For optimal heart health, I’ve been recommending the Pan-Asian Modified Mediterranean (PAMM) diet—a combination of the heart-healthy diet plan followed by the people on the Greek island of Crete (also known as the Mediterranean diet) and a diet common among people living on the Asian side of the Pacific Rim—since the mid-1990s, when the results of the Lyon Heart Diet Study were published.
In the Lyon [France] trial, 605 heart attack survivors were assigned to eat either a Mediterranean-style diet or a diet then recommended by the American Heart Association (AHA). Four years later, participants following the Mediterranean-style heart-healthy diet plan were 50 percent to 70 percent less likely to have had repeat heart attacks. Best of all, there had been no sudden deaths in this group.
Even more promising, a separate analysis of the study found that deaths from all causes were also significantly lower among those following the Mediterranean diet (there were 14 deaths in the Mediterranean group compared with 24 among those following the AHA diet). When researchers looked at cancer development in the third and fourth years of the study, they found similar advantages to the Mediterranean-style heart-healthy diet plan: Only two people on the Mediterranean diet had developed cancer, compared with 12 in the AHA diet group.
The Key to a Heart-Healthy Diet Plan: Essential Fatty Acids
Given such striking differences, I was eager to pinpoint exactly what it was about the Mediterranean diet that made it so superior for heart health. The key appeared to be essential fatty acids (EFAs). A separate study of EFAs published in 1995 supported this assumption. People who ate two meals of fatty fish per month—such as salmon, anchovy and mackerel—experienced a 30 percent reduction in cardiac arrest; four fatty-fish meals a month were associated with a 50 percent reduction in cardiac arrest!
EFAs, which cannot be manufactured by the body (hence the name “essential”), penetrate layers of cholesterol-laden plaque, soothing inflammation in blood vessels and preventing blood-clotting deposits from lining coronary arteries. EFAs can also prevent spasms of the coronary blood vessels and the rupture of plaque.
In this context, the advantage of the Mediterranean heart-healthy diet plan is clear. It, along with the diet favored along the Pacific Rim, is rich in the omega-3 fatty acids that include two particularly important EFAs, docosahexaenoic acid (DHA) and eicospentaenoic acid (EPA). The typical Western diet, by contrast, is rife with refined carbohydrates and animal proteins, and includes few, if any, inflammation-reducing omega-3s.
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