Is Atherosclerosis Reversible?

Support your heart health and prevent atherosclerosis with these diet and lifestyle tips.

Is Atherosclerosis Reversible? photo

How you can prevent or manage atherosclerosis to improve your heart health.

Your heart is a fist-sized muscle located in the chest. It is responsible for continuously pumping blood around your body, taking oxygen and nutrients to cells and removing carbon dioxide and waste products from cells. Atherosclerosis is a major cause of cardiovascular disease that occurs in the arteries restricting blood flow. Here, we discuss ways in which you can prevent or manage atherosclerosis through diet and lifestyle actions.

What is atherosclerosis?

Atherosclerosis is an inflammatory disease characterised by the hardening of artery walls. It is caused by a build-up of lipid plaques on artery walls and of inflammatory cells within artery walls. It begins with fatty streaks which develop into plaques as more cholesterol is deposited. It can take many years to manifest resulting in the narrowing of the artery leading to chest pain or angina. Ultimately, the plaques may rupture, creating a blood clot that may lead to a heart attack or stroke.

Cholesterol type and levels are key

The development of atherosclerosis is affected by the level of cholesterol in the body. Low density (LDL-C) and high density (HDL-C) cholesterol are two forms of cholesterol with particular relevance for atherosclerosis. High levels of LDL-C with low levels of HDL-C (a condition known as dyslipidemia) promote atherosclerosis. HDL-C is cardio-protective, anti-inflammatory, acts as an antioxidant as well as having antithrombotic properties and protecting endothelial function. It is responsible for the removal of cholesterol from cells and arteries and returning it to the liver for excretion.

What can you do to prevent atherosclerosis?

You can prevent the progression of atherosclerosis and in the early stages of its development, you may be able to reverse the fatty streak deposits or at least reduce their size. A key strategy is to improve your HDL-C level and improve its functionality.

5 ways to improve your HDL-C level and functionality

1. Lose weight

When we lose weight, our body composition improves by losing fat mass in particular fat from around our organs (visceral fat) which supports our heart health and reduces the risk of atherosclerosis. This can be achieved through either calorie restriction or intermittent fasting without starvation, ie. ensuring you eat at least enough calories to meet your basal metabolic needs (the number of calories your body burns in order to perform basic life-sustaining functions such as breathing, blood circulation, controlling body temperature, brain function, and contraction of muscles). Weight loss can lead to an improved HDL-C level and functionality as well as reducing LDL-C levels. Aim for your waist measurement to be <88cm for women, <102cm for men which is a good indicator for visceral fat level.

2. Increase healthy fat consumption

Healthy fats contain mono-unsaturated and polyunsaturated fatty acids. They are found in olive oil, nuts such as walnuts , seeds such as linseeds, avocados and oily fish such as salmon, mackerel, herring, anchovies, trout, sardines. These fats help maintain a good balance and level of triglycerides in the body, promote the reduction of LDL-C and increase the level of HDL-C and improve the HDL-C functionality which help prevent atherosclerosis and its progression. Aim to include a portion of healthy fat at every meal.

3. Exercise regularly

We are recommended to participate in 150 minutes of moderate intensity exercise per week. This could be done in multiples of 30 minutes per day or in other combinations to suit your lifestyle. We should also include 2 sessions of resistance training per week to build and maintain muscle strength. Physical activity (both aerobic and resistance) promotes cardiovascular health through its anti-inflammatory and anti-atherogenic effect plus it improves our HDL-C levels and functionality.

4. Eat colourful vegetables and fruit for their polyphenols

There is evidence that polyphenols, a group of natural compounds found in plants, can help balance cholesterol levels and HDL-C functionality, reducing the risk of atherosclerosis and heart disease.

Aim to include these food groups daily:

• Anthocyanins found in brightly coloured berries such as blueberries, blackberries, strawberries

• Quercetin found in onions and garlic, apples and broccoli

• Catechins found in green tea, grapes, cocoa

• Reservatrol found in red wine and grapes

• Curcumin found in turmeric

• Extra Virgin Olive Oil contains a number of polyphenols that are beneficial to HDL-C

5. Follow a Mediterranean-style Diet

The Mediterranean Diet has much research supporting its beneficial effects for heart health, including atherosclerosis and HDL-C level and functionality. It is characterised by high intake of olive oil, vegetables, fish, legumes, whole grains and nuts with low-moderate intake of dairy, meat and fruit. You can check out this article, Eating for a healthy heart with a Mediterranean-style diet for more information.

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Lechner, K., von Schacky, et al. (2020) Lifestyle factors and high-risk atherosclerosis: Pathways and mechanisms beyond traditional risk factors. European Journal of Preventive Cardiology, [online] 27(4), pp.394–406.

Luna-Castillo, K.P., et al. (2021) Functional food and bioactive compounds on the modulation of the functionality of hdl-c: A narrative review. Nutrients, [online] 13(4).

Marques, L.R.,et al. (2018) Reverse cholesterol transport: Molecular mechanisms and the non-medical approach to enhance HDL cholesterol. Frontiers in Physiology, [online] 9(MAY).

Stadler, J.T. and Marsche, G. (2021) Dietary Strategies to Improve Cardiovascular Health: Focus on Increasing High-Density Lipoprotein Functionality. Frontiers in Nutrition, [online] 8, p.761170.