The Mediterranean diet is the gold standard of healthy eating. Research continues to support the many health claims of the diet: reduced risk of death from a heart attack or stroke, lower “bad” cholesterol levels, and lower risk of type 2 diabetes.
From moderate servings of fish and wine to cutting back on red meat, its guiding principles remain relatively easy to stick to in a confusing — and often extreme — nutrition landscape.
Now, a new diet seeks to upend the good name of the Mediterranean diet while simultaneously claiming it’s based on some of the same principles.
The Pioppi diet, which was created by cardiologist Dr. Aseem Malhotra and Donal O’Neill, director of such anti-carbohydrate films like “Run on Fat” and “Cereal Killers,” shifts the plant-forward emphasis of the Mediterranean diet to one with a focus on eliminating carbs and eating more fat and protein.
For this book, the two authors visited the small, rural fishing village of Pioppi, Italy. They came back with a new “lifestyle plan” based on their observations of the roughly 200 people living there.
The pair didn’t perform actual studies or research in Pioppi. Instead, they relied on their observations of the healthy villagers that are purported to live a long life, to craft their new healthy-living formula.
For critics, the plan is short on science and heavy on hyperbole.
What is the Pioppi diet?
The Pioppi diet is the latest in a series of diets that encourage low-carb, high-fat (LCHF) eating as a way to transform your health.
Despite the name, this diet doesn’t encourage calorie counting or excessive exercise, but it does ask you to embrace very specific eating guidelines.
“Simply put, [the Pioppi diet] is basically a take on the popular Mediterranean diet, and follows a lot of those same rules and guidelines, in addition to adding a few of its own,” said Vanessa Rissetto, a registered dietitian and nutritional expert.
The Pioppi diet principles include:
- Starches are out. Eliminate all added sugar and refined carbohydrates, like rice, bread, pasta, and potatoes. You can’t cheat with a natural sweetener like honey either. It’s banned.
- Fruits and vegetables are in. Each day, you should aim to get five to seven servings of fruit and vegetables, with at least five of those coming from low-sugar fruit.
- Aim for weekly fish and egg quotas, too. Oily fish like salmon and sardines should be on your plate at least three times each week, and find a way to eat at least 10 eggs weekly, too.
- Olive oil remains. Olive oil is a key cornerstone of the Pioppi diet. You should aim for two to four tablespoons of the pressed oil each day. Unlike the Mediterranean diet, the Pioppi diet encourages you to eat coconut oil, something the Pioppi people don’t do.
- Treat yourself. You can also indulge a bit with a glass of wine each day, and you can have up to 30 grams of dark chocolate, too.
“There are health benefits to things like nuts, olive oil, fish, etc., but it’s as much what the diet doesn’t include that helps improve health,” noted Jamie Logie, a nutritionist, personal trainer, and wellness coach.
“There isn’t any refined sugars or carbohydrates, no trans fats, artificial sweeteners, or flavors, or things like high-fructose corn syrup. The focus is on real whole food,” she told Healthline.
The food guidelines are just the start of the Pioppi diet. This diet also encourages substantial life changes.
This is how, the authors claim, this philosophy becomes a whole-life approach to health and nutrition, not just an eating guideline or short-term diet.
These lifestyle changes include:
- Fasting weekly. Once a week, fast for 24 hours. The authors recommend starting after dinner, then skipping breakfast and lunch while only drinking fluids the next day.
- Get moving. They encourage physical fitness, though the recommendations are based more on personal preference than specific guidelines. Malhotra suggests brisk walking every day for 30 minutes, plus getting up from your desk every 45 minutes. O’Neill is an advocate of high-intensity interval training (HIIT) workouts.
- Sleeping plenty. The Pioppi diet writers encourage at least seven hours of sleep each night, the same amount the National Sleep Foundation recommends.
- Relaxing more. You should also adopt breathing or meditation exercises each day, and spend more time with your friends and family.
Is the Pioppi diet bad science?
Ancel Keys, a famous American researcher, retired in Pioppi. Keys was one of the first nutrition scientists to discover the health benefits of the foods people living in the Mediterranean coastal communities primarily ate. Indeed, he was one of the first researchers to link saturated fat with heart disease.
“By claiming that their advice is based on the people of Pioppi, Italy, they are obviously trying to insult Ancel Keys, who told people to avoid eating animal fats,” explained Laurie Thomas, a medical and academic editor and writer, and author of several books, including “Thin Diabetes, Fat Diabetes: Prevent Type 2, Cure Type 2.”
“Not only is the Pioppi Diet far different from what Keys recommended, it does not really represent what the people from Pioppi actually eat. Nor is it a health promoting diet for human beings,” she pointed out.
Keys died in Pioppi in 2004 at age 100. This new diet is seen by some, Thomas said, as a final dig at a man who advocated against LCHF diets for much of his professional career.
“The Pioppi diet is just another attempt to make people think that a fatty, low-carb, Atkins-style diet is healthy,” Thomas said. “By calling it a Mediterranean diet and associating it with Pioppi, they are trying to confuse people.”
There’s another critical wrinkle that opponents of the Pioppi diet point to: the lifestyle factors of the Pioppian people that aren’t considered in the Pioppi diet’s guidelines. People who live in the village often don’t have the financial resources to eat red meat, and sometimes, they don’t have the resources to eat much of anything. This is reflected in the new diet by suggesting people eat red meat sparingly and fast weekly.
Again, Thomas pointed out, these diet cornerstones are based on the authors’ observations and not research they conducted.
“The Mediterranean diet that Keys advocated was based on grain products — bread and pasta — vegetables and fruit, and legumes. It included olive oil, moderate amounts of fish and wine, and only small amounts of meat and dairy foods,” Thomas shared.
“In contrast, the Pioppi diet urges people to shun wheat and pasta and eat large amounts of fatty meat and dairy foods,” she explained. “The Pioppi diet also encourages people to eat a lot of coconut oil, which is not a normal part of the diet in any Mediterranean country.”
For Rissetto, the basic concept of the Pioppi diet seems okay, but, she added that it’s nothing unique or special in the diet realm.
“Nothing about this diet is revolutionary. The basic concept of eating more fruits and vegetables and less red meat is worth following, but it’s also not totally unique,” Rissetto said.
“Eating whole, unprocessed foods [is] what we as dietitians preach,” Rissetto pointed out.
“Unfortunately, people often times need that packaged up in some sexed up way in order to believe it might work,” she explained.