Is there a diet that can reduce arterial plaque?

Mediterranean Diet Can Effectively Reduce Arterial Plaque

The Mediterranean diet is the most effective dietary pattern for reducing arterial plaque and preventing atherosclerosis progression, as demonstrated by clinical trials showing significant reductions in intima-media thickness and carotid plaque height. 1

Key Components of an Anti-Atherosclerotic Diet

Plant-Based Foods

• Vegetables and Fruits: Consume >400g/day of each 2

  • Emphasize deeply colored vegetables (spinach, carrots) and fruits (berries, peaches) which have higher micronutrient content 2
  • Prefer whole fruits over juices which lack fiber 2

• Legumes: Consume up to 400g/week 2

  • Associated with significant cardiovascular disease risk reduction
  • Should replace red meat as a protein source

• Whole Grains: Choose foods made with whole grains rather than refined grains 2

  • Whole grain products are associated with increased diet quality and decreased CVD risk 2
  • Limit high glycemic index refined starches which increase CHD risk 2

• Nuts: Consume about 30g/day of unsalted nuts 2

  • Part of the Mediterranean diet pattern associated with CVD reduction

Fats and Oils

• Olive Oil: Use as the primary fat source 2, 1

  • Extra virgin olive oil specifically showed benefits in the PREDIMED trial with 30% reduction in total CVD 2
  • Replace solid fats with liquid vegetable oils 2

• Omega-3 Fatty Acids: Consume fish 1-2 times/week, preferably oily fish 2

  • Fish consumption is associated with lower risk of CAD and stroke 3
  • Anti-inflammatory effects help prevent atherosclerosis 3

Animal Products

• Dairy: Moderate consumption (up to 200g/day) is acceptable 2

  • Fermented dairy products like yogurt and small amounts of cheese are preferred 2
  • No significant difference between full-fat and low-fat dairy for CVD risk in healthy individuals 2

• Meat: Limit red meat and avoid processed meats 2

  • White meat (poultry) shows a neutral relationship with CVD in moderate amounts 2

Foods to Limit or Avoid

• Salt: Reduce intake by choosing products with less sodium and limiting condiments 2
• Added Sugars: Limit beverages and foods high in added sugars 2
• Processed Foods: Avoid highly processed foods, especially those high in saturated fat and sodium 2

Evidence for Plaque Reduction

The CORDIOPREV randomized controlled trial specifically demonstrated that long-term consumption of a Mediterranean diet rich in extra virgin olive oil was associated with decreased atherosclerosis progression compared to a low-fat diet 1. Key findings included:

• Decreased intima-media thickness of common carotid arteries (IMT-CC) at 5 years (-0.027±0.008 mm)
• Maintained reduction at 7 years (-0.031±0.008 mm)
• Reduced carotid plaque height compared to low-fat diet

This provides direct evidence that the Mediterranean dietary pattern can actually reverse arterial plaque, not just prevent its formation.

Implementation Strategy

1. Start with plant foods: Make vegetables, fruits, legumes, and whole grains the foundation of your diet
2. Switch fats: Replace butter and animal fats with olive oil
3. Add omega-3 sources: Include fatty fish twice weekly or plant sources of omega-3
4. Limit animal products: Reduce red meat consumption, choose poultry in moderation
5. Eliminate processed foods: Particularly those high in refined carbohydrates, added sugars, and sodium

Common Pitfalls to Avoid

• Focusing only on fat reduction: Simply lowering total fat percentage without addressing fat quality is ineffective 4
• Vitamin supplementation: While antioxidant vitamins from foods are beneficial, supplements of beta-carotene and vitamins C and E show no benefit and may increase mortality 3
• Ignoring overall dietary pattern: Individual nutrients are less important than the complete dietary pattern 2
• Excessive carbohydrates: Low-fat, high-carbohydrate diets can increase triglycerides and small, dense LDL particles, creating an atherogenic lipid profile 2

The Mediterranean diet not only effectively reduces atherosclerosis but also offers good dietary compliance due to its palatability and cultural acceptability 2, making it a sustainable long-term approach for cardiovascular health.