I was taught in medical school that coronary artery disease (CAD) progresses from minor “fatty streaks” in youth, to plaques in early adulthood, to complicated plaques causing heart attacks and death later in life. The arrows always pointed to the disease advancing and never reversing. This paradigm was first shown to be incorrect in 1990 by Dr. Dean Ornish, who used a plant-based diet without added fats along with walking, social support and stress management to reverse CAD on follow up angiograms. Since that first report, the data that heart disease can be reversed by intensive lifestyle changes emphasizing a plant based diet became so robust that the Ornish Lifestyle program was recognized by Medicare in 2010 for reimbursement as a therapy of CAD.

Although researchers like Dr. Ornish did not emphasize particular plant-based foods, subsequent studies suggest that certain foods may have special abilities to reverse CAD. Four foods that could reverse plaque in arteries are discussed here.

1) Garlic. The ability of garlic to lower blood pressure, cholesterol and blood clotting has been recognized for some time and has been shown again in a recent trial. In addition, garlic, along with onions, provides a source of sulfur in the diet which may be crucial for optimal amounts of antioxidants. In a study published earlier this year using baseline and follow up CT angiograms of heart arteries, garlic reduced areas of low attenuation plaque at the one-year follow-up.

2) Pomegranates have powerful antioxidant properties and may improve the function of the HDL cholesterol moiety to boost the “reverse cholesterol transport” that may reverse CAD. In studies of mice, pomegranates can reduce atherosclerosis. In humans with increased oxidative stress at risk for CAD, pomegranates reduced evidence of arterial damage. In another study using pomegranate juice for 3 years, the degree of narrowing in carotid arteries of five study subjects was reduced.

3) Bergamot. The bergamot is a citrus fruit that is native to the Calabria region of Italy. It has powerful antioxidant components that lower blood sugar and cholesterol. In a recent study of subjects with thickened carotid arteries, those given bergamot supplements had a marked reduction in carotid intimal thickening after six months of therapy.

4) Green tea. Green tea is comprised of many bio-active compounds that may lower oxidative stress, inflammation and cholesterol fractions leading to improved arterial health. In a study using angiographic analysis, the more green tea that was consumed, the lower was the risk of heart attack. A relationship between tea intake and lower cardiac mortality risk has also been reported.

The optimal goal of therapy of patients with CAD should be the reversal of disease with intensive lifestyle related measures and not just disease management. Indeed, in the Lifestyle Heart Trial, participants managed with medical therapy alone demonstrated progression of their CAD in follow-up. In addition to the scientifically proven approach utilizing a whole food, plant based diet without added oils, as demonstrated by the Lifestyle Heart Trial, certain specific plant based foods may have unique properties for promoting the reversal of CAD. A diet rich in garlic, pomegranates, bergamot fractions, and teas may accelerate the reversal of CAD.

Follow Joel Kahn, M.D. on Twitter: www.twitter.com/drjkahn

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