By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
What’s the best diet for weight maintenance, heart health and overall body health? Hands down, the truly anti-inflammatory, Pan-Asian Modified Mediterranean Diet – meet PAMM: a blend of the best of traditional Asian and Mediterranean dietary approaches.
Best Diet for Health
Over the years we’ve seen many diets come and go in the name of health and wellness. Some have employed extreme approaches, eliminating one or more of the macronutrients (fat, carbohydrates, and proteins) we need, and others have generally emphasized calorie restriction. But it’s about much more than weight loss, folks… Maintaining a healthy weight is, of course, important to help keep heart disease, osteoporosis and some cancers away; but what’s really crucial for health is preventing excess inflammation in the body, which can cause all sorts of degenerative diseases, including the ones mentioned above.
This is why – after much observation, study, and personal research – I’ve concluded that the absolute best overall diet for health is one I call the Pan-Asian Modified Mediterranean diet. Why? PAMM is truly anti-inflammatory, which means it supports quality of life and longevity. It also, as a lifestyle approach, can help you reach your weight loss goals of losing excess weight and keeping it off.
Why Are Asian and Mediterranean Diets Healthy?
Before American fast food “modernized” the world, populations living in the Mediterranean regions of countries like Italy, Greece and Spain and in some Asian countries, which also consumed “traditional” diets particular to these regions, had a much lower incidence of heart disease than people in Northern Europe and the United States. While lifestyle and eating patterns may also be interdependent factors in this cardiac phenomenon, foods native to some Mediterranean and Asian cultures also tend to be anti-inflammatory. If chronic inflammation underlies so many degenerative diseases, shouldn’t we begin with what we put in our mouths each day? The PAMM diet, which is more of a food guide, combines the best foods from each region.
When compared with the traditional American diet of burgers and fries, pizza, hot dogs, heaping plates of pasta served with bread, macaroni and cheese, etc., the traditional Mediterranean and Asian diets are healthy-vibrational: not only do they have less of what we don’t want (e.g. refined sugar and “bad fats”), they have more of what we do want (essential nutrients). While the Mediterranean diet generally includes helping-after-helping of fresh fruits and vegetables, legumes, local fish, home-produced olive oil, fresh garlic, seeds and nuts, the typical Asian diet is bountiful in fish, fresh vegetables and fruits, locally-harvested seaweeds, and soy products.
What Is the PAMM Diet?
The PAMM diet is an anti-inflammatory diet by nature. Designed to prevent excess insulin response and free radical activity in the body, the PAMM diet is essentially a specific combination of select foods (macronutrients):
- 20 to 25 percent lean protein
- 35 to 40 percent healthy fats
- 40 to 45 percent low-glycemic carbohydrates
Remember, the PAMM diet is a lifestyle choice for good health, not a temporary quick fix or weight loss tool. It’s got to be fun, filling, tasty and not too restrictive.
20 to 25 Percent Lean Protein
By eating protein, we get the amino acids we need to build and repair the cells in our bodies. There are 22 amino acids, eight of which are “essential,” which means we have to get them from dietary sources. Animal sources of protein like meat, dairy products and eggs are considered “complete” in that they contain all the essential amino acids. Plant sources of protein, like beans, nuts, soy, and rice, are considered “incomplete;” we need to eat combinations of them to get all the amino acids our bodies need.
With the exception of fish, which contain anti-inflammatory omega-3 essential fatty acids – healthy fats we want, it’s best to eat more lean proteins like skinless chicken or turkey, and lean beef. Because animals (and humans) store toxins in their fat, eating fattier parts of meats and cheeses can contribute to inflammation. Be sure to eat organic or wild-caught sources of protein whenever possible to protect against the pesticides, antibiotic residues, and artificial hormones that are permitted in conventional food production.
The best sources of protein are wild-caught fish, organic chicken, pork or beef, eggs, organic low- or non-fat dairy products, or non-GMO soy products like tofu, edamame, or tempeh.
35 to 40 Percent Healthy Fats
Fat often gets a bad rap as the culprit behind heart disease and obesity. However, we need fats, which contain twice the energy per unit weight than proteins and carbohydrates, to use for energy and to make and maintain structures like neurons and cell membranes. Our brains, for example, are comprised of more than 60 percent fat. Fats also help our bodies absorb nutrients like vitamins A, D, E, and K, as well as carotenoids. As foods that do not provoke insulin release, they can actually help us lose weight when eaten in moderation. It’s not whether we should eat fats, then, but which kinds of fats we should eat.
Many doctors credit the enhanced longevity and health patterns of Mediterranean people to the large quantity of olive oil in their diets. Studies have shown that olive oil, which is primarily a monounsaturated fat, lowers risk of heart disease, and breast, skin, and colon cancers, and other research points to benefits for arthritis and diabetes. Olive oil contains vitamins and squalene, an immunoprotective factor, as well as potent antioxidants that help support immune function and healthy blood pressure. Another great source of healthy fat is avocado. Avocados offer invaluable antioxidant and anti-inflammatory protection. They are rich in vitamin E, folic acid, vitamin B-6, and pantothenic acid, and are a great source of essential minerals and alpha-linolenic acid (ALA), an essential fatty acid. Avocados are also rich in glutathione, an anticarcinogenic antioxidant, and beta-sitosterols, which help lower cholesterol.
Omega-3 essential fatty acids (EFAs) are other important fats to consume. Polyunsaturated omega-3s not only help us produce necessary chemicals and hormones in our bodies, but they are anti-inflammatory, and help lower our risk of heart disease. The best sources of polyunsaturated omega-3s include fish, walnuts, and flaxseed. Polyunsaturated omega-6 fats, some of which are essential, are inflammatory, on the other hand, which is why we should consume equal amounts of polyunsaturated omega-3 and omega-6 fats. As omega-6s are often hidden in processed foods or served in restaurants, we tend to get as many of them as we need without trying; the typical American diet tends to be extremely omega-6 heavy. Omega-6s like corn, canola, and soy oils lower HDL cholesterol (which we need significant amounts of), as well as oxidize quickly in our bodies, making us more vulnerable to heart disease, cancer, Alzheimer’s disease and cataracts.
Saturated fats are usually found in animal products like meats, poultry, fish, dairy products and eggs, but also come from plant sources like coconut and palm oil. Saturated fats have been given a bad rap in the past because they can contribute to higher cholesterol levels in the body. However, we now know that inflammation of the arteries, not cholesterol, is what causes heart disease. Hence, saturated fats like eggs and coconut oil are good dietary choices. Saturated fats are generally less inflammatory than unsaturated fats in that they are very resistant to oxidation, which causes inflammation. Some sources of saturated fat may be more inflammatory, though, due to toxic load. Like humans, animals store toxins in subcutaneous fat, so try to choose grass fed, organic, and wild-caught meat, fish, dairy products and eggs in order to avoid inflammatory chemicals (insecticides and pesticides) and other toxins found in commercially produced food sources of saturated fat.
The absolute worst fats are hydrogenated, or trans, fats. These killer fats, which are commonly found in processed and fried foods, have an extra hydrogen molecule artificially added to them as a preservative. They trigger inflammatory processes and cause free radical damage to cell membranes. Avoid hydrogenated, or trans, fats altogether.
40 to 45 Percent Low-Glycemic Carbohydrates
Carbohydrates are the most common source of energy in the diet. However, not all carbohydrates are created equally, so to speak. There is a significant difference between unrefined (healthy) carbohydrates, such as fruits, vegetables, and whole grains, and refined (unhealthy) carbohydrates like bleached flour, white rice, and sugar. The difference lies in how quickly our bodies break them down and glucose enters the bloodstream as fuel for cells.
While we digest refined carbohydrates relatively quickly, our bodies take a much longer time to break down unrefined and complex carbohydrates, especially those with a lot of fiber (which promotes a healthy digestive tract in addition to filling us up) and/or fat. This longer digestion period results in a moderate and sustained release of insulin, the pancreatic hormone which helps guide blood glucose into cells. Refined carbohydrates, on the other hand, require that the body immediately release enough insulin to accommodate the amount of sugar quickly entering the bloodstream.
Eating too many refined carbohydrates, and not enough of carbohydrates in their natural form, can cause chronic surging of insulin levels and a vicious cycle of carbohydrate cravings. Too much insulin in the bloodstream, over time, can cause chronic inflammation of blood vessels and engender insulin resistance, a condition where cells no longer recognize insulin. Insulin resistance eventually can cause diabetes, obesity, and cardiovascular disease.
The key with carbohydrates is to primarily eat the ones that require the least amount of insulin to be immediately released for digestion. There are a few ways of achieving low to moderate insulin release. The first is choosing to eat more low-glycemic carbohydrates. Glycemic index, or GI, is a ranking of carbohydrates on a scale of 0 to 100, based on how quickly they enter the bloodstream. Healthy carbs generally have a GI of less-than-50; carbs become less healthy the closer the GI number is to 100. You can learn the glycemic index of particular carbohydrates by searching the GI Database at www.glycemicindex.com. Ideally, the majority of the 40 to 45 percent carbohydrate portion of food should consist of plenty of fresh fruits and vegetables, which have the lowest glycemic indexes and are full of phytonutrients.
If you’re getting depressed reading this, thinking “I can’t eat pasta or rice anymore,” never fear! Complete avoidance is not only unrealistic, but unnecessary. Just practice the second and third ways to achieve low insulin release: practice moderation with these foods – small appetizer portions are key – and eat them in combination with healthy fats and proteins to offset insulin response.
- Esposito K, Marfella R, et al. Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome. JAMA.2004;292:1440-1446.
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