A Pesco-Mediterranean Diet With Intermittent Fasting

JACC Review Topic of the Week

James H. O'Keefe, MD; Noel Torres-Acosta, MD; Evan L. O'Keefe, MD; Ibrahim M. Saeed, MD; Carl J. Lavie, MD; Sarah E. Smith, PHD; Emilio Ros, MD, PHD


J Am Coll Cardiol. 2020;76(12):1484-1493. 

In This Article

Seafood as Key Component of the Mediterranean Diet

Fish and seafood in general are important components of the Mediterranean diet.[17] Epidemiological studies support the cardioprotective properties of fish and ω-3FA consumed with the usual diet. A meta-analysis of 16 cohort studies with 422,786 observations, focused on dietary fatty acids and CVD risk, reported a significant 13% risk reduction when comparing extremes of omega-3 fatty acid intake.[18] Similarly, a consortium of 19 observational studies from 16 countries reported that plasma or adipose tissue levels of ω-3FA (objective biomarkers of intake) were associated with a reduced risk of fatal and nonfatal coronary heart disease comparing extreme quintiles.[19] Higher fish consumption (as long as the fish is not fried) has been associated with reduced risk of heart failure[20] and a reduction in the incidence of metabolic syndrome.[21]

The 2015 to 2020 Dietary Guidelines for Americans recommend that adults consume fish and/or seafood at least twice per week, totaling at least 8 to 10 oz/week, preferably in place of other protein foods such as red meat, poultry, or eggs.[15] In a 2018 Science Advisory, the American Heart Association recommended "1 to 2 seafood meals per week be included to reduce the risk of congestive heart failure, coronary heart disease, ischemic stroke, and sudden cardiac death, especially when seafood replaces the intake of less healthy foods".[22]