While it whittles your waistline, the Pescetarian Plan is also busy staving off pretty much every age-related condition, such as heart disease, cancer, diabetes, and erectile dysfunction. It can even give your skin a healthier glow!
But what if you already have heart disease, type 2 diabetes, or another ailment? This Pescetarian lifestyle can improve your condition—and possibly even reverse it. That’s because it helps relieve inflammation, keeps you at a healthy weight, clears arteries, and is packed with the nutrients you need to thrive. While I don’t want to oversell this plan as a miracle cure, it certainly works better than any drug at preventing and, in some cases, treating many of the diseases that debilitate or kill us.
Of all the ways the Pescetarian Plan fights aging, reducing chronic inflammation may be the most critical, as it affects every part of your body. Inflammation is one of the hottest buzzwords in health these days, and with good reason. It has been shown to trigger a host of killer conditions—heart disease, cancer, dementia, and others. And it shortens your telomeres—the little protective segments at the end of your chromosomes. Shorter telomeres can mean a shorter life span and are associated with all the diseases I just mentioned. Brand-new research led by Dr. Dean Ornish (a giant in the disease prevention field) found, for the first time, that a healthy lifestyle can actually increase telomere length.
What exactly is inflammation? There are two types: There’s acute inflammation, which is swelling and fluid buildup that happens when your immune system attacks invaders. You’ve seen it in action when your finger swells and reddens around a splinter. That’s an indication that white blood cells and chemicals produced by your immune system have rushed to the area to destroy bacteria. As you can probably guess, this is the type of inflammation you want!
You don’t want chronic inflammation, the second type. This type of inflammation can hang around for years, often at a level too low to cause obvious symptoms. This time, instead of targeting a foreign invader, the inflammatory compounds are directed at your arteries, your joints, and other tissues. It’s a health double whammy: The inflammation causes or contributes to conditions like heart disease, diabetes, cancer, ulcerative colitis, and Alzheimer’s, and these diseases, in turn, create more inflammation in the body.
Here’s how you get chronic inflammation and how The Pescetarian Plan combats it:
| INFLAMMATION TRIGGER | PESCETARIAN TRIGGER DEFENSE |
Being overweight or obese. |
You’re eating foods that quell appetite and aid your weight-control efforts. Plus, by keeping sugar low and avoiding refined flour, you’re helping prevent visceral fat in particular. |
Not enough vitamins, minerals, and phytonutrients. |
This ultra-nutritious diet is rich in anti-inflammatory compounds. A recent study found that Italians adhering closely to a Mediterranean eating pattern had four times the levels of anti-inflammatory compounds in their blood and just a third of the pro-inflammatory compounds as those whose diets were closer to an American way of eating. |
The wrong mix of fats in the diet. |
The ratio of omega-6 to omega-3 fats is even in this plan, and the bulk of the fat is monounsaturated. |
Too much sugar and white flour. |
Refined flour is eliminated, and added sugar hovers around a low 5 percent of your daily calories. |
Having a chronic disease. It’s a vicious cycle, because inflammation is also a cause (or one of the triggers) for these diseases. |
The Pescetarian Plan will help prevent—and even treat—chronic diseases. |
Being sedentary. |
Exercise helps remove visceral fat and prevent insulin resistance. |
There’s a condition that ignites chronic inflammation, doubles or triples your heart disease risk, and bumps up your odds of getting type 2 diabetes anywhere from four- to tenfold. It strikes over a third of American adults, but it still isn’t a household word. It’s “metabolic syndrome,” and it’s characterized by at least three of the following symptoms:
• A waistline that’s 35 inches or greater for women, 40 inches or greater for men (See tips on measuring your waistline)
• Blood triglyceride (a type of fat in the blood) level of 150 milligrams per deciliter (mg/dL) or more
• HDL (“good” cholesterol) that’s less than 40 mg/dL in men or less than 50 mg/dL in women
• High blood pressure
• Fasting blood sugar of 100 mg/dL or more
• Insulin resistance—a condition in which the body can’t properly use insulin. It’s usually measured in a lab by a glucose tolerance test (where blood sugar is measured after you drink a glucose solution).
The good news is that 90 percent of cases of metabolic syndrome can be prevented by diet and exercise. Simply losing weight can reverse this condition. But a University of Laval, Canada, study found that in people with this condition, dropping pounds on a Mediterranean diet lowered inflammation even further than on a typical American diet (26 percent lower by one marker called C-reactive protein).
Okay, maybe The Pescetarian Plan can’t guarantee that things will be steamier in the bedroom, but it can certainly help ensure that all the necessary parts are functioning properly.
Erectile dysfunction (ED), the persistent inability to have or maintain an erection sufficient for satisfactory sex, affects at least 30 percent of men between the ages of 40 and 70. Its causes: psychological issues like stress or anxiety and often a physical problem, usually clogged arteries, the same way that plaque-filled coronary arteries cause heart disease. In fact, ED is considered a harbinger of heart disease because if the penile arteries are narrowing, the odds are high that the same thing’s going on in the coronary arteries.
Studies show that a Mediterranean diet as well as exercise may reduce the likelihood of developing ED. For instance, a study from the University of Naples indicates that 52 percent of men with diabetes eating a more Western-style diet had moderate to severe ED compared to 39 percent of those with a more Mediterranean style of eating.
Women are often left out of this conversation, but they too suffer from sexual dysfunction. It’s not as obvious as ED, but standardized questionnaires rating desire, arousal, lubrication, orgasm, satisfaction, and pain help diagnose the problem. While psychology and hormones are at play in women, so is artery narrowing, just as in men. Research is still sparse on this, but an Italian study suggests that women with type 2 diabetes whose diets most closely resembled a Mediterranean pattern were more apt to be sexually active (65 percent of women compared to 54 percent) and have less sexual dysfunction (47.5 percent versus 57.8 percent) than women whose diets were the least Mediterranean.
Take a moment to appreciate the amazing-ness of your heart. It’ll beat about 100,000 times today, keeping you alive by sending out blood that oxygenates and nourishes every cell.
Now consider this: Nearly 40 percent of men and women aged 40 to 59 have heart disease, an umbrella term for a number of things that can go wrong with your heart: coronary heart disease, heart failure, congenital heart defects, and arrhythmia. That number jumps to 72 percent for people in their sixties and seventies and about 83 percent for those age 80 and up. But the vast majority of cases of heart disease can be prevented by eating right and moving more.
A diet like the Pescetarian Plan cuts your risk of developing heart disease (or dying from it) by 30 to 50 percent. Exercise can slash it by about 50 percent. And the combination of a good diet and exercise could reduce heart disease cases by a whopping 80 percent. How? By helping keep the arteries that supply blood to your heart muscle clear and flexible—that’s what happens when inflammation is low and you’re taking in nutrients (like those in nuts) that encourage blood vessels to relax, keeping blood pressure low. The Pescetarian Plan is also low in sodium—another boon to low blood pressure. (For ways to slash sodium, see here.)
There are a jillion studies linking Pescetarian Plan components to heart disease prevention; here’s just the tip of the iceberg:
• People who ate a diet highest in omega-3 were only half as likely to die from sudden cardiac death (due to arrhythmias) over a sixteen-year period compared to people who ate the least, shows a Harvard School of Public Health study. Even more impressive: The omega-3 eaters lived 2.2 extra years on average! The study, which excluded people taking fish oil supplements and looked at participants who were free of heart disease at outset, reflects the power of diet to prevent disease.
• People at risk for heart disease who went on a Mediterranean diet cut their chances of developing the condition by 30 percent compared to a group who followed a standard low-fat diet. The study, which was published in The New England Journal of Medicine in 2013, was cut short after four years because it was considered unethical to keep the control group off the Mediterranean diet.
• Eating fish just one to two times per week was associated with a 42 to 50 percent reduction in the risk of sudden cardiac death in healthy adults, according to a special report in the American Heart Association journal Circulation.
What if you already have heart disease? Then switching to this pescetarian way of eating could literally be a lifesaver. A diet like the one in this book can reduce the risk of a heart attack or dying from heart disease by up to 70 percent.
How’s this for a shocker: More than a quarter of Americans have pre-diabetes, but only 11 percent know they have the condition. And of the 8.3 percent of the population that has diabetes, only 63 percent are aware they have it. You might think you’re diabetes-free, but given how common these diseases are, it’s absolutely worth getting tested. In fact, cases of type 2 diabetes are rising so fast that it’s estimated that within forty years, one in three Americans will have it. About 90–95 percent of diabetes cases are type 2.
The reason for the twin epidemics of pre-diabetes and type 2? Another epidemic: being overweight or obese. Too much body fat is the cause of about 80 percent of the cases of type 2 diabetes, and it’s roughly the same for pre-diabetes.
Type 2 diabetes occurs when your cells become resistant to insulin (the hormone that controls blood sugar) and/or you don’t produce enough of it. Sometimes oral medication can control blood sugar, and in other cases, you must inject insulin. (Type 1 diabetes, in which you stop making insulin, is not on the rise because it’s not related to diet or obesity but has an autoimmune origin.)
The encouraging research on prevention:
• If you’re overweight, losing about 7 percent of your initial body weight (that’s 14 pounds if you weigh 200 pounds) could be enough to reduce the incidence of developing type 2 diabetes by 58 percent. That’s what the Diabetes Prevention Program Research Group showed. This landmark study proved that diet and exercise are even more effective than medication at staving off type 2 diabetes.
• In a study of men and women living in Spain who were at high risk for developing heart disease and type 2 diabetes, those who most closely followed a Mediterranean diet cut their risk for type 2 diabetes by 56 percent compared to those who didn’t follow a Mediterranean diet.
If you have diabetes—either type 1 or type 2—The Pescetarian Plan can help stave off diseases triggered by your condition. For example, having diabetes makes it two to four times more likely that you’ll develop heart disease. It can prompt painful neuropathy of the feet and other areas, dim your vision, and cause kidney disease.
To prevent all these complications, you want to keep blood sugar as close to normal as possible—that’s what a good diet, enough exercise, losing weight (if you need to), and proper medication can do.
In some cases of type 2 diabetes—albeit a minority—you can reverse the condition, at least for a number of years.
• The Look AHEAD Trial found that 11.5 percent of people went into remission after changing their diets and exercising. Remission rates were even higher—15 to 21 percent—in the participants in the diet and exercise group who lost the most weight (more than 6.5 percent of starting weight) and made the biggest fitness gains.
• In an Italian study, only 44 percent of newly diagnosed diabetes patients (they were not yet on medication) who followed a Mediterranean-style diet required medication to control their blood sugar four years later. That’s compared to 70 percent of those who ate a low-fat diet. Mediterranean dieters were essentially able to reverse their condition partly because they lost more weight than folks on the low-fat diet. Plus, they reaped other diet-related health benefits, including less inflammation, lower blood sugar and “bad” LDL cholesterol, and higher “good” HDL cholesterol compared to the low-fat dieters.
The saying “You are what you eat” is especially true when it comes to the skin. Most Americans are well nourished enough to avoid the all-out vitamin or mineral deficiencies that cause skin sores, spots, and cracking, but many have a borderline deficiency that can make skin more wrinkly and rough. Of course, wearing sunscreen and limiting sun exposure is your first line of defense, but a good diet can help offset the sun’s damaging ultraviolet rays.
There are two basic skin-protecting compounds in the diet: antioxidants and healthy fats. The more antioxidants you have in your diet, the better equipped you are to fight off skin-damaging molecules called free radicals, which are formed in response to sunlight exposure. (Skin’s number one enemy is the sun—it’s the main culprit behind wrinkles and cancer.) Most of the fat in your skin is unsaturated—polys and monos—so you need adequate amounts of these fats in your diet.
Both a Mediterranean diet—and omega-3s in general—have been linked to skin health.
• People of various ethnicities (Greek, Australians, and Swedes) living in different areas (either their native country or abroad) who ate the most vegetables, olive oil, fish, yogurt, nuts, and legumes had the least amount of skin wrinkling. Meanwhile, high intake of butter, milk, meat, processed meat (like sausage), and sugar (from soft drinks and foods like cake and pastries) was linked to more wrinkles.
• People living along the Mediterranean Sea tend to have lower rates of melanoma, a potentially deadly skin cancer, despite the sunny climate. There are just 3 to 11 cases of melanoma per 100,000 inhabitants in Mediterranean countries, compared to 20 cases per 100,000 in the United States; 50 per 100,000 in Australia; and 9 to 22 per 100,000 in Scandinavia. While differences in skin pigment (darker skin is more protective), latitude (higher latitudes—further from the equator—are protective), altitude (the higher, the more risky), and how much people expose their bodies to the sun all come into play, so does diet.
The stats still amaze me: Genetic defects are thought to be responsible for only 5 to 10 percent of cancer cases. That means that 90 to 95 percent of cancers are due to the way we live. This includes smoking, diet, alcohol, sun exposure, pollution, infections, stress, obesity, and a sedentary lifestyle.
Diet can prevent up to 35 percent of cancer cases (up to 75 percent for prostate cancer and colorectal cancer), exercise up to 40 percent. Pretty much everything about The Pescetarian Plan reduces cancer risk:
• Superfoods like broccoli and olive oil contain a wealth of antioxidants and other substances that disable carcinogens (cancer-causing substances) and slow cancer growth. The risk that avid extra-virgin olive oil eaters have of getting any type of cancer compared to infrequent users may be up to a third lower, according to a University of Athens review of the research. Extra-virgin olive oil appears to be particularly protective against breast cancer and cancers of the digestive system (colorectal, oral cavity, pharynx and esophagus, and pancreatic). Credit goes to the oil’s monounsaturated fat and phytonutrients, both of which fight inflammation. The thirty-plus phenolic compounds in extra-virgin olive oil also disable cancer-causing substances before they can do harm. The diet quashes inflammation, which is a cancer trigger.
• The appetite-suppressing foods on this plan help you get down to—and maintain—a healthy weight, which can reduce cancer risk by 4 to 40 percent. (The higher numbers are for breast, colon, and endometrial cancers.)
While there are countless studies on how to prevent cancer, research into the best way to eat and exercise once you’ve had cancer (or are in treatment for it) is still paltry. The few studies that are out there indicate that the same things that help prevent the disease also help prevent a recurrence. I do want to point out results from the Harvard Nurses’ Health Study: While close adherence to a Mediterranean diet didn’t make it more or less likely that breast cancer survivors would die from the disease, it did appear to significantly lower their odds (by 60 percent) of dying of other causes, like heart disease and respiratory illnesses such as pneumonia. This is important to know, because cancer treatment can increase risk for these other illnesses.
Something else to keep in mind: There’s a difference between getting a vitamin or other substance through food and through supplements. For instance, the beta carotene in carrots, cantaloupe, spinach, and many other fruits and vegetables protects against the development of cancer. But when smokers were given beta carotene supplements, their chances of developing lung cancer actually increased. So until the research makes a compelling case that taking supplements helps prevent cancer, I’m recommending that you stick with this healthy pescetarian approach. That means getting your nutrients through food and using supplements sparingly, if at all (more on supplements later in the book).