Not so long ago scientists believed that once plaque is formed in an artery, it never goes away. Medical researchers thought that appropriate lifestyle and pharmacological treatment could show the process of atherosclerosis, but could not undo damage already done. In recent years, however, researchers have discovered that, given the right conditions, the body’s own healing process can sometimes reverse arterial plaque buildup. This need has provided hope for the millions of America who have been diagnosed with arterial disease.
The first step in preventing, slowing, and hopefully reversing arterial disease is to control the risk factors associated with its progression. Of course, some risk factors are out of our control; family history, race, gender, and age. But many factors can be modified by lifestyle change, and sometimes by lifestyle combined with medication, if lifestyle change do3s not produce adequate control.
Who is not familiar by now with public health recommendation for a heart heathy lifestyle? No smoking; regular exercise (at least 30 minutes of moderate-intensity exercise per day); stress management; and a heart heathy diet. Heart-healthy diet recommendation include limiting fat intake to 30 percent of daily caloric intake, and increasing consumption of plant foods, such as grains, fruits, and vegetables. These recommendation help prevent arterial disease by reducing obesity, blood lipids, platelet stickness, and blood pressure, and by improving blood sugar control in people at risk for type II diabetes.
Are Heart-healthy Recommendations Enough?
People formulating public health guidelines such as “consume less than 30 percent of your daily caloric intake as fat” have a tough job. Their goal is to weigh all available scientific evidence and propose recommendation that are simple and practical enough for everyone to follow. Some researchers believe that while current public health recommendations are fine for many North Americans, they are not stringent enough for people at high riskfor developing arterial disease and those already diagnoses with atherosclerosis. These researchers believe that some people are willing and able to make greater lifestyle modifications that offer a significant health advantage over the general public public health recommendations, and should not be limited by these general recommendations.
Several studies have compared participants who either
1. Received conventional medical care, which included advice to quit smoking, manage stress, reducer fat intake to less than 30 percent of daily caloric intake, and exercise regularly
2. Follow more stringent lifestyle modifications.
In these studies, the latter groups experienced significantly greater degrees of plaque regression, or at least slower progression.
What is “stringent”? Most stringent are lifestyle followed by patients who participated in Dean Ornish’s Lifestyle Heart Trial. They consumed a 6.8 percent fat diet, exercised over four hours a day, quit smoking, and participated in ov3r an hour of stress management and relaxation training per day. And while their lifestyles we’re most stringent, their results were also the most striking. Eighty-two percent of the patients in this group showed a regression of plaque in their coronary arteries, compared to 10 percent of the patients in the conventional care group. This means that your lifestyle can make a difference.
Other studies have used less demanding lifestyle change but hav3 found significant, albeit less striking difference between treatment and control groups. Studies which have included drug therapy along with lifestyle change have also observed plaque regression in many of their subjects. The best predictors of plaque regression in all studies were a decrease in LDL cholesterol and an increased aerobic capacity.