If You’re Worried About Your Health, This Test Is the Most Important One to Get

You might think that plaque is something you only have to worry about on your teeth. But plaque, the type that builds up in your arteries and heart, can be a major health threat, even a killer. The good news? Eating more plant-based foods and giving up meat and dairy (along with junk food like chips and heart-clogging oils) can not only halt the build-up of plaque but prevent it and even reverse its presence, as the body on a whole food plant-based low-oil diet appears to reabsorb plaque and achieve the amazing feat of healing itself.

Plaque (think of it as little pebbles of hardened cholesterol that lodge into the walls of your arteries, blocking blood flow like rocks in a stream) is harmful, even deadly, causing blockages, high blood pressure, heart attacks, and strokes (when oxygen can't get to the brain). One of the biggest culprits in the creation of plaque in the body is the standard American diet. This high-fat diet, which is focused on animal products and loaded with unhealthy fat, sugar, and sodium, can cause your system to become overwhelmed, resulting in deposits of plaque, which is one reason heart disease has long been the leading killer of Americans, causing 655,000 deaths a year.

Yet getting rid of that plaque in your heart isn’t like getting rid of the plaque on your teeth. You can't just scrape it away at an annual cleaning appointment. Fortunately, adopting a plant-based diet–along with other lifestyle habits such as daily exercise, and learning to manage stress–can prevent plaque from taking you or your ticker down.

What is plaque and how can you tell if you have it in your arteries?

You have probably heard a lot about the importance of cholesterol, especially LDL the so-called "bad" cholesterol, and its effects on your heart health. Good cholesterol, or HDL, is driven up by exercise and you can think of it as mobilizing fat for energy–so while both HDL and LDL get measured in a cholesterol blood test, only LDL is likely to cause you adverse health effects, research shows. Your body produces cholesterol for numerous functions, including making hormones, but it naturally creates all the cholesterol you need. Yet when you eat animal products, including poultry and fish, eggs, and dairy, you're adding cholesterol in your food, and only a small amount gets absorbed by the body, sp the excess can build up and set you up for trouble in the form of plaque.

Cholesterol build-up starts early, even in your teens, studies show

Plaque is not just an "old person's problem" as you may think. Surprisingly, studies have shown that the early stages of cholesterol build-up can start in childhood and teen years, depending on diet and exercise habits. “Diet and lifestyle have a dramatic impact on how quickly plaque builds up and whether it will ever cause you any problems,” says cardiologist Nicole Harkin, M.D., founder of Whole Heart Cardiology in San Francisco. She points to eating a diet high in saturated fat as the biggest cholesterol culprit for Americans. While saturated fat is found mainly in animal foods like meat and dairy, you’ll also find it in a few plant foods like coconut oil. So if heart disease runs in your family you need to skip tropical oils.

The cholesterol that enters your body gets deposited in the blood vessel walls, creating plaques or blockages, causing your heart to have to work harder to pump blood to the organs, brain, and outer extremities. This sets off an inflammatory cascade of events in the body,” Harkin says. Over time, those plaques can harden, essentially becoming calcified, and narrow your arteries. As your blockages build-up, you may notice symptoms like poor circulation, inflammation, poor night vision or loss of contrast eyesight, loss of sexual function, or lightheadedness, according to cardiologists such as Dr. Caldwell Esselstyn, a  proponent of a whole food plant-based diet to reverse heart disease.

As a result, you’ll then have an increased risk of heart attacks and strokes. “Inflammation and cholesterol are key drivers of these conditions,” Harkin says. Other risk factors include high blood pressure, smoking, obesity, and lack of physical activity. Genetic conditions like inherited cholesterol problems can also put you at risk for heart disease.

How plaque in your heart is measured: Get the inexpensive Calcium Score test

If you’re determined to be of borderline or immediate risk for a heart problem your doctor may order a coronary artery calcium score. The test, which generally costs about $100 (covered by most insurance carriers), is a type of CT scan that measures calcified plaque in your heart’s arteries. Those calcifications appear as bright white dots on the scan, allowing the amount of calcium in the arteries of your heart to be measured or quantified, Harkin says.

How much calcium you have can then be compared to an “average” person your age and gender, which will give you a better idea of your overall risk of a heart attack. “Studies have shown that the higher the calcium score, the higher your risk of a heart event,” Harkin says. If your score is high–normal is zero–your doctor will work with you to determine if you might benefit from certain medications like a statin or intensification of lifestyle changes, like switching to a whole-food, plant-based diet.

But should you get a scan if you’re healthy and not outwardly at risk? While there isn’t a guideline as there is for colonoscopies and mammograms, which are recommended over the age of 50 and 40, respectively, some medical experts say yes. “I recommend this for everybody, starting at age 45,” says Joel Kahn, M.D., founder of the Kahn Center for Cardiac Longevity in Bingham Farms, Mich., and author of Lipoprotein(a), The Heart’s Quiet Killer.  If your score is normal (aka zero), he recommends screening again in five to 10 years to make sure the disease hasn’t started. But some people are unlucky in genetics, and their body creates cholesterol no matter how healthy they eat or how active they are. The book's description states: "An estimated one in five people have elevated levels of a type of cholesterol called lipoprotein(a) which can increase the risk for cardiovascular disease, including blocked arteries, blood clots, and stroke," according to the book. "Dr. Kahn explains how this condition is a factor of genetics rather than poor lifestyle choices, pinpoints who needs to have their levels checked, and which types of tests to request."

How to manage–and prevent–the buildup of plaque in your arteries and heart

Although studies have shown blockages never truly or completely disappear, you can reduce your risk of them, even stabilize what plaque you do have, so it hopefully won’t cause issues. Medications such as statins are one strategy, but in terms of lifestyle changes, dietary change is the number one way to stabilize–and help prevent–this dangerous plaque buildup. “Randomized controlled trials have shown that even patients who have had prior heart attacks can lower their risk of recurrent events with improvements in their diet,” says Harkin, adding, though, that even the perfect plant-based diet is not a magic cure-all if you have a high genetic risk. But of course, eating more plants comes with numerous other benefits.

For starters, ditch foods that will cause inflammation in your body and cause plaque to form in your arteries, Harkin says. Because animal foods such a beef, pork, poultry, and dairy are loaded with saturated fat, eliminating them is key. You should also avoid items like packaged and processed foods, highly refined grains added sugars, and processed meat.

Once you’ve moved the animal based, high-fat foods off your plate and out of your cabinets, you have more room for whole plant foods, and the more you can eat, the better. These foods, after all, lower risk of heart disease through numerous mechanisms, the key one being fiber. “Fiber helps lower cholesterol, which is one of the main drivers of heart blockages,” Harkin says.

Plus, diets that are either plant-based or predominantly plant foods (vegetables, fruit, whole grains, nuts, seeds, and legumes) can lower blood pressure, decrease weight, and lower inflammation in the body, all of which lower the risk of heart attack and stroke. But how close to 100 percent do you have to come to eating plant-based? “While I advise a 100 percent whole-food, plant-based diet, I accept progress of any kind,” Kahn says.

A diet of whole plant foods can help reverse heart disease, but there are some foods that stand out, Kahn says. Take, for instance, garlic, which has been shown to lower cholesterol and blood pressure. In fact, Kahn points to a study in The Journal of Nutrition that found that individuals taking aged garlic extract for one year had reduced areas of plaque in their heart’s arteries. Pomegranate seeds and pomegranate juice may also help improve HDL, the type that is also referred to as “good” cholesterol because it essentially carts away the excess to be used for energy in all those long runs, walks and bike rides you commit to doing.

Vitamin supplements may also help, according to Kahn, who recommends D3 plus K2 in almost all of his patients not only for heart health but also for bone health. He also recommends not smoking (or quitting smoking if you do still smoke), getting regular exercise (follow guidelines of at least 150 minutes of moderate-intensity or 75 minutes of high-intensity or a combination of the two every week), logging adequate sleep, and managing stress.

Bottom line? Eat more whole-food plant-based, follow the additional lifestyle habits of being active and lowering stress, and you might just be able to say... Plaque off!