The Proof with Simon Hill

Reversing atherosclerosis with diet | Simon Hill, Msc


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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)
    • This episode is brought to you by:

      38TERA

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      Function Health

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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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