The ultimate Polymeal

Although the concept of a Polypill (proposed in 2003) is exciting in terms of reducing risk of cardiovascular disease, the potential costs and adverse effects are its main pitfalls.¹ Last December a paper in the BMJ investigated the concept of a tastier and safer alternative—the Polymeal.² Chocolate, wine, fish, nuts, garlic, fruit, and vegetables are all known to have a positive effect on cardiovascular disease, and have been enjoyed by humankind for centuries. The researchers found that a combined meal of these components may reduce cardiovascular disease by more than 75%.

The BMJ ran a competition to find the ultimate Polymeal,³ and, after many months and many tasting sessions, has announced a winner. The competition was strong and the quality of many recipes was extremely good. In the interests of thorough, hands-on research, we would have liked to cook all the meals in our office kitchen, but the limited equipment (microwave, kettle, and toaster) affected our ability to follow the methods set out in the recipes.

We finally resorted to the eminent chef Raymond Blanc, whose own Polymeal recipe started the ball rolling for a final decision.³ His choice of the winner was based on six criteria: presentation, tastes and textures, creativity, method, clarity of setting out the recipe, and adherence to the recommended quantities of the essential ingredients. The winner is Heather A Haywood, a general practitioner at the Camelon Medical Practice, Falkirk; her Polymeal is set out below. All recipes submitted to the competition can be found on bmj.com.

Starter—Roasted red pepper and almond dip, with lots of raw vegetables

• 80 g almonds, shelled
• 285 g jar roasted red peppers in olive oil
• 3 garlic cloves, peeled and finely chopped
• 2 teaspoons red wine vinegar
• 2 tablespoons olive oil from the jar of peppers
• salt and freshly ground black pepper

1. Preheat oven to 220°C (regulo 7). Place almonds on a baking tray and roast for 8 minutes, until just golden. Allow to cool slightly and then whiz in a blender until fine.
2. Drain the peppers, reserving 2 tablespoons oil.
3. Add peppers, garlic, and vinegar to blender and whiz until coarse. With machine running, pour in the oil. Season. Serve with carrot, cucumber, and celery sticks or any other dipping vegetables that come to hand.

Main course—Cod with red wine sauce

• 4 x 275 g cod steaks
• 25 g butter
• 1 tablespoon sunflower oil
• seasoned flour
• For the sauce:
• 25 g butter, diced and chilled
• 4 shallots, sliced
• 100 g streaky bacon, cut into strips
• 150 ml fruity red wine
• 150 ml chicken stock
• 2 tablespoons chopped fresh parsley
• seasoning

1. Season the cod steaks. Heat oven to 180°C (regulo 4).
2. Put first portion of butter and oil in a roasting tin and melt over medium heat. Lightly dust both sides of the fish steaks with the flour then lightly brown in the roasting tin. Remove and set aside.
3. For the sauce, gently fry shallots and bacon in remaining oil.
4. Return the cod to the tin, cover with foil and roast for 15-20 minutes. Transfer fish to an ovenproof dish and keep warm.
5. Drain any excess fat from tin. Place over a medium heat and add the wine to the shallots and bacon. Bring to boil while stirring and scraping in the sediment. Add the stock and boil until reduced by two thirds. Gradually add the chilled butter, swirling it in to thicken the sauce. Add parsley and season.
6. Pour a little sauce on to four warmed plates, place cod steaks on top and spoon remaining sauce over. Serve with boiled new potatoes, steamed broccoli, and momentarily stir fried mangetout.

This recipe allows for three people to have a small glass of wine and one driver to enjoy the aroma in the fish!

Finishers—Marbled chocolate fondue

• 400 g plain bitter chocolate
• 100 g white chocolate
• 4 tablespoons white rum—or something from the cupboard
• 500 g-1 kg fresh fruit, for example strawberries, cherries, bananas, pineapple, kiwis, grapes—anything that will go with chocolate and hang on to the end of a fondue fork
• 200 g nuts

1. Toast nuts in a dry pan or in the oven until lightly browned. Cool and then chop finely.
2. Prepare the fruit and cut into bite size pieces—get your guests to do this at the table or while hanging around your kitchen.
3. In two separate bowls over hot water melt the plain and white chocolate, or melt them in the microwave. Add 3 tablespoons rum to the plain chocolate, 1 tablespoon to the white. Pour the plain chocolate into the fondue and swirl the white in lightly, using a skewer. Keep barely warm—a constant candle will singe the bottom.
4. Spear a piece of fruit, dip it into the chocolate without allowing it to be pinched by the opposition, dip into the nuts to coat, and devour—or feed it to whichever guest is pronouncing an opinion with which you are not entirely in agreement.

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



studentBMJ 2005;13:265-308 July ISSN 0966-6494

1. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003;326: 1419-24.
2. Franco OH, Bonneux L, De Laet C, Peeters A, Steyerberg EW, Mackenbach JP. BMJ 2004;329:1447-50.
3. Festive fare and Christmas competition: eat healthily, eat well. BMJ 2004;329:1496.