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Pescatarian twist with fish is the best diet for heart health

If you were to design the ideal eating plan for a healthy heart, there is plenty of evidence to suggest that it would be the Pesco-Mediterranean diet with built-in daily fasting, a group of doctors said this week.

It is still the plant-rich, olive-oiled Mediterranean diet that most people know, but with more emphasis on seafood as the main source of animal protein.

This eating style has many benefits, especially when it comes to long-term cardiovascular health and longevity, the authors wrote in a review of studies published Monday in the Journal of the American College of Cardiology.

It also solves the “omnipotent dilemma.”

; When you can eat something – as humans can – what do you choose that is good for you, but also tasty and sustainable in the long run?

It is not the “junky” western diet with a high content of processed meat, refined carbohydrates and saturated fat, says Dr. James O’Keefe, lead author of the paper and director of preventive cardiology at Saint Luke’s Mid America Heart Institute in Kansas City, Missouri.

Vegan diets can reduce the risk of cardiovascular disease, but also lead to weak bones and muscles or anemia, he noted.

Enter the Pesco-Mediterranean diet that O’Keefe himself follows.

“It’s filling, it’s pleasant, it’s delicious and it’s super healthy,” O’Keefe said TODAY.

When it came to adding intermittent fasting to the mix, he and his colleagues felt “science is robust enough now that we can join it as a healthy thing to do,” he said.

Plant-based diet

The traditional Mediterranean diet – which has been called the “gold standard for cardiovascular health” – is primarily a plant-rich diet that includes plenty of fruits, vegetables, legumes, whole grains, seeds and nuts. Olive oil serves the main source of fat, while consuming very few red and processed meats.

Many studies and randomized clinical trials have found that this diet is associated with lower risks of dying prematurely from heart disease or developing coronary heart disease, the authors noted.

The diet should include three or more servings of vegetables and two or more servings of fruit a day.

Fish and shellfish

A pescatar diet – the “Pesco” part of the eating plan approved by this paper is still a plant-rich diet, but with seafood as the main source of meat. Fish is a high quality protein that is filling and helps build muscle and bone mass. It provides vitamins, minerals and other nutrients that are lacking in vegetarian or vegan diets.

Regular consumption of fish has been shown to reduce cardiovascular risk, “so we felt it deserved a certain place in the title,” O’Keefe said.

The goal is to eat seafood at least three times a week. Choose low-mercury fish such as salmon, sardines, trout, herring and anchovies. Avoid charring or burning fish during cooking, which can introduce carcinogenic compounds, the authors warned.

Fish contains a lot of omega-3, low in saturated fat and moderate calories, so it is better than beef or chicken as a source of protein, agreed Lisa Young, a registered New York dietitian and author of “Finally Full, Finally Slim.”

Studies have found that mortality from coronary artery disease was 34% lower in pescatarians compared to regular meat eaters, the authors noted.

Liberal use of extra virgin olive oil is an important part of the Mediterranean diet. It is crucial to choose high-quality oil made from cold-pressed olives, a process that preserves their potent antioxidants and creates a product similar to “pure olive juice,” the study noted.

The authors recommended consuming four or more tablespoons a day with EVOO, which can be used for dressing salads or for light cooking.

“In our household, I can tell you that we do not even think about limiting the amount of olive oil, we use it just as much as we want, and we go through a liter a week – just my wife and I,” O ‘ Said Keefe.

But Young warned against going overboard with the elixir for most people.

“You can’t add a bottle of olive oil to the typical American diet,” Young warned. “If you have full-fat cheese, some meat, fried foods and croutons, you will not pour a bottle of olive oil on top of it.”

Eggs and dairy products

The Pesco-Mediterranean diet allows the consumption of eggs, but preferably no more than five egg yolks a week – although there is no limit to egg whites. It also allows gently fermented low-fat versions of dairy products, including yogurt, kefir and soft cheeses.

Nuts and legumes

Nuts filled with unsaturated fats, fiber, protein and nutrients are “one of the most effective foods for improving long-term health outcomes”, the study noted. They fill so they do not promote weight gain. Young advised exchanging a lollipop or other typical afternoon snack for a handful of nuts.

Eating legumes has been linked to improvements in blood sugar, cholesterol levels and blood pressure.

Young recommended eating a variety of both foods to capture most of the nutrients: mixed nuts and lots of legumes including chickpeas, lentils and split peas.

Go for a serving of 1 ounce of nuts a day and three or more servings of legumes a week.


The main drink for this diet is water – either quiet, carbonated or used to make tea or coffee. It may be flavored but not sweetened. Dry red wine is gently allowed: one glass a day for women and up to two glasses for men consumed with meals.

Intermittent fasting

“Most Americans eat from the moment they get up to the moment they go to bed,” O’Keefe said. “But when we give our body a break from digesting food, it tends to be good for it.”

A daily fast of at least 12 hours, much of which is performed during sleep, and which can be extended to 16 hours a day, appears to improve cardiovascular health and lower blood pressure, the study noted.

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