A Comparative Analysis of Anti-inflammatory Mediterranean Cardiac Diet, Intermittent Fasting, and Plant-based Anti-inflammatory Diet in Cardiac Patients

Authors: Amina Khalpey, PhD, Ujjawal Kumar, BA, Ezekiel Mendoza, BS, Jessa Deckwa, BS, Brynne Rozell, BS, Parker Wilson, BS, Zain Khalpey, MD, PhD, FACS

Cardiovascular diseases (CVD) are a leading cause of mortality globally. Various dietary approaches have been proposed to mitigate the risks associated with CVD, such as the Mediterranean cardiac diet, intermittent fasting, and plant-based anti-inflammatory diets. This blog post examines the rationale for each dietary strategy in reducing inflammation, improving cardiac health, and preparing patients for heart surgery. Finally, a two-week Mediterranean anti-inflammatory diet plan is proposed for cardiac patients before they undergo heart surgery.

Breaking Down The Different Types of Cardiac Diets

Cardiovascular diseases (CVD) continue to be a major health concern, with a significant burden on the global population. According to the CDC, one person dies every 34 seconds from CVD in the US. As a result, researchers have focused on understanding the role of diet in the prevention and management of CVD. Three prominent dietary strategies have emerged: the Mediterranean cardiac diet, intermittent fasting, and plant-based anti-inflammatory diets. Each of these diets boasts potential benefits for cardiac patients, but the focus of this essay is on the rationale for adopting the Mediterranean anti-inflammatory diet for patients before heart surgery.

The Mediterranean Cardiac Diet

The Mediterranean diet is rich in fruits, vegetables, whole grains, legumes, nuts, and olive oil, with moderate amounts of fish, poultry, and dairy products. This diet is low in red and processed meats, as well as refined sugars and grains. The primary rationale for the Mediterranean cardiac diet is its anti-inflammatory properties, which stem from the high consumption of antioxidants, fiber, and healthy fats found in these foods (Estruch et al., 2013).

Several studies have demonstrated the cardioprotective effects of the Mediterranean diet. In particular, the PREDIMED study showed that participants who followed a Mediterranean diet supplemented with extra-virgin olive oil or nuts had a 30% reduction in major cardiovascular events compared to those on a low-fat diet (Estruch et al., 2013). These results highlight some potential benefits, but not all, of a Mediterranean cardiac diet in reducing inflammation and improving heart health.

Intermittent Fasting

Intermittent fasting (IF) is an eating pattern that alternates between periods of fasting and eating. There are various types of IF, such as the 16/8 method (fasting for 16 hours and eating during an 8-hour window) or the 5:2 method (eating normally for five days and restricting calorie intake for two non-consecutive days). The rationale for IF in cardiac patients is based on its potential to reduce inflammation, promote autophagy (cellular repair), and improve insulin sensitivity (de Cabo & Mattson, 2019).

Research on IF has shown promising results in improving cardiometabolic health. A review of human studies found that IF can lead to weight loss, reductions in blood pressure, and improvements in lipid profiles (Patterson & Sears, 2017). However, more long-term studies are needed to confirm the benefits of IF for cardiac patients.

Plant-based Anti-inflammatory Diet

A plant-based anti-inflammatory diet is characterized by a high intake of fruits, vegetables, whole grains, legumes, nuts, and seeds, while minimizing animal products, processed foods, and added sugars. This diet is similar to the Mediterranean diet, but with an even stronger emphasis on plant-based foods. The rationale for this diet is that plant-based foods are rich in antioxidants, fiber, and anti-inflammatory compounds, which can improve cardiovascular health (Satija et al., 2017).

Several studies have shown that plant-based diets can reduce the risk of CVD. A meta-analysis of prospective cohort studies found that a higher adherence to a plant-based diet was associated with a lower risk of CVD mortality (Kim et al., 2019). Furthermore, a randomized controlled trial demonstrated that a low-fat, plant-based diet led to significant improvements in blood pressure, cholesterol levels, and weight loss compared to a control diet (Barnard et al., 2005). These findings suggest that plant-based anti-inflammatory diets can be beneficial for cardiac patients.

Comparison and Rationale for Mediterranean Anti-inflammatory Diet

All three dietary approaches have shown potential benefits for cardiac health. However, the Mediterranean anti-inflammatory diet stands out for its practicality, cultural acceptability, and the breadth of evidence supporting its cardioprotective effects. Intermittent fasting, while promising, requires more long-term research to understand its full implications on cardiac health. The plant-based anti-inflammatory diet, although effective in reducing CVD risk, may be less appealing and challenging to adhere to for many individuals, particularly those accustomed to consuming animal products.

Given the strong evidence supporting the benefits of the Mediterranean cardiac diet in reducing inflammation and improving heart health, it is recommended for cardiac patients before they undergo heart surgery. Adopting this dietary pattern can help patients prepare for surgery by optimizing their cardiovascular health, reducing inflammation, and potentially minimizing postoperative complications.

Two-Week Mediterranean Anti-inflammatory Diet Plan:

The following is a two-week Mediterranean anti-inflammatory diet plan for cardiac patients before heart surgery:

Week 1:

Breakfast: Greek yogurt with honey, walnuts, and fresh berries

Lunch: Grilled vegetable panini with pesto and fresh mozzarella

Dinner: Baked salmon with lemon, steamed asparagus, and quinoa

Week 2:

Breakfast: Steel-cut oats with almond butter, dried fruits, and a drizzle of honey

Lunch: Mediterranean salad with mixed greens, cucumber, tomatoes, olives, feta, and a lemon-olive oil dressing

Dinner: Grilled chicken with roasted vegetables and whole-grain couscous

These meals provide a balanced mix of nutrients, rich in antioxidants, fiber, and healthy fats, while emphasizing the use of whole, minimally processed foods. Encourage patients to snack on fresh fruits, nuts, and seeds as needed.

Optimizing Health

The Mediterranean anti-inflammatory cardiac diet, intermittent fasting, and plant-based anti-inflammatory diet all show potential in improving cardiac health. However, given the strong evidence base, cultural acceptability, and practicality, the Mediterranean anti-inflammatory diet is recommended for cardiac patients before they undergo heart surgery. This diet can help optimize patients’ cardiovascular health, reduce inflammation, and potentially minimize postoperative complications.

Day-by-Day Breakdown of a Two-Week Anti-inflammatory Cardiac Diet for Cardiac Surgery Patients

Our lab has created a full two-week diet plan based off of the anti-inflammatory cardiac diet. This diet is designed to provide diverse and balanced meals for cardiac surgery patients, incorporating key principles of the Mediterranean diet while focusing on anti-inflammatory ingredients. We recommend printing off this resource for use.

This two-week anti-inflammatory cardiac diet includes a variety of nutrient-dense meals that focus on whole, minimally processed foods. Encourage patients to drink water, herbal tea, and, in moderation, red wine, while minimizing the consumption of sugary drinks and alcohol. Regular physical activity, stress management, and adequate sleep are also essential components of a heart-healthy lifestyle. Always consult with a healthcare professional or registered dietitian before starting any new diet or exercise plan, particularly for patients with existing health conditions or those preparing for surgery.


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