Over the past few months, I have received more messages than ever asking whether it is possible to reverse atherosclerosis through diet. That curiosity intensified after I shared my own coronary CT angiogram results, and it prompted me to revisit a body of research I first explored while writing my book.
Since then, several high quality clinical trials have been published. In this episode, I walk through the strongest evidence we have to date and ask a simple but important question. Can diet meaningfully slow, stabilise, or even reverse atherosclerosis, and if so, what does that actually look like in the real world?
What we cover
- What atherosclerosis actually is and why it is not an inevitable part of ageing
- The difference between soft plaque and calcified plaque and why plaque type matters
- How doctors and researchers measure atherosclerosis, including CAC scores, IMT, CT angiography and invasive angiography
- The six major randomised controlled trials that have tested whether diet can reverse or slow atherosclerosis
- What the Dean Ornish Lifestyle Heart Trial really showed and what it did not
- How Mediterranean style diets performed in both primary and secondary prevention trials
- Whether diet alone can influence plaque progression independent of medications
- What these studies tell us about fat quality, fibre, and refined carbohydrates
- My three biggest takeaways for protecting your arteries over the long term
Taken together, these trials show that diet can play a meaningful role in slowing atherosclerosis, stabilising plaque, and in some cases modestly reversing it. While results vary depending on context and adherence, the overall direction of the evidence is clear. What we eat has a measurable impact on our arteries and long term cardiovascular health.
- Intro (00:00)
- What is Atherosclerosis? Understanding Plaque Buildup (02:06)
- 4 Ways to Measure Plaque: CAC, IMT, CTA, and QCA (05:35)
- The Gold Standard: 6 Randomized Controlled Trials (RCTs) (09:36)
- The 1990 Lifestyle Heart Trial (Dean Ornish) (12:20)
- The STARS Trial: Omega-3s & Fiber for Plaque Reversal (19:17)
- The SCRIP Trial: Stacking Lifestyle and Medication (23:36)
- PREDIMED Study: The Power of the Mediterranean Diet (26:53)
- CORDIOPREV Results: Secondary Prevention of Heart Disease (32:53)
- DISCO CT Trial: Modern AI Imaging of Plaque Changes (39:24)
- Summary of Clinical Evidence: What Actually Shrinks Plaque? (43:53)
- 3 Critical Takeaways for Managing Your Heart Health (46:25)
Resources and links:
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