James Gandolfini Did Not Die of Natural Causes

Celebrity illnesses and deaths often shine a useful spotlight on neglected conditions. Catherine Zeta-Jones' revelations about bipolar disorder, Glen Campbell's fight with Alzheimer's disease, and Angelina Jolie's surgery to prevent breast cancer in the face of high genetic risk have at least some sort of silver lining -- they brought these conditions into the open.

But Emmy-award-winning James Gandolfini's death may have the opposite effect. The New York Times quoted the actor's family as saying, "Today we received the results of the autopsy, which stated he died of a heart attack, of natural causes."

The idea that a heart attack is "natural" for a man of only 51 is a dangerous fallacy that medicine has tried very hard to dispel. A heart attack is a disease state caused by specific circumstances, and it needs to -- and can -- be prevented.

According to the Centers for Disease Control and Prevention, about 600,000 people die of heart disease in the United States every year -- and heart attacks can happen at any age. More than 80 million Americans have one or more forms of cardiovascular disease. Lifestyle and dietary choices often are at fault. Smoking, lack of exercise, and the standard American diet all cause high blood pressure, diabetes, and obesity.

The average American now eats around 188 pounds of meat and more than 30 pounds of cheese a year. Meat-heavy diets are strongly linked with obesity and heart disease. Eating meat increases the risk of dying prematurely from heart disease, according to a 2012 study from the Harvard School of Public Health. Dairy products are the No. 1 source of saturated fat in the U.S. diet, according to the Dietary Guidelines for Americans.

If reports of Gandolfini's last meal -- prawns and foie gras -- are correct, he got a significant dose of saturated fat, sodium, and cholesterol shortly before he died. Abundant research shows that even a single fatty or salty meal can stiffen the arteries and greatly increase the risk of a heart attack.

A study published last year in the Canadian Journal of Cardiology found that damage to arteries occurs almost immediately after one fatty meal. A study in the American Journal of Clinical Nutrition showed blood flow through arteries was significantly impaired within 30 minutes of eating a salty meal.

But eating a low-fat, low-cholesterol, plant-based diet can actually reduce the risk of dying of heart disease, since eliminating meats, fatty cheeses, and animal products lowers blood pressure and cholesterol. Vegetarian men weigh less and have less cardiovascular disease risk, compared with nonvegetarians, according to a 2011 study in Nutrition and Metabolism.

We'll want to remember James Gandolfini fondly. And we do no favors to his memory or to those who are at risk of a heart attack if we misinterpret his untimely death as "natural."