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Best Diet to Prevent Heart Disease?

What is your opinion of the "heart attack proof diet"? How do you think it stacks up against other diets when it comes to heart-health benefits?

Answer (Published 1/9/2012)

The "heart attack proof diet" was devised by Caldwell Esselstyn, Jr., M.D., a retired Cleveland Clinic surgeon, who views heart disease as "a food borne illness" and advocates a diet that eliminates meat, eggs, dairy and added oils. If you follow this diet, Dr. Esselstyn says you will be "heart attack proof" regardless of your family history. He maintains that his diet will either halt the progression of heart disease or reduce blockages in blood vessels that could contribute to heart attacks.

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The strict, plant-based diet Dr. Esselstyn advocates may benefit those who can stick to it long-term, but I see it as too extreme for most people to follow indefinitely. We already know that the Mediterranean diet can protect against heart disease and cancer. An impressive study from the University of Athens published in the June 26, 2003, issue of The New England Journal of Medicine found that people who ate a Mediterranean-style diet had a 33 percent reduction in the risk of death from heart disease, and a cancer death rate that was 24 percent lower than that for those who followed other eating practices. Even earlier, the Lyon Diet Heart Study found that within four years, the Mediterranean diet reduced the rates of heart disease recurrence and cardiac death among patients who already had had heart attacks by 50 to 70 percent when compared with the American Heart Association diet.

The Mediterranean diet is a composite of the traditional cuisines of Spain, southern France, Italy, Greece, Crete and parts of the Middle East. It emphasizes high-quality fresh fruits and vegetables, nuts, legumes, unrefined cereals, olive oil, cheese, yogurt and fish. The diet only includes rare (monthly) servings of meat and infrequent (weekly) servings of poultry, eggs and sweets; it includes wine, in moderation. Bear in mind that the traditional Mediterranean diet is part of a whole cultural package, which includes regular physical activity (more than most Americans get) as well as strong social and family bonds, which are often enjoyed around shared meals. Unfortunately, this way of eating is changing as processed food and American fast food appear in these areas of the world, but that doesn’t alter the fact that eating the traditional Mediterranean way is protective against heart disease and a lot easier to follow over time than the "heart attack proof diet."

Andrew Weil, M.D.

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