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

Fish and Seafood in the Diet

The Pesco-Mediterranean eating style is primarily a plant-rich diet, but the aquatic animal food sources provide an array of vitamins, minerals, and other nutrients, some of which are not readily accessible in vegetarian or vegan diets. Fish and other seafood are not just rich in ω-3FA, but are generally good sources of zinc, iodine, selenium, B vitamins, calcium, and magnesium. Furthermore, fish and seafood provide high-quality protein, which is both satiating and helpful for the building and maintenance of muscle and bone mass.

Two recent systematic reviews comprising 106,237 mother-offspring pairs, and 25,960 children reported that fish/seafood consumption was associated with dose-dependent benefits to neurocognitive development that became significant at 4 oz/week and increased from there.[30] Adverse neurocognitive outcomes were not seen even with the highest amounts of fish/seafood consumption (>100 oz/week), despite associated increases in mercury exposures.[30] Even so, it is prudent to choose low-mercury fish, such as salmon, sardines, trout, herring, and anchovies, all of which are naturally high in ω-3FA, and scallops, shrimp, lobster, oysters, and clams—which are not as high in ω-3FA, but remain low in mercury.[4,28] It is best to use lower temperatures (target internal temperature 145º or until flesh is opaque and separates easily with fork); avoid charring or burning fish/seafood, which can introduce carcinogenic compounds.[31]