The treated group was advised to have an intake of 250–300 g of fruit, 125–150 g of vegetables, 25–50 g of walnuts and almonds, 400–500 g of whole grains, legumes, rice, maize, and wheat, and 3–4 servings of mustard seed or soybean oil daily. The mean intake of alpha-linolenic acid was twofold greater in the intervention group. Approximately 73% of the patients had mild hypercho-lesterolemia, 21% had diabetes, 36% had hypertension, and about 50% were smokers.
Results: Total cardiac events were significantly fewer in the treated group than in the controls: 39 versus 76 events (P < 0.001), nonfatal heart attacks 21 versus 43 (P < 0.001), and sudden deaths 6 versus 16 (P ¼ 0.015).
Perspective: An Indo-Mediterranean diet that is rich in alpha-linolenic acid appears to be more effective in primary and secondary prevention of CAD in Asians than the so-called healthy-heart prudent diet. It is of interest that the author of this book obtained supplies of alpha-linolenic acid from Parke-Davis in 1966 and started a small clinical trial in patients following a heart attack. The work was based on the theory that linolenic acid inhibits platelet aggregation, an action now known to initiate the beneficial effects of aspirin and platelet IIa/IIIb receptor blockers now used for the prevention of CAD events.

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