Views & Reviews Outside the Box

Anyone for Club Med?

BMJ 2008; 337 doi: (Published 04 July 2008) Cite this as: BMJ 2008;337:a677
  1. Trisha Greenhalgh, professor of primary health care, University College London
  1. p.greenhalgh{at}

    A group of Spanish epidemiologists recently published a paper in the BMJ offering evidence that we can reduce our relative risk of developing diabetes by 83% by following a strict Mediterranean diet (BMJ 2008;336:1348-51, doi: 10.1136/bmj.39561.501007.BE). In view of my family history of the condition I made a unilateral (and, in retrospect, foolish) decision to amend the whole family’s diet.

    The paper describes a Mediterranean diet as one “rich in olive oil, plant based foods (fruits, vegetables, and legumes), and fibre but low in meats.” My animal protein comes from battered fish (every Friday, without fail) and soft boiled eggs, so I had plenty of room for improvement, despite describing my diet as “vegetarian.”

    The other day I proudly served up an aubergine, basil, and tomato casserole with couscous. The family sniffed at it politely and asked what else was coming. Nothing—this is the main course. Hmmm. No mashed potato then? Spouse covered his in a generous grating of Cheddar cheese. The kids asked whether I minded if they fried up some bacon to go with it.

    Don’t get me wrong: my teenagers are no junk food junkies. For years they have been coming home from school to find notes on the kitchen table: “Home late, ingredients in fridge—Mum.” They know their coriander from their cardamom. The younger one makes a mean sag aloo. It’s good to come home from a four hour committee meeting to find the boys in aprons in the kitchen and another wholesome, creative curry bubbling in the pot.

    I had always assumed it was an anthropologist who challenged the population to “tell me what you eat and I’ll tell you who you are,” but actually it was the 18th century French politician Jean Anthelme Brillat-Savarin (who, like everyone else these days, has a page on Wikipedia) in his book Méditations de Gastronomie Transcendante (Meditations on Transcendental Gastronomy).

    Once humankind has moved beyond subsistence, food is not really about staying alive or even of staying healthy but about social pleasure and symbolic meaning. We put effort into making food, and particularly into making it tasty, because this is one of the most efficient ways of drawing a family or group of friends together.

    Which I guess is why, despite Camembert, foie gras, and pain au chocolat, the French outlive the Spanish by a mean of seven months and the British by a full two years. It’s also why, despite robust evidence that I’m stacking up an adverse risk profile, I’ve reinstated the coconut milk and ghee on the weekly shopping list.


    Cite this as: BMJ 2008;337:a677

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