The Playbook

TL;DR. The whole book, distilled into what to actually do. It is deliberately boring, because the strongest evidence in this field points at unglamorous things. If you read nothing else, read this chapter and the emergency one after it.

1. Food: the twelve things that matter

Ranked roughly by strength of evidence and size of effect.

1. Eat more plants, of more kinds. Fruit, vegetables, pulses, whole grains, nuts, seeds. The dose-response continues to around 800 g of fruit and vegetables a day, and variety matters as much as quantity (Chapter 37).
2. Eat pulses regularly. Beans, lentils, chickpeas. The single highest-leverage change for fibre, at 12 to 16 g per cooked cup, plus protein, iron, folate, and potassium (Chapter 47).
3. Get fibre to about 30 g a day, gradually, with water. Most people eat half that, and the evidence linking fibre to lower mortality, heart disease, diabetes, and colorectal cancer is among the most consistent in nutrition (Chapter 14).
4. Choose intact over milled. Whole grains, whole fruit, whole pulses. Physical structure matters as much as composition: finely milled wholemeal behaves much like white flour (Chapter 11).
5. Cut sugar-sweetened drinks first, before anything else. They are the clearest single dietary harm and the easiest to remove (Chapter 57).
6. Cut processed meat next, then reduce red meat. Processed meat is IARC Group 1 and the association with cardiovascular disease and diabetes is stronger still (Chapter 55).
7. Eat oily fish twice a week, or take algal oil. Small oily fish (sardines, anchovies, mackerel, herring) win on omega-3, price, mercury, and sustainability at once.
8. Replace saturated fat with unsaturated fat, not with refined carbohydrate. Extra virgin olive oil has a randomised hard-endpoint trial behind it (Chapter 34).
9. Get protein up if you are over 60, losing weight, or training: 1.2 to 1.6 g/kg, spread across three meals (Chapter 12).
10. Reduce salt, mostly by cooking from raw ingredients rather than by moving the salt cellar, and consider a potassium salt substitute unless you have kidney disease.
11. Reduce alcohol. There is no safe level for cancer risk, and the heart benefit has largely dissolved (Chapter 61).
12. Reduce ultra-processed food, prioritising drinks, processed meat, and packaged snacks rather than treating tinned beans and wholemeal bread as the enemy (Chapter 58).

What is not on the list, deliberately: superfoods, detoxes, supplements for well-fed people, alkaline diets, food combining, and any specific fruit or vegetable as a cure for anything.

2. The kitchen rules

Preparation:

• Add fat to orange, red, and dark green vegetables. Carotenoid absorption depends on it, and a fat-free salad delivers a fraction of what is in it.
• Cook tomatoes with oil for lycopene; eat raw ones too for vitamin C.
• Steam or microwave rather than boil. If you boil, keep the water.
• Chop brassicas 40 minutes before cooking, or steam briefly, or add mustard, horseradish, or rocket to cooked ones (Chapter 39).
• Crush garlic and wait 10 minutes before heating (Chapter 40).
• Eat the skins: apple, potato, carrot, kiwi, aubergine. Most of the fibre and polyphenols are there or just beneath.
• Eat the stems, stalks, and tops: broccoli stems, chard stems, beetroot leaves, cauliflower leaves.
• Cook and cool starchy foods for resistant starch.
• Marinate before grilling, and keep meat away from flame and dripping fat.
• Golden, not brown; brown, not black (Chapter 91).

Storage:

• Counter, not fridge: bananas, unripe tomatoes, unripe avocados and stone fruit, cucumbers, aubergines, whole melons, whole winter squash, basil.
• Dark cupboard, not fridge: potatoes, sweet potatoes, onions, garlic.
• Fridge: greens, berries, apples, grapes, carrots, brassicas, mushrooms (in paper), everything cut.
• Never together: apples/bananas with potatoes, greens, or anything you do not want ripened; onions with potatoes.
• Do not wash produce before storing. Wash at the point of eating.
• Frozen vegetables and berries are nutritionally equal or better than travelled fresh, and much cheaper (Chapter 9).

Shopping:

• Smell the stem end. For melons, stone fruit, mango, pineapple, strawberries: no smell, no flavour.
• Heavy for its size for citrus, melons, cucumbers.
• Tinned pulses, tinned tomatoes, tinned oily fish, frozen vegetables, oats, and eggs are the cheapest nutritional bargains in the shop.
• Read the ingredients list, not the front of the pack.

Safety:

• Scrub melons before cutting. The knife carries rind bacteria into the flesh.
• Boil red kidney beans hard for 10 minutes. A slow cooker on low makes them worse.
• Discard green, sprouted, or bitter potatoes, and any bitter courgette or squash.
• Do not wash raw chicken.
• Cool cooked rice fast and refrigerate within an hour.
• Whole cuts of beef can be rare; mince cannot.
• Cut grapes and cherry tomatoes lengthways for under-5s, and no whole nuts.

3. The medicine rules

Every time:

• Read the active ingredient, not the brand. This is how paracetamol overdoses happen (Chapter 64).
• Check every over-the-counter box for paracetamol and ibuprofen before adding another.
• Never crush or chew anything marked MR, SR, XL, XR, CR, LA, EC, or gastro-resistant.
• Keep a written list of everything you take, including supplements, and bring it to every appointment.
• Use one pharmacy.

Specific:

• Paracetamol: 4 g a day maximum, less if you are small, unwell, or drink heavily. Overdose produces no symptoms for a day and the antidote works best within 8 hours (Chapter 65).
• Ibuprofen: lowest dose, shortest time. Never with an ACE inhibitor plus a diuretic without asking. Use topical NSAIDs for local pain.
• Combine paracetamol and ibuprofen rather than escalating; it beats most opioid combinations for acute pain.
• Take PPIs 30 to 60 minutes before breakfast, and review them annually.
• Take levothyroxine on an empty stomach, away from calcium, iron, coffee, and soy.
• Separate calcium, iron, dairy, and antacids from tetracyclines, quinolones, levothyroxine, and bisphosphonates by 2 to 4 hours.
• Never stop beta blockers, steroids, benzodiazepines, antidepressants, or antiepileptics abruptly.
• Ask about grapefruit and alcohol with any new drug.
• Do not keep medicines in the bathroom. Return unused ones to a pharmacy.
• Get your penicillin allergy label tested if you have one (Chapter 72).
• Have your inhaler technique checked, and use a spacer with a pMDI (Chapter 78).
• Never buy prescription medicines from a site that does not require a prescription.

Three questions for any new medicine: what is it for, how will I know it is working, and what should make me stop and call someone?

One question for any preventive medicine: what is the number needed to treat, over what period?

4. The supplements worth taking

Everything else, for a well-fed person, has failed to show benefit in trials. Beta-carotene and high-dose vitamin E have shown harm (Chapter 81).

5. Everything else that goes in

• Coffee: 3 to 4 cups a day is fine and probably beneficial. Stop 8 to 10 hours before bed. Filter it if your cholesterol is a concern. Not with meals if you need the iron.
• Do not smoke, and if you do, switch completely or quit with combination NRT plus support.
• Fit a carbon monoxide alarm. Test for radon if you are in an area.
• Vent your cooking outside, use the back burners, prefer induction.
• Do not heat food in plastic. Transfer to glass or ceramic.
• Never preheat an empty non-stick pan, and keep birds out of the kitchen.
• Use cold water only for drinking and cooking if you have old plumbing.
• Sunscreen daily on exposed skin, in adequate quantity, alongside shade and clothing.
• Vary your grains and cook rice in excess water and drain.
• Take your shoes off indoors.

6. The five habits that would change most people's diet

If the lists above are too long, this is the compressed version:

1. A tin of pulses in something, most days.
2. Frozen vegetables in the freezer, used.
3. A cooked-from-raw meal instead of a packaged one, most days.
4. Water, tea, or coffee instead of sugary drinks.
5. Whole fruit instead of juice, and nuts instead of crisps.

7. What to ignore

• Superfoods, ORAC scores, and exotic berry powders.
• Detoxes, cleanses, and alkaline diets. Your liver and kidneys work continuously and cannot be helped.
• IgG food intolerance tests, hair analysis, and applied kinesiology.
• "Chemical-free," "natural," and "60 percent of what you put on your skin."
• Single-study headlines, especially about mice.
• Anyone selling certainty, in either direction.

8. The honest summary of the evidence

Very strong: don't smoke; keep moving; sleep enough; eat plants and fibre; drink less alcohol; vaccinate; treat blood pressure; don't get lead in your water.

Strong: whole grains, pulses, nuts, oily fish, olive oil; less processed meat and sugary drinks; statins in those at risk; weight loss for type 2 diabetes.

Reasonable: most of the cooking and storage advice; fermented foods; the timing findings; the supplement short-list.

Weak and interesting: most single-nutrient claims, most phytochemical claims, most microbiome products, most of what is exciting.

The uncomfortable truth is that the strongest evidence supports the least interesting advice, and that almost everything sold as a shortcut is either unsupported or a repackaging of the boring list.

9. The bottom line

• Plants, fibre, pulses, whole grains, oily fish, olive oil, nuts. Less sugary drink, less processed meat, less alcohol, less ultra-processed food.
• Cook from raw ingredients more often. It solves salt, sodium, phthalates, packaging, and ultra-processing simultaneously.
• Add fat to coloured vegetables, keep the skins, steam rather than boil, cook golden not brown.
• Read the active ingredient on every medicine box. Know the paracetamol limit. Never crush a modified-release tablet. Keep a list and use one pharmacy.
• The supplements worth taking are a short specific list, and everything else has failed in trials.
• Don't smoke, fit a CO alarm, test for radon, vent your cooking, and wear sunscreen.
• Ignore anyone selling certainty.

👉 Last of the practical chapters: emergencies, which is worth reading before you need it.