The 21-day live-longer diet
Dr Aseem Malhotra reveals how Pioppi, the world’s healthiest village, holds the key to beating obesity, diabetes and heart disease
In southern Italy, two hours south of Naples, there is a sleepy little village called Pioppi (population: 197), where the average man outlives the average elite Tour de France cyclist by an additional eight years. The Pioppians do not just live long, they live well; without contracting the chronic diseases of ageing such as type 2 diabetes that the rest of the world accepts as inevitable. And this tiny village with no gym and no supermarket has asserted a greater influence on global nutritional and health policies than anywhere else on the planet. It was here, in the Seventies, that American scientist Prof Ansel Keys conducted research that ultimately framed our modern, albeit skewed, interpretation of the Mediterranean Diet.
In yesterday’s Sunday Telegraph, i explained how Irish filmmaker Donal O’neill and I travelled to Pioppi to make a documentary called The Big Fat Fix. Here, we discovered, a catastrophic case of “lost in translation” had over-simplified the locals’ much broader, health-positive lifestyle into fatally flawed dietary advice that demonised fat; advice that I (and many others) now argue has in fact driven the twin epidemics of type 2 diabetes and obesity, by increasing the consumption of sugar and other refined carbohydrates.
We have distilled our discoveries, and the expertise of a multitude of respected international cardiologists and obesity experts, to create
The Pioppi Diet. An easy-to-follow 21-day action plan, it is designed to target and improve health markers – including waist circumference, triglycerides, Hdl-cholesterol, HBA1C and ALT – linked to insulin resistance which, together with inflammation, lies at the root of heart disease, high blood pressure, type 2 diabetes, dementia and cancer.
Be prepared for everything you believe to be true about nutrition to be turned on its head. Stop fearing saturated fat and cholesterol; stop counting calories; and start recognising sugar as public enemy number one.
THE TRUTH ABOUT FAT
Dietary fat in unprocessed food is not just a crucial provider of essential amino acids, vital to health, it helps you feel fuller for longer – thereby helping weight control. In comparison to protein and carbohydrates, it also has the smallest impact on raising blood sugar and thus spiking insulin. Yet the misconception that saturated fat is harmful persists, resulting in supermarket shelves stacked with “low fat”, processed foods that are loaded with sugar; the only substance (other than alcohol) that humans ingest that has no nutritional value.
When Prof Keys singled out foods high in saturated fat as having a harmful correlation with heart disease, he failed to note many were processed carbohydrates such as cakes, ice cream, biscuits and pastries. Meanwhile, recent Canadian research, looking at all relevant studies, including those undertaken on over 300,000 healthy people followed for up to 25 years, found no association between the consumption of saturated fat and heart disease or type 2 diabetes.
THE PROBLEM WITH SUGAR
Traditionally, sugar was considered a rare treat in Pioppi, and dessert eaten roughly once a month. Today, many of us effectively eat dessert two to three times a day. I used to be that person – with cereal for breakfast, a mid-morning biscuit and slice of cake after dinner, I was consuming up to 40 teaspoons a day of sugar on occasion, and thought feeling hungry every couple of hours was normal.
I’ve never been overweight by the conventional definition of body mass index but, from my teens onwards, I’ve always carried fat around my belly. I assumed this was a normal part of my genetic make-up, as my father, who has also been very active, also has a pot belly. However, within weeks of cutting out sugar, bread and pasta, I managed to lose a stone in weight – all it seemed, from my midriff – without increasing the amount of exercise I was doing.
THE PIOPPI PLAN
Less of a diet, more of an “intervention”, this 21-day plan combines great food with small but powerful lifestyle changes to deliver not just weight loss, but better health and happiness.
Towards the end of his life, the pioneering heart transplant surgeon Christiaan Barnard said, with some regret: “I have saved the lives of 150 people through heart transplants. If I had concentrated on preventive medicine earlier, I could have saved 150 million.” Lifestyle, the Pioppians’ diet, is that medicine.
ENJOY…
Three meals a day, and eating until you feel full.
At least 2-4 tbsp of extra virgin olive oil a day (one of the healthiest foods for your heart, it reduces inflammation and prevents high blood pressure, especially when combined with vegetables).
One small handful of tree nuts (hazelnuts, walnuts, almonds, macadamias) a day.
At least 5-7 portions of fibrous vegetables (broccoli, cauliflower, courgette, aubergine) and low-sugar fruits (tomatoes, apples, berries) a day. Vegetables with at least two meals a day, preferably three (for potatoes, opt for the sweet variety and if you’re overweight or have type 2 diabetes, try to limit to no more than two portions a week).
Fatty fish at least three times a week. At least 10 eggs (pasture-raised or organic) a week.
Full-fat dairy products, eg Greek yogurt, cheese and butter (ideally) produced by grass-fed cattle.
AVOID…
All added sugars (it’s everywhere, check those labels). Have fruit juice, honey and syrups for the first two weeks to break the addiction of sugar cravings. After that, you can reintroduce a square of dark chocolate (at least 85 per cent cocoa solids) if you wish.
All packaged, refined carbohydrates, in particular anything flour-based – bread, cake, pastries, muesli bars, packaged noodles, pasta, couscous and rice (if you miss bread, pasta and rice at the end of the 21 days, think of them as treats to have infrequently). Industrial seed oils (ie sunflower). Processed red meats (ideally, opt for meat from grass-fed animals, and eat no more than 500g a week).
FAST
It may not have been intentional, but intermittent fasting was a natural part of traditional life in Pioppi, due to poverty and food availability. As we now know, fasting is a rising star in the treatment of type 2 diabetes.
So, for one 24-hour period each week, fast by eating as normal until the end of the day, then extending the natural overnight fast by not eating breakfast or lunch the next day. Consume fluids such as tea, coffee or sparkling water only, during this time.
ALCOHOL
In excess, this has a similar metabolic effect on the body as sugar. Stick to the current recommended guidelines of 14 units a week, and drink like they do in the Mediterranean – no more than one large glass of red wine with your evening meal.
MOVE
Do not sit for more than 45 minutes at a time – take two-minute mini-movement breaks.
Walk for at least 30 minutes, five days a week, and make it brisk.
SLEEP
Aim for a minimum of seven hours each night. Reduce exposure to blue light (phones, computers etc) for at least two hours before bedtime.
DR MALHOTRA’S TYPICAL DAY
Breakfast: Single espresso mixed with 1 tbsp of extra virgin coconut oil, 1 tsp turmeric, 1 tsp of organic raw cacao powder and 1 tsp cinnamon powder; 1 square dark chocolate, a small handful of nuts and an apple.
Lunch: 1 fillet of smoked mackerel marinated in 2 tbsp extra virgin olive oil, 2 boiled eggs and a side of pickled cabbage.
Dinner: Salmon curry served with Indian mixed vegetables (green beans, broccoli and cauliflower), full-fat yogurt and side salad.
For delicious recipes inspired by Pioppi: telegraph.co.uk/health-fitness