The first issue is the role of omega-3 fatty acids (see Chapter 19), which act in two ways: by reducing general levels of inflammation, risks for heart disease are lower; and by reducing serum triglyceride levels, there’s less chance of plaque buildup. The second issue is insulin, because insulin increases coronary artery smooth muscle proliferation, making it more likely to get a clot. And the third issue is sugar—the percent of calories in the diet as added sugar predicts risk for dying of a heart attack, exclusive of calories or obesity. Conversely, removing added sugar from the diet
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