"When you make the changes to adopt a healthier lifestyle substantially matters in terms of longevity. It’s great to change your diet after your first non-ST-elevation MI, but in fact you want to do it before," Dr. Vogel observed.
• Which components of the Mediterranean diet are most beneficial? Greek investigators involved in the EPIC study addressed this question in 23,349 subjects followed for a mean of 8.5 years, during which 1,075 deaths occurred. Greater adherence to the Mediterranean diet was associated with larger reductions in total mortality. By analyzing Mediterranean diet adherence scores, the investigators determined that 16% of the mortality benefit was attributable to high vegetable consumption, 11% to high fruit and nut intake, 10% to legume consumption, 24% was from moderate alcohol consumption, 17% to low intake of meats, and just 11% to fats and oils having a high monounsaturated-to-saturated lipid ratio (BMJ 2009;338:b2337).
"We think that the Mediterranean diet is olive oil, but probably olive oil is good because you put it on a salad; and fruits and vegetables are the best part of a diet," the cardiologist said.
• How to maximize longevity: "If I had one recommendation based upon all the data I’ve reviewed," Dr. Vogel said, "it would be to become a pesco-vegetarian. They in fact are the longest-living Americans. That’s a vegetarian diet with the addition of fish."
Seventh-Day Adventists as a group have the longest life expectancy among all Americans. And analysis of 73,308 Seventh-day Adventists participating in the Adventist Health Study 2 showed that during a mean follow-up of 5.8 years, the adjusted risk of all-cause mortality was 12% lower among all vegetarians than in non-vegetarians, and 19% lower in the subgroup composed of pesco-vegetarians (JAMA Intern. Med. 2013;173:1230-8).
Dr. Vogel serves as a consultant to the Pritikin Longevity Center.