet and moderate red wine
intake on haemostatic cardiovascular risk factors
Mezzano, D., et al. European Journal of Clinical Nutrition 55(6): 444-451 (2001)
The data confirms the impressive protective effect of the Mediterranean diet. The protective effect of
the Mediterranean dietary pattern was maintained up to 4 years after the first infarction.
Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular
Complications After Myocardial Infarction. Final Report of the Lyon Diet Heart Study
de Lorgeril, M., Salen, P., Martin, J.L., et al. Circulation, 99: 779-785 (1999)
Adherence to the principles of the traditional Mediterranean diet ... is likely to be associated with
lower overall mortality. Moreover, key features of this diet appear to be transplantable to other dietary
cultures and cuisines, and may have a substantial beneficial impact on the general mortality of elderly
people who have the Westernized dietary habits. We conclude that a diet that adheres to thee principles
of the traditional Mediterranean diet is associated with longer survival.
Are the Advantages of the Mediterranean Diet Transferable to Other Populations?
A Cohort Study in Melbourne, Australia
Kouris-Blazos, A. British Journal of Nutrition 82: 57-61 (1999)
Adoption of a Mediterranean diet results in a significant reduction of total and LDL-cholesterol with
also a significant effect on triglycerides and a small positive or no effect on HDL-cholesterol. However,
the Mediterranean diet has been shown to be cardioprotective (for instance, prevention of sudden
death) through biological effects (probably induced by omega-3 fatty acids) independent of its effect on
blood lipoproteins. The association of these cardioprotective and beneficial effects on blood lipids, in
addition to gastronomic properties, renders this type of diet extremely attractive for public health
Hyperlipidemias. Concern with the Mediterranean diet
Salen, P., de Lorgeril, M. Presse Medicale 28(36): 2018-24 (1999)
There is increasing scientific evidence that there are positive health effects from [Mediterranean-type]
diets which are high in fruits, vegetables, legumes, and whole grains, and which include fish, nuts, and
low-fat dairy products. Such diets need not be restricted in total fat as long as there is not an excess of
calories, and the diet is low in saturated fats and partially hydrogenated oils. Diets that emphasize
vegetable oils (predominantly monounsaturated), nuts, and fish are preferable to those high in animal
products and partially hydrogenated oils. Many individuals will have to limit their intake of fat or
carbohydrate to avoid excess calories.
1998 Consensus Statement on Total Dietary Fat and the Overall Dietary Pattern
American Journal of Medicine, January 30, 2003 Supplement (in press)
From the Scientific Exchange of the 1998 International Conference on the Mediterranean Diet


Positively Good For You

Patients who followed a Mediterranean-type diet had reduced... combined all-cause mortality,
nonfatal cancer, and myocardial infarction compared with those who followed an approximate
American Heart Association Step 1 diet. The Mediterranean-type diet also showed a trend toward a
decreased risk for cancer. A Mediterranean-type diet reduced mortality in patients with a first MI.
Mediterranean dietary pattern in a randomized trial:
prolonged survival and possible reduced cancer rate
de Lorgeril, M., Salen, P., et al. Arch Intern Med.; 158: 1181-1187 (1998)
The Mediterranean diet or its elements have repeatedly been shown to provide remarkable
protection against chronic diseases.
Albanian Paradox, Another Example of Protective Effect of Mediterranean Lifestyle?
Gjona, A., Bobak, M. Lancet 350: 1815-1817 (1997)
As conceptualized in the Mediterranean and Asian-vegetarian types of diet, it is very important
that a healthy diet should be thought of as a whole rather than as a recitation of good and bad
components. Although these protective dietary modifications should probably all be used in each
patient to obtain maximal efficacy, these scientifically quantitated principles should be adapted to the
culture, ethnic origin and image of the world of each patient in order to create an environment
favourable to the perception of positive associations between various foods and healthy habits.
The diet heart hypothesis in secondary prevention of coronary heart disease
de Longeril, M., Salen, P., et al. European Heart Journal 18(1): 13-8 (1997)
The Mediterranean diet was found not only to produce favourable effects on blood lipid profiles, but
also to protect against oxidative stress and carcinogenesis... the dietary profile has maintained its basic
features, and vital statistics still demonstrate a comparative advantage of eating behaviors in
Mediterranean countries.
Mediterranean Diet, Italian-style: Prototype of a Healthy Diet
Ferro-Luzzi, A., Branca, F. American Journal of Clinical Nutrition 61: 1338S-1345S (1995).
We present a food pyramid that reflects Mediterranean dietary traditions, which historically have
been associated with good health. This Mediterranean diet pyramid is based on food patterns...
where adult life expectancy was among the highest in the world and rates of coronary heart disease,
certain cancers, and other diet-related chronic diseases were among the lowest. The pyramid describes
a dietary pattern that is attractive for its famous palatability as well as for its health benefits.
Mediterranean Diet Pyramid: A Cultural Model for Healthy Eating
Willett, W.C. et al., American Journal of Clinical Nutrition 61: 1402S-1406S (1995)
A Mediterranean diet with more cereal, vegetables, fruit, less saturated fats and more n-3 fatty acids
has recently been shown to afford a rapid and exceptional protection from recurrences and death in
coronary patients.
Nutrition, atherosclerosis and coronary heart disease
Renaud, S., de Lorgeril, M. Reproduction, Nutrition, Development 34(6): 599-607 (1994)
An alpha-linolenic acid-rich Mediterranean diet seems to be more efficient than presently used diets
in the secondary prevention of coronary events and death.
Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease
de Lorgeril, M., Renaud, S., et al. Lancet 3 43(8911): 1454-9 (1994).
13th Congress of Dietetics 2000; High MUFA diet beats low fat and weight reducing diets in
cardioprotection (Dr Kris-Etherton, Am J Clin Nut 1999)
Following Myocardial Infarction between 9 and 19 people will need to be given Mediterranean dietary
advice to prevent 1 death NHS Centre for reviews and dissemination. Source British Dietetics
BNF Report 2000; The adoption of a Mediterranean-style diet and lifestyle would confer substantial
health benefits to populations in Northern Europe. Growing evidence suggests that this diet provides an
alternative to the low fat diet for improving lipid profile and promoting weight maintenance

Ref 3; Olive oil and health

12th International Symposium on Atherosclerosis, 2000 Olive oil improves blood lipid profiles,
protects against atherosclerosis, decreases risk of atherothrombosis, improves blood vessel endothelial
function and clears post prandial apolipoproteins
12th Congress of the European Society of Cardiology...antioxidant effects of olive oil based on a
number of bioactive substances ...


The wide range of antiatherogenic effects associated with olive oil consumption could contribute to
explain the low rate of cardiovascular mortality found in Southern European countries in comparison
with other Western countries, despite a high prevalence of CVD factors
Review of olive oil and health, M.Covas, Pharmacological Research, 2007.01.010
Olive oil is the principle source of fat in the Mediterranean Diet which is associated with low
mortality for cardiovascular disease ... a large body of knowledge exists providing evidence of the
benefits of olive oil consumption on secondary end points for cardiovascular disease. The benefits of
olive oil consumption are beyond a mere reduction of the low density lipoprotein cholesterol.
Pharmacol Research 2007 March; 55 175-86
The Mediterranean Diet, rich in olive oil, improves the major risk factors for cardiovascular
disease ... some of these effects are attributed to components of virgin olive oil.
International conference on the healthy effects of virgin olive oil.
European Journal clinical Investigation 2005, July 35 421-4
Olives and olive oil contain antioxidants in abundance..and substantial amounts of other compounds
that are deemed to be anticancer agents
Olives and Olive oil in cancer prevention. Owen et al,
European Journal Cancer Prevention, 2004 Aug 13 (4), 319-26
The role of dietary extra virgin olive oil in preventing the onset of atherosclerosis and inflammatory
bowel disease.
A report to the 12th international symposium on atherosclerosis
Stockholm, Sweden. June 25-29. Masella et al, Rome
Antioxidant polyphenolic compounds such as quercetin which is abundant in olive oil help switch
off the mechanisms which lead to atherosclerosis by inhibition of endothelial activation, the process by
which the lining of the blood vessels contribute to the development of atherosclerosis.
Report to the 12th Congress of the European society of cardiology,
Amsterdam, 2000. Carluccio, University Milan
Olive oil intake showed a significant reduction of oesophageal cancer risk, even allowing for total
vegetable consumption.
International Journal of Cancer 2000, 87;2 289-94. Bosetti et al
Olive oil contains a vast range of substances such as monounsaturated free fatty acids (e.g., oleic
acid), hydrocarbon squalene, tocopherols, aroma components, and phenolic compounds. Higher
consumption of olive oil is considered the hallmark of the traditional Mediterranean diet, which has
been associated with low incidence and prevalence of cancer, including colorectal cancer. The
anticancer properties of olive oil have been attributed to its high levels of monounsaturated fatty acids,
squalene, tocopherols, and phenolic compounds. Nevertheless, there is a growing interest in studying
the role of olive oil phenolics in carcinogenesis. This review aims to provide an overview of the
relationship between olive oil phenolics and colorectal cancer, in particular summarizing the
epidemiologic, in vitro, cellular, and animal studies on antioxidant and anticarcinogenic effects of olive
oil phenolics.
Components of olive oil and chemoprevention of colorectal cancer.
Nutr Review 2005 Nov63 374-86. Hashim et al
In the Mediterranean basin, olive oil, along with fruits, vegetables, and fish, is an important
constituent of the diet, and is considered a major factor in preserving a healthy and relatively diseasefree population. Epidemiological data show that the Mediterranean diet has significant protective
effects against cancer and coronary heart disease. We present evidence that it is the unique profile of
the phenolic fraction, along with high intakes of squalene and the monounsaturated fatty acid, oleic
acid, which confer its health-promoting properties. The major phenolic compounds identified and
quantified in olive oil belong to three different classes: simple phenols (hydroxytyrosol, tyrosol);
secoiridoids (oleuropein, the aglycone of ligstroside, and their respective decarboxylated dialdehyde
derivatives); and the lignans [(+)-1-acetoxypinoresinol and pinoresinol]. All three classes have potent
antioxidant properties. High consumption of extra-virgin olive oils, which are particularly rich in these
phenolic antioxidants (as well as squalene and oleic acid), should afford considerable protection
against cancer (colon, breast, skin), coronary heart disease, and ageing by inhibiting oxidative stress.
Olive-oil consumption and health: the possible role of antioxidants,
Lancet Oncol 2000 Oct;1:107-12. owen et al. Division of Toxicology and Cancer Risk Factors,
German Cancer Research Center, Heidelberg


Positively Good For You

Ref 4;
Eurosciences communications 2000; American Diabetes Association 1998 clinical practice

Ref 5;
AHA Science Advisory Committee Monounsaturated Fatty Acids and Risk of Cardiovascular Disease
Penny M. Kris-Etherton, PhD, RD; for the Nutrition Committee

Ref 6, 7;
Menendez et al; Annals of Oncology Jan 2005. Goldacre et al. Olive oil, diet and colorectal cancer...
Community Health 2000;54:75660

Ref 8;
Espino-Montoro nutr metab cv dis 6 147-154; Katsilambros et al nutr metab cv dis 164-167
Associations of Dietary Fat, Regional Adiposity, and Blood Pressure in Men . Paul T. Williams, PhD;
Stephen P. Fortmann, MD; Richard B. Terry; Susan C. Garay, MS; Karen M. Vranizan, MA; Nancy
Ellsworth; Peter D. Wood, DSc JAMA. 1987;257(23):3251-3256.

Ref 9;
American Journal of Clinical Nutrition, Vol. 70, No. 6, 1077-1082, December 1999
Dietary factors in relation to rheumatoid arthritis: a role for olive oil and cooked vegetables Athena Linos

Ref 10;
Epic Study reports Trichopoulou BMJ 2009; 338: b2337

Ref 11;
Bosetti et al, International Journal of Cancer 2000, 87; 2; 289-94

Ref 12;
Pitt J, Roth W, Lacor P, et al. Alzheimers-associated A oligomers show altered structure,
immunoreactivity and synaptotoxicity with low doses of oleocanthal. Toxicology and Applied
Pharmacology 2009; 240: 189-197. Mediterranean Diet, Alzheimer Disease, and Vascular Mediation
Nikolaos Scarmeas, MD; Yaakov Stern, PhD; Richard Mayeux, MD; Jose A. Luchsinger, MD Arch Neurol.
2006;63:1709-1717. Scarmeas and colleagues from Columbia University Medical Center, New York
Archives of Neurology, February 2009

Ref 13;
Buijsse, B, Weikert C, Drogan D et al. Chocolate consumption in relation to blood pressure and risk of
CV disease in German adults. Eur Heart J 2010: DOI:10.1093/eurheartj/ehq068

Ref 14;
C. Samieri, C. Fart, C. Proust-Lima, E. Peuchant, C. Tzourio, C. Stapf, C. Berr, P. Barberger-Gateau.
Olive oil consumption, plasma oleic acid, and stroke incidence: The Three-City Study. Neurology, 2011

Ref 15;
Chiuve SE, Fung TT, Rexrode KM et al. Adherence to a Low-Risk, Healthy Lifestyle and Risk of Sudden
Cardiac Death Among Women. JAMA 2011; 306: 62-69.

Ref 16;
Adherence to Mediterranean Diet and Health Status Meta Analysis. Sofi et al. BMJ 2008; 337:a1344

Ref 17;
Kastorini C-M, Milionis H, Esposito K, Giugliano D, Goudevenos J, Panagiotakos D. (2011). The Effect
of Mediterranean Diet on Metabolic Syndrome and its Components. Journal of the American College
of Cardiology 57 (11): 12991313.

Ref 18;
Snchez-Villegas A, Delgado-Rodrguez M, Alonso A, et al. Association of the Mediterranean Dietary
Pattern With the Incidence of Depression. The Seguimiento Universidad de Navarra/University of
Navarra Follow-up (SUN) Cohort. Arch Gen Psychiatry 2009; 66: 1090-1098


Further bibliography
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Study. Am J Epidemiol 124: 903-915 (1986)
2. Willett WC: Diet and coronary heart disease. Monographs in Epidemiology and Biostatistics 15:
341-379 (1990)
3. World Health Organization: Diet, nutrition, and the prevention of chronic diseases. Report of a WHO
Study Group. WHO Technical Report Series 797, Geneva 1990
4. Denke M: Cholesterol-lowering diets. A review of evidence. Arch Intern Med 155: 17-26 (1995)
5. Gardner CD, Kraemer HC. Monounsaturated versus polyunsaturated dietary fat and serum lipids.
A metaanalysis. Arterioscler Thromb Vasc Biol 15: 1917-1927 (1995)
6. Mensink RP, Katan MB. Effect of a dietary fatty acids on serum lipids and lipoproteins A metaanalysis of 27 trials. Arterioscler Thromb 12: 911-919 (1992)
7. Riemersma RA, Wood DA, Butler RA, et al.: Linoleic acid content in adipose tissue and coronary
heart disease. BMJ 292: 1423-1427 (1986)
8. Espino-Montoro A, Lopez-Miranda J, Castro P, et al.: Monounsaturated fatty acid enriched diets
lower plasma insulin levels and blood pressure in healthy young men. Nutr Metab Cardiovasc Dis
6: 147-154 (1996)
9. Garg A, Grundy SM, Unger RH: Comparison of effects of high and low carbohydrate diets on plasma
lipoprotein and insulin sensitivity in patients with mild NIDDM. Diabetes 41: 1278-1285 (1992)
10. Griffin ME, Dimitriadis E, Lenehan K, et al.: Non-insulin-dependent diabetes mellitus: dietary
monounsaturated fatty acids and low-density lipoprotein composition and function. Q J Med 89:
211-216 (1996)
11. Hannah JS, Howard BV: Dietary fats, insulin resistance, and diabetes. J Cardiovasc Risk 1: 31-37
12. Bosello O, Armellini F, Zamboni M: Obesity. In: Spiller GA: The Mediterranean diets in health and
disease. Van Nostrand Reinhold, New York, 252-276 (1991)
13. Graham S, Marshall J, Hanghey B, et al.: Dietary epidemiology of cancer of the colon in Western
New York. Am J Epidemiol 128: 490-497 (1988)
14. Miller AB, Howe GR, Jain M: Food items and food groups as risk factors in a case-control study of
diet and colon cancer. Int J Cancer 32: 155-161 (1983)
15. Willett, WC, Stampfer JF, Colditz GA, et al.: Relation of meat fat and fibre intake to the risk of colon
cancer in a prospective study among women. N Engl J Med 323: 1664-1672 (1990)
16. World Health Organisation: World Health Statistics Annual. World Health Organisation, Geneva,
Switzerland, (1992)
17. Hill MJ: Diet and cancer: A review of scientific evidence. Europ J Cancer Prev 4: 3-42 (1995)
18. Hill MJ, Giacosa A, Caygill CPJ, eds.: Epidemiology of diet and cancer. Ellis Horwood, Chichester
19. Block G, Patterson B, Subar A: Fruit, vegetables and cancer prevention. Nutr Cancer 18: 1-29 (1992)
20. Steinmetz KA, Potter JD: Vegetables, fruit and cancer. I: Epidemiology. Cancer Causes and Control
2: 325-357 (1991)
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population. Am J Clin Nutr 61 (Suppl): 1374-1377 (1995)
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313-320 (1994)
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Int J Cancer 58: 774-780 (1994)


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24. La Vecchia C; Negri E, Francheschi S, et al.: Olive oil, other dietary fats, and the risk of breast
cancer (Italy). Cancer Causes and Control 6: 545-550 (1995)
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secondary prevention of coronary heart disease. Lancet 343: 1454-1459 (1994)
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heart disease. Am J Clin Nutr 61: 1360S-1367S (1995)
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Some Example Recipes

The concepts outlined in this book describe a pattern of eating and specific
ingredients which are common constituents of the Mediterranean Diet. With a
little imagination, there are limitless combinations of beautiful foods which can be
combined in quick and simple ways to produce a wonderfully healthy meal. This
book is intended to provide guidance, but leave the creativity to the reader. Below
are just a few examples of how the fabulous foods celebrated in this book can be
brought together to be enjoyed as a full and healthy positively good for you
taste of the Mediterranean meal.

Seafood with Wholewheat Penne Pasta

This recipe is quick and easy. It combines wonderful seafoods rich in
micronutrients such as zinc and selenium as well as omega3s. The seafoods can
be varied, with prawns, scallops, mussels, squid, or simply flakes of salmon. The
wholewheat pasta is low GI. The extra virgin olive oil used to fry will fully cook
the ingredients with minimal degradation, so most of the antioxidant polyphenol
content will remain helping promote a healthy heart. Celery is rich in apigenin, a
chemical thought to play a role in decreasing inflammation, and gingers most
active compound gingerol has been shown to have antibacterial properties. The
capsaicin in chilli is known to have effects which may help circulation.
Prepare the wholemeal pasta whilst lightly frying the red onions, peppers and
celery with a little ginger and chilli, adding the seafood cooked as recommended
by the producer to the pan. Season with black pepper and add fresh basil or
coriander to taste.


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Roasted Salmon with Honey and Herbs

and Rosemary New Potatoes
Succulent and healthy omega3 rich salmon fillets can be great with a
combination of flavours which are packed with goodness. Honey has been
known for centuries for its healing properties, probably derived from natural
protective preservatives from bees and many herbs, particularly rosemary
contain antiinflammatory salicylates compounds with properties similar to
aspirin, so widely used in modern medicine. New potatoes contain many
vitamins and minerals, particularly in their skins.
Roast the salmon in the oven with a combination of extra virgin olive oil, a
little balsamic vinegar, chilli flakes or paste and a teaspoon of mild honey.
Dried herbs or prepared pastes of herbs can be used in any combination to
taste. Boiled new potatoes sprinkled with fresh rosemary or paprika may be
accompanied by sauteed (in olive oil of course!) red onions, peppers and
sliced aubergines.


Cajun Chicken and Walnut Salad

Antioxidant spices, low saturated fat chicken, and mineral rich leafy spinach and
watercress creates a fabulous combination any time of year. Walnuts (and pine
nuts) add a source of vitamin E, and omega 3 oils. Nuts also contain natural
stanols which may be one of the reasons they lower cholesterol levels. This
salad can be created with a combination of sundried tomatoes, peppers, feta
cheese and beetroot which is packed with an antioxidant called betacyanin
which contributes to healthy circulation and blood pressure control.
Pomegranate seeds add a crunchy, fruit flavour. Their longstanding role in
ancient Indian medicine is now generating considerable interests in the
antioxidant content and possible beneficial effects on health. A dressing with
extra virgin olive oil, garlic, lemon juice, and a teaspoon of honey and mustard
complement this dish beautifully.
Prepare the chicken pieces with Cajun spices and fry lightly in extra virgin
olive oil until cooked. Meanwhile prepare the salad bed with the spinach and
watercress leave and add the nuts, beetroot, peppers etc to taste. Prepare the
dressing and drizzle over the completed salad.


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Lemon and Garlic Swordfish with Rice

This is a wonderfully simple recipe to prepare in a few minutes. Brown rice is
low GI and a great source of B vitamins and minerals, and of course fish is full
of omega3 heart healthy oils. The dressing, based on antioxidant rich extra
virgin olive oil contains lemon juice, rich in Vitamin C, and garlic, considered to
have beneficial effects on the cardiovascular system. The compound known as
lycopene present in the tomato of the passata is also a powerful antioxidant, and
is not diminished by gentle cooking.
Swordfish, (or tuna ) can be grilled or griddled, basted with a little olive oil
dressing, whilst boiling the rice. The ingredients for the dressing can include
crushed garlic, lemon juice, black pepper, and a little passata, and a can be
drizzled over the dish to enhance the delicious brown rice. Spring onions can
be mixed with the rice to add a little extra flavour. Serve with coloured


Further Useful Resources

British Dietetic Association
British Nutrition Foundation

American Heart Association

American Dietetic Association

NHS Choices

British Heart Foundation

American Cancer Society

Cancer Research UK


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