Atherosclerosis is the thickening or hardening of arteries due to the deposit of fatty plaques. This can occur in any artery in the body and is the most common cause of heart attacks and strokes. Diet is the key component in prevention and reversal of atherosclerosis.

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As Americans continue to make poor lifestyle choices, the current prevalence rates of atherosclerosis will continue to climb. Even young adults and children have been found to have atherosclerotic plaque, as demonstrated in the Bogalusa Heart Study.1

Atherosclerosis can occur throughout the body. Coronary heart disease refers to atherosclerosis in the arteries of the heart. Patients can experience chest pain, shortness of breath, dizziness, and nausea when suffering from plaque build-up in the heart. Carotid artery disease refers to atherosclerosis of the carotid arteries in the neck, which can result in strokes. Renal artery stenosis occurs in the kidneys and can cause elevated blood pressure and kidney dysfunction. Peripheral arterial disease occurs in the arteries of arms and legs and can cause pain, numbness, or tingling in extremities. Symptoms occur either by blockage of blood flow by enlarging plaques or by rupture of plaque leading to clot formation. Plaques can often become calcified making them more stable and less likely to rupture but more slow to dissolve with the dramatic benefits and reversals that routinely occur with a Nutritarian diet.

Although an emphasis is put on family history as a risk factor, lifestyle factors such as nutrition and exercise, as well as environmental exposures have a powerful influence over the development of cardiovascular disease. Risk factors primarily develop as a result of the dangerous Standard American Diet, high in processed foods and animal products and low in protective, micronutrient-rich vegetation.

  1. Tzou WS, Douglas PS, Srinivasan SR, et al. Increased subclinical atherosclerosis in young adults with metabolic syndrome: the Bogalusa Heart Study. J Am Coll Cardiol 2005, 46:457-463.

Action Plan


  • A Nutritarian diet reduces atherosclerotic plaque buildup in the arteries. It lowers inflammation in the body that can contribute to the buildup of plaque and cause clot formation. It also provides important minerals and other vital nutrients. Hundreds of individuals have reversed their atherosclerotic heart disease following a Nutritarian diet. Calcified plaque may take longer to resolve but is still possible with a Nutritarian diet.
  • I have been treating patients with advanced atherosclerotic heart disease for over 25 years, with spectacular results. Coronary artery disease is routinely reversed in a reasonable time frame eliminating chest pain (angina) and enabling the avoidance of angioplasty and coronary artery bypass surgery.
  • Eat sufficient foods with omega-3 fatty acids such as flax, chia, and hemp seeds, walnuts, and soybeans. Nuts and seeds have a beneficial effect on multiple cardiovascular risk factors and have been shown to benefit cardiovascular health.1,2
  • Avoid animal products or limit to a condiment or flavoring in only 1-2 ounce portions a few times a week. Patients with diagnosed CVD should avoid animal products altogether, as these can promote inflammation leading to damaged blood vessels.
  • Meal plan: Cardiovascular disease reversal



An exercise routine is essential in promoting cardiac health. Routines should be catered to the individual, as some patients may experience episodes of chest pain with aggressive exercise, so some limitations may be necessary.


Other considerations

Elimination of tobacco in conjunction with a high nutrient diet is essential to lower your risk of cardiovascular disease and allow disease reversal to improve symptoms.4

Find additional help

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* Foods containing at least 0.4 grams per serving of plant sterols, taken twice a day with meals for a daily total intake of at least 0.8 grams, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease. LDL Biotect provides 0.54 grams of plant sterols in each two-capsule serving.

  1. Aune D, Keum N, Giovannucci E, et al. Nut consumption and risk of cardiovascular disease, total cancer, all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective studies. BMC Med 2016, 14:207.
  2. Kris-Etherton PM, Hu FB, Ros E, Sabate J. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr 2008, 138:1746s-1751s.
  3. Fuhrman J, Singer M. Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. Am J Lifestyle Med 2015.
  4. Li S, Yun M, Fernandez C, et al. Cigarette smoking exacerbates the adverse effects of age and metabolic syndrome on subclinical atherosclerosis: the bogalusa heart study. PLoS One 2014, 9:e96368.

Ask The Doctor

The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)


Does the Nutritarian diet reduce the plaque build-up in your arteries that existed before you started your Nutritarian diet? Or, will it only eliminate soft plaque as opposed to the hard plaque? How long does it take for that plaque formation to be eliminated?


It starts reducing plaque immediately, just like you start losing weight immediately, however, the speed and efficiency of plaque reduction occurs after you have lost most excess weight, so getting thin facilitates the burn off of the plaque. Both types of plaque can be eliminated, but it could take years. The probability of having a clot and heart attack is reduced immediately, and the plaque still stabilizes and becomes resistant to rupture and clots in a reasonable time frame way before the plaque is totally removed.


My understanding is that to reverse heart disease, you recommend a vegan diet with 1 oz. of nuts and seeds/day. My question is, if someone is only 5-8 pounds overweight (by your guidelines) and they adhere to a vegan diet but include 2-3 oz. of nuts/seeds, will they still be able to reverse atherosclerotic plaque? I know most importantly, they need to be very lean, but if this weight loss can be achieved with 2 oz. nuts and seeds in place of extra fruit, is reversal still possible?


It is not necessary to limit nuts and seeds to only one ounce. High levels of ALA, an unsaturated fatty acid found in flax, walnuts, vegetables, and soy have been inversely associated with IMT scores, which is a surrogate marker for atherosclerosis. In one study, individuals with the highest levels of polyunsaturated fatty acids had a 44% reduced risk of inflammatory disease mortality. Nuts containing these fatty acids, as well as other components like magnesium and sterols, appear to be anti-atherogenic.

It is not the fat (from nuts and seeds) but the total calories that determine one’s weight and body fat percent. So, if you are consuming too much food, the 3 ounces of nuts could contribute to the excess calories that you did not need. Overeating on any food could slow or retard the reversal that is possible because a lower body fat percent (not diet percent) accelerates the reversal process.

In other words, only eat when hungry. Err on the side of under-eating, not overeating. Do not snack, and it would be fine to eat 2 ounces of seeds and nuts a day. The nutritional profile of a nut containing diet is safer and more effective at reversing heart disease and has been found in studies to be linked to longer life in general, meaning reduced mortality from cancer, possibly due to the increased absorption of phytochemicals and fat-soluble nutrients.

The End of Heart Disease