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The True "Heart Attack Proof" Diet
A couple of months ago a reader asked me for my opinion of Dr. Esselstyn's 'Heart Attack Proof' diet. This is essentially an extremely-low-fat diet that completely eliminates meat, fish, dairy, and all oils, including nuts. On the one hand, we know that extremely-low-fat diets are not the magic bullet in preventing heart disease that it once was thought to be (JAMA. 2006;295:655-666).
Eating Healthier After a Heart Attack
There is good research to show that once you've had a heart attack, you can reduce your risk of having another heart attack (or a stroke or other cardiovascular event) up to 35% by quitting smoking, exercising regularly, and improving your diet.
Improve Your Diet, Live Longer - Even After a Heart Attack
This was an important finding, showing that even if your adherence to a Mediterranean-style diet wasn't perfect, just a few differences in your diet could improve your risk of surviving a heart attack. Yet the study looked only at the patients' diets before their heart attack - what happened if they improved their diet after their heart attack?
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We know that the Mediterranean Diet can help prevent cardiovascular disease, but what if you have an acute coronary event anyway? Dr. Panagiotakos and his team of researchers in Greece (Nutrition 2006(7-8);22:722-730) selected six major hospitals in Greece, and for a term of one year enrolled in their study almost all the patients in those hospitals who were diagnosed with acute coronary syndrome (meaning either a heart attack or unstable angina).
Once the patients had been treated and were stable, they were interviewed regarding their lifestyle habits (smoking, exercise, etc.) and demographic information. Their diet was assessed using a very detailed food frequency questionnaire that helped the researchers assess just how closely the patient’s diet matched the Mediterranean Diet. The researchers assigned points to the various components of the diet, with a maximum score of 55 being most closely matching the Mediterranean Diet. Patients were considered to have "high adherence" with a score of 36 or above, and "low adherence" with a score below 30.
The patients were then monitored through the first thirty days after their hospitalization, and their outcomes and final diagnosis were correlated with their Mediterranean Diet score.
The results are pretty astounding. A Mediterranean Diet score just 5 units higher than another patient's meant: 1) a 15% lower risk of having a heart attack (remember that not all patients had been hospitalized for a heart attack); 2) a 23% lower risk of dying during hospitalization; and 3) a 19% lower likelihood of having another cardiac event during the first 30 days after hospitalization for an initial cardiac event. Finally, those whose diet matched the Mediterranean Diet more closely tended to be those who were hospitalized for unstable angina, as opposed to those who were hospitalized for heart attack.
You don't have to follow the Mediterranean Diet perfectly to see its advantages for your heart. Look at my recent article on the components of the Mediterranean Diet to see where you might make one or two improvements in your adherence to the Diet.
First posted: July 11, 2006