Intended for healthcare professionals

The Limits Of Medicine

The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%

BMJ 2004; 329 doi: (Published 16 December 2004) Cite this as: BMJ 2004;329:1447
  1. Oscar H Franco, scientific researcher (o.francoduran{at},
  2. Luc Bonneux, senior researcher2,
  3. Chris de Laet, senior researcher1,
  4. Anna Peeters, senior researcher3,
  5. Ewout W Steyerberg, associate professor1,
  6. Johan P Mackenbach, professor1
  1. 1 Department of Public Health, Erasmus MC University Medical Centre Rotterdam, PO Box 1738, 3000 DR Rotterdam, Netherlands
  2. 2 Belgian Health Care Knowledge Centre (KCE), Wetstraat 155, B-1040, Brussels, Belgium
  3. 3 Department of Epidemiology and Preventive Medicine, Monash University Central and Eastern Clinical School, Melbourne, Australia
  1. Correspondence to: O H Franco
  • Accepted 4 November 2004


Objective Although the Polypill concept (proposed in 2003) is promising in terms of benefits for cardiovascular risk management, the potential costs and adverse effects are its main pitfalls. The objective of this study was to identify a tastier and safer alternative to the Polypill: the Polymeal.

Methods Data on the ingredients of the Polymeal were taken from the literature. The evidence based recipe included wine, fish, dark chocolate, fruits, vegetables, garlic, and almonds. Data from the Framingham heart study and the Framingham offspring study were used to build life tables to model the benefits of the Polymeal in the general population from age 50, assuming multiplicative correlations.

Results Combining the ingredients of the Polymeal would reduce cardiovascular disease events by 76%. For men, taking the Polymeal daily represented an increase in total life expectancy of 6.6 years, an increase in life expectancy free from cardiovascular disease of 9.0 years, and a decrease in life expectancy with cardiovascular disease of 2.4 years. The corresponding differences for women were 4.8, 8.1, and 3.3 years.

Conclusion The Polymeal promises to be an effective, non-pharmacological, safe, cheap, and tasty alternative to reduce cardiovascular morbidity and increase life expectancy in the general population.


  • Contributors All authors participated actively in conception and design of the study or analysis and interpretation of data, in drafting the article or revising it critically for important intellectual content, and in final approval of the version to be published. OHF is the guarantor.

  • Funding This study was supported by grants from the Netherlands Heart Foundation (grant no 98.138) and the Netherlands Organization for Scientific Research (grant no 904-66-093). OHF, LB, CdL, AP, EWS, and JPM were partly funded by the Netherlands Heart Foundation (grant no 98.138) and the Netherlands Organization for Scientific Research (grant no 904-66-093). AP was also partly funded by VicHealth (fellowship grant no 2002-0191). All authors have acted independently from the funders of this project.

  • Competing interests None declared.

  • Ethical approval Not needed as this was a secondary data analysis.

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