Intro

Can diet really reverse atherosclerosis, or is that an overpromise? Since sharing my own coronary CT angiogram results, this question has come up almost daily. In this episode, I revisit the best clinical trials to see what the evidence actually says.

I break down six randomised controlled trials and explain how different dietary patterns influence plaque progression, plaque stability, and cardiovascular events.

What we cover

• What atherosclerosis is and how it develops over time
• The tools used to measure plaque and artery health
• Evidence from six major randomised controlled trials on diet and atherosclerosis
• What Mediterranean and low fat diets actually achieve in practice
• Whether diet still matters if you are already on medication
• Key takeaways for prevention, progression, and long term heart health

Diet cannot do everything, but the evidence shows it can meaningfully change the trajectory of atherosclerosis and reduce cardiovascular risk.

• 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)

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Simon Hill, MSc, BSc (Hons)

• Creator of theproof.com
• Host of The Proof with Simon Hill
• Author of The Proof is in the Plants

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