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LMU 27 – Preventing Heart Attacks and Vascular Disease: The Power of Diet and Lifestyle

Preventing Heart Attacks: Interview with a Leading Cardiologist

LMU 27 – Preventing Heart Attacks and Vascular Disease: The Power of Diet and Lifestyle

Source: Medscape, Oct. 5, 2016 (Big Fat Fix Challenges Mediterranean Diet)

Lifestyle Medicine Update (Oct 16, 2016)


Heart attacks, strokes, and vascular diseases are still the leading causes of death and reduced quality of life in modern society. Dr. Aseem Malhotra, a renowned cardiologist from the UK, sheds light on the potential of dietary changes to rapidly reduce the risk of cardiovascular disease. While acknowledging the importance of cholesterol-lowering statin drugs, Dr. Malhotra emphasizes that dietary modifications are often overlooked and could be more effective in preventing future heart attacks and related vascular events.

The Original Mediterranean Diet

Dr. Ancel Keys, a pioneer in the study of Diet and Heart Disease, conducted extensive research in Pioppi, Italy, a region known for its exceptional health and longevity with a documented low rate of heart disease and stroke. He found that high serum cholesterol was a significant risk factor for heart disease, as evident in the famous 7 Countries Study. The traditional Mediterranean diet, consumed by the people of Pioppi, seemed to offer protection against heart disease and degenerative diseases, including cancer.

Revisiting the Mediterranean Diet

Dr. Malhotra endorses the original Mediterranean diet, which includes a small serving of pasta as a meal starter, not as the main course. The bulk of the diet should consist of green vegetables, various cruciferous vegetables (broccoli, cauliflower, cabbage, etc.), tomatoes, and other non-starchy carbohydrates rich in protective nutrients. Additionally, nuts, beans, peas, extra virgin olive oil, and fatty fish are essential components of this heart-healthy diet. These foods not only help lower cholesterol but also effectively reduce blood vessel inflammation, a key factor in triggering heart attacks and ischemic strokes.

Combatting Inflammation

Reducing blood vessel inflammation is crucial, and the main approach involves limiting the intake of refined sugars and excessive starchy carbohydrates like bread, pasta, and potatoes. Dr. Malhotra highlights the alarming prevalence of pre-diabetes in about 40% of the U.S. population, attributed to overconsumption of refined and starchy carbohydrates and unhealthy fats, coupled with insufficient physical activity. Medications that control blood sugar may not necessarily reduce the risk of heart attack or stroke, emphasizing the significance of adopting an anti-inflammatory diet.

Embracing an Active Lifestyle

Physical activity plays a pivotal role in reducing inflammation and promoting heart health. The residents of Pioppi spend more time walking outside, benefiting from both increased physical activity and higher vitamin D levels due to sun exposure. Dr. Malhotra encourages individuals with sedentary jobs to take breaks every 45 minutes and engage in short walks throughout the day, even if they already exercise in a gym or at home. Minimizing sedentary behavior is crucial as sitting for extended periods has adverse health effects akin to smoking.

Managing Stress

Stress, though challenging to measure accurately, significantly affects health. Chronic stress, especially stemming from childhood trauma, can reduce life expectancy by up to 20 years compared to less-stressed individuals. Dr. Malhotra emphasizes the importance of managing stress through practices such as yoga, deep breathing, exercise, and meditation, which can lower the risk of heart disease and contribute to overall well-being.

The Essential Role of Lifestyle Changes

While drugs play a crucial role in treating heart disease, Dr. Malhotra underscores the significance of lifestyle changes. Recommending lifestyle modifications to heart disease patients can be more impactful in enhancing their long-term health outcomes.


Dr. Aseem Malhotra’s insights emphasize the immense potential of dietary and lifestyle changes in preventing heart attacks, stroke, and vascular diseases. The original Mediterranean diet, rich in vegetables, fruits, nuts, and healthy fats, has proven protective effects against cardiovascular diseases. Reducing inflammation by avoiding excessive refined sugars and starchy carbohydrates is essential for heart health. An active lifestyle, combined with stress management techniques, further enhances heart health and longevity. Integrating these lifestyle changes alongside medical interventions can significantly improve heart health and overall well-being.


Medscape. (2016, October 5). Interview with Dr. Aseem Malhotra: How Best to Prevent Heart Attacks, Stroke, and Vascular Disease. (

Dr. James Meschino


Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.

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