How doctors measure plaque

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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