Atherosclerosis is a disease in which plaque builds up inside the arteries. Plaque, made from fatty deposits, calcium, cellular waste and blood clotting materials, can harden and narrow your arteries, reducing blood flow and potentially causing a heart attack or stroke. Genetic factors, physical inactivity, tobacco use -- and certain dietary factors -- can increase your risk for atherosclerosis, also known as hardening of the arteries. Your food choices play a specific role in preventing heart disease, and reversal of plaque buildup can also occur with aggressive dietary interventions. However, understanding the specific role of diet on regression can be challenging because people with atherosclerosis are often treated with a synergistic approach of diet, medications and other lifestyle interventions.
While diet is known to reduce the risk of hardening of the arteries, less is known about diet's role in reversing plaque buildup. According to a review published in the January-February 2014 issue of “Annals of Global Health,” animal studies completed over the past several decades have demonstrated that regression of plaque can occur with dramatic decreases in lipoprotein or blood cholesterol levels. Drastic diet manipulations can be used in animal studies to create these changes, but regression in humans is more challenging to study.
Effects of Weight Loss
A study published in the March 2010 issue of “Circulation” randomly assigned 140 participants to a low-fat, Mediterranean or low-carbohydrate diet. After 2 years, researchers observed that all 3 diet plans were able to reduce carotid vessel wall volume -- a measure that reflects reduction in plaque -- by 5 percent. Study authors attributed the plaque regression to weight loss-induced blood pressure improvements in study participants, as high blood pressure contributes to atherosclerosis by making the arteries more susceptible to plaque buildup.
Effects of Intensive Lifestyle Changes
Intensive lifestyle changes have also been shown to reverse plaque buildup. Notable research published in the December 1998 issue of "JAMA" demonstrated regression of artery plaque buildup and fewer cardiac events in participants who closely followed a low-fat, vegetarian diet for 5 years. Improvements were noted after the first year and continued in this small group of people with heart disease who were not on cholesterol-lowering medication. In addition to the diet changes, this program included aerobic exercise, stress management training, smoking cessation and group support. Additional research published in the July 2014 issue of "The Journal of Family Practice" concluded that a plant-based diet restricting animal products, oils and sugars also reduced cardiac events such as heart attacks. However, this study didn't specifically measure whether plaque buildup was reversed, and study participants were not restricted from taking cholesterol-lowering medications.
Combined Effects of Lifestyle and Medications
In addition to the role of diet, other factors such as smoking cessation, regular exercise and stress management are known to help reduce heart disease risk. However, research investigating solely these measures on plaque reversal is not available. The cholesterol-lowering drugs known as statins have been shown to cause plaque regression, as summarized in the September 2012 issue of "Vascular Health and Risk Management." As a result, the majority of research on atherosclerosis reversal includes the use of statin therapy along with medications to manage conditions known to increase heart disease risk such as diabetes and high blood pressure, making it difficult to tease out diet-only benefits.
Next Steps and Precautions
While you can’t change your family history, making specific diet and lifestyle changes can reduce your risk of heart disease -- and aggressive enough lifestyle changes have the potential to reverse plaque buildup. Meet with a dietitian to learn how you can optimize your diet and follow a diet targeted at regression of heart disease. Work with your physician to discuss any other lifestyle changes that would benefit your health, and discuss the medications that will help manage your health conditions and reduce your risk of heart disease. If you have known narrowing or blockage of an artery, your doctor may recommend surgery to open up the artery or bypass the plugged portion.
Plaque buildup usually doesn't cause symptoms until an artery is narrowed or blocked. So if you have a condition that increases your risk of heart disease, such as high blood pressure or diabetes, or if you have a family history of heart disease, see your doctor regularly. If you have symptoms that include chest pain, chest pressure, confusion, paralysis, trouble speaking or understanding words, call 911 or seek emergency treatment.
Reviewed by: Kay Peck, MPH, RD