Effect of a Mediterranean diet with fresh lean Australian pork on blood pressure, cardiovascular risk factors and cognition, mood and wellbeing in high risk individuals.

This is a randomised cross-over dietary intervention trial with two 8-week dietary phases (Mediterranean diet and low fat diet) separated by an 8 week washout period. Total duration of the trial is 24 weeks. Outcome measures will be recorded at the start and end of each 8 week phase (ie baseline, week8, week 16, week 24). At baseline volunteers will meet with the dietitian, for approximately 30mintues, and received instructions regarding their dietary prescription for the next 8 weeks. Volunteers will be prescribed their allocated diet, receive recipes and their sample menu (during Mediterranean diet) to help guide food choices. Volunteers will be given advice on eating out strategies to assist with compliance to their allocated diet.They will be issued a diet checklist to ensure they are complying with the diet. During the MedDiet phase, volunteers will receive lean fresh Australian pork plus foods characteristic of the MedDiet (olive oil, canned fish, nuts etc) to assist with compliance. All volunteers will be asked to maintain their usual exercise pattern. Volunteers will be asked to return fortnightly to see the dietitian (for 15-30 minutes), have their weight measured, return checklists, collect study foods and discuss any problems that may have arisen during the intervention. During the washout periods between diet phases, volunteers will be asked to return to following their habitual diet. Mediterranean Diet (MedDiet) with pork. The MedDiet is characterised by a variety of foods including wholegrain cereals, nuts, legumes, extra virgin olive oil, red wine, small amounts of red meat, low intakes of dairy (mainly yoghurt and cheese), fish, fruits and vegetables. The MedDiet will be based on the PREDIMED-EVOO diet as described by Estruch R et al (NEJM 2013) and fresh lean pork will be included as an alternative option for protein food. Guidelines for following the MedDiet are adapted from Estruch R et al 2013 NEJM, include: Abundant use of extra virgin olive oil for cooking and dressing vegetables and salads 2-3 or more daily servings of fresh fruits including 100% natural juices 3 or more weekly servings of legumes (75g per serve) 3 or more weekly servings of fish and seafood (at least one serving of oily fish) (100g per serve) 3 or more weekly serving of nuts (7.5g hazelnuts, 15g walnuts, 7.5g almonds) or seeds (30g per serve) Ad-libitum consumption of wholegrain cereal products (bread, pasta, rice, cereal), nuts, fish, eggs, cheese and raw and cooked vegetables. Select white meats (poultry without skin) instead of red meats or processed meats (burgers, sausages, deli meats) Limit consumption of cured ham, red meat (remove all visible fat) to 1 or less serve/week Remove chicken skin Cook regularly (at least twice a week) with tomato, garlic and onion Dress vegetables, pasta, rice and other dishes with tomato, garlic and onion Eliminate or limit the consumption of cream, butter, margarine and discretionary foods Adherence to the MedDiet will be assessed using a 14-point adherence score assessed fortnightly. Compliance to the MedDiet will be assessed from weighed food records conducted at the beginning and end of each dietary phase and through daily checklists. All volunteers will see the dietitian fortnightly who will discuss strategies to maintain compliance to the MedDiet.