By Gabe Mirkin, M.D.
Almost anyone can get rid of plaques in their arteries, even if they have already had a heart attack or already have severe narrowing in the arteries leading to your heart (Arterioscler Thromb Vasc Biol, Feb 2016;36(2):226-35). However, you have to do far more than just take drugs. The formation of plaques in arteries that eventually leads to heart attacks and strokes comes from chemical processes that start in the liver. Plaques can be reversed by changes in diet, exercise, weight, environmental exposures and medications.
Forty percent of all North Americans die of heart attacks because they:
- do not know that plaques are reversible,
- do not believe that they can be saved by lifestyle changes,
- do not know how to change their lifestyle, or
- are not capable of making the extreme changes necessary to prevent a heart attack.
Statins save fewer lives than do exercising and eating sensibly (BMJ Open, January 22, 2015;5(1)). Stents and bypass surgery do absolutely nothing to stop the formation of new plaques in arteries, so if you do not change the behaviors that caused the plaques, you will soon have the same blockage that you had before the procedure was done.
Reversing Plaques Requires Major Lifestyle Changes
Diet: You cannot reverse plaques in your arteries with a half-hearted change in diet. You should eat lots of vegetables, fruits and seeds, even if you are trying to lose weight. You need to avoid or severely restrict sugared drinks, sugar-added foods, fried foods, red meat and processed meats. Earlier studies have shown that changing the foods you eat and getting rid of excess fat stored in your body are major factors in reversing plaques in your arteries (JAMA, 1998;280:2001-2007 and J Fam Pract, 1995;41(6): 560-8). We do not have good data to show that eating red meat less often than once a week is harmful, but it is my opinion that people who want to reverse their plaques should try to avoid meat from mammals and all processed meats.
Exercise: You should try to exercise every day. The only days you should take off are when your muscles feel sore. Sore muscles are a warning that exercise on that day increases risk for an injury. The most beneficial way to exercise is to follow the hard/easy principle. On one day, go a little bit faster and more intensely and you will feel sore in the morning. On the next day, go easy and slow. When your muscles feel fresh again, go more intensely.
Weight loss if needed: Excess fat in your liver increases risk for both diabetes and heart attacks. Having fat in your belly is associated with having excess fat in your liver. If you can pinch three inches or more when you grasp the skin overlying your belly, you are at high risk for having too much fat in your liver and thus for having high blood sugar and high cholesterol. Excess fat on your buttocks or thighs appears not to be as harmful.
Vitamin D: If your hydroxy vitamin D blood level is below 50 nmol/L, you need more sunlight or vitamin D pills. Since lifetime cumulative exposure to sunlight increases skin cancer risk, do not expose your face, head, neck and arms to sunlight. Use a hat and arm coolers and apply sun screens daily to your face and ears. Expose your legs, but limit your sun exposure if you have signs of sun damage: mottled skin appearance, small bumps on your sun-exposed skin, or a past history of pre-cancers and cancers. It takes only a few minutes of sun each day on a small area of skin to get the vitamin D you need.
How to Lose Excess Weight
A major part of dissolving plaques is to lose excess weight. Your liver helps to control high blood sugar and cholesterol levels that lead to heart attacks. Having extra fat in your liver raises blood sugar and cholesterol. Many people will not be able to control their blood sugar and cholesterol levels effectively until they get the fat out of their liver. Unfortunately, when a person stores fat primarily in the belly, the liver will stay full of fat until they get the excess fat out of the rest of their body.
The most effective way I have found to lose weight and keep it off is intermittent fasting. Since you will also be working to reverse plaques, your intermittent fasting weight loss program should use primarily plant-based foods.
Fasting every other day for 12 weeks caused 32 people to lose an average of 12 pounds more than those who followed a daily program of calorie restriction (Nutrition Journal, 11/27/2013). The intermittent-fasting group also markedly lowered several heart attack risk factors:
- They lost an average of eight pounds of fat.
- Their triglycerides dropped 20 mg/dL. (High triglycerides signify increased risk for diabetes).
- Their bad LDL particle size increased. (The larger the particle size, the less likely you are to become diabetic).
- CRP decreased 13 percent. (CRP measures inflammation that causes heart attacks. The lower your CRP, the less likely you are to have a heart attack).
- Blood adiponectin increased six percent. (Adiponectin is released from your fat cells. The higher your levels, the less likely you are to become diabetic).
- Blood leptin decreased 40 percent. (Leptin predicts weight gain. Lowered leptin levels indicate fat loss).
In another study, intermittent fasting for three months caused twice as much weight loss as daily calorie restriction (British Journal of Nutrition, April 2013). Sixty-five percent of those who fasted intermittently lost weight, compared to only 40 percent of those on calorie-restricted diets. In a third study, 107 overweight women who spent six months eating 650 calories per day for two days a week lost an average 14 pounds of fat and 3 inches from their waists, compared to 11 pounds of fat and 2 inches from waist for daily calorie-restricted dieters (Int J Obes, May, 2011;35(5):714-27). See my report on Intermittent Fasting
If you have already had tests showing that you have plaques in your arteries, you know that you need to act immediately. If you have high cholesterol or high blood sugar, are overweight or have heart problems, your arteries are probably clogged with plaques and you don’t need further tests to start your plan of action, with your doctor’s permission. Since plaques are reversible, you can get rid of your plaques and resultant high risk for a heart attack by following the steps listed above for the rest of your life.