Best Diet to UNCLOG Arteries

[@Masterr59]

Gil, I wanted to write this out for you in the chance you get to see this, as well as for anyone else who may be in the comments who can relate. I am almost 30 years old, have a BS in computer science so I have a background in lots of logic and reasoning, analyzing data. During COVID I started getting heavily into nutrition with my extra time, experimenting and being exposed to these new trends of intermittent fasting, prolonged fasting, low carb, keto, carnivore, "ketovore", early Time Restricted Feeding, and all the other variations of the trends. I listened to many, many hours of podcasts on the hate for seed oils, that saturated fat getting the bad rap in the 50s and 60s was a mistake, that processed foods are the enemy. I couldn't say how many hours I was spending listening to discussions on nutrition and long term health. I believe it was one of your videos on saturated fat I found first, almost two years ago. And at first, my thought was "here we go again, another biased doctor being paid to go against the trend that's actually helping people". At this point I had lost 100 lbs after being morbidly obese for 15 years, gained muscle, improved my flexibility, decreased my A1C to well into the low normal, same with blood pressure, drastically improved my stiffness and inflammation, constantly got told I look even younger. It would be easy to put myself on a pedestal at this time. I wanted to dislike your videos, because you were saying things that made me yet again challenge some of my beliefs, such as carbs, too much saturated fats, and grouping all seed oils together, using the appeal to tradition ("we ate this way for thousands of years, so it has to be the best" argument). You helped me with not just your data, but explaining why to stay critical in a respectful and inviting way. I continue to watch your videos not just for your content, but because you felt like my older experienced online brother scientist to me, helping me be a better researcher, and stay more true to trying to be a proper scientist, not caught up into just looking for what I want to hear. So that you for taking time in your videos, and even making special videos, to explain what makes something more or less credible, why an argument doesn't work, what to look for in studies as well we reminding the hierarchy of types of studies. You are doing great work. 💙

[@williamburnell529]

[@WiseMindNutrition]

This!! So many people only look at the evidence that already supports their beliefs, and get stuck in a nutrition lifestyle tribe. What you said can be really hard to admit, especially in the comments section. Respect!

[@goclick]

So how are you eating now, and have you continued to lose weight?

[@mrmacguffin6886]

Agreed here, I really love his emphasis on trying to find high-quality data and looking at either RCTs or meta-analyses.

[@aurapopescu1875]

Why would he? Keto is the only diet that reverses heart disease and almost any other disease. I have reversed diabetes, NAFLD and chronic headaches. Keto for life ❤​@@williamburnell529

[@cc2020-d4w]

Great informative video. Thank you. Thing is... my 62 year old husband ate this way all his life. And no added sugars, avoided red meat & so much of the saturated fats or butter etc. Fruits, vegetables, whole grains, steel cut oats, no processed junk, etc. He ate while foods so his life, the Mediterranean Diet full of whole grains beans, legumes olive oil etc But pretty high carb. He's NEVER smoked, he'd have maybe a couple glasses of red wine in a week, never did drugs. He did have high BP & had been on meds for that since his 20's & had always been super lean like his entire immediate family. All very lean. He's at 10% body fat. He's retired now since July but had a sedentary desk job for 39 years but always been active hiking, biking, kayaking, ice hockey, certified diver, water skiier etc. And guess what? He had a heart attack a year ago this past May! 3 blockages. 90% in the widow maker plus 100% in 2 other areas. He got 3 stents put in. All I've done is research research research & I truly believe it's hyperinsulinemia that's caused the inflammation in his arteries through time due to all the carbs. We've decided to now try a directly opposite root... He's gone ketogenic because we can't continue to have him eating & doing the same things that got him that way. I'm just so disappointed that everyone & all the experts keep advising us how he needs to eat the Mediterranean diet when that's EXACTLY what he's been doing ALL HIS LIFE. Going keto, he's been doing GREAT! I 🙏 pray this will at least help in no more progression of this disease. I feel we have no other choice. Thanks for your content.

[@NutritionMadeSimple]

have you checked lp(a)? also his ApoB needs to be kept quite low given existing risk

[@cc2020-d4w]

​@@NutritionMadeSimple Yes, we've checked it & still watching it. Thanks for the prompt reply & for your informative videos & content

[@NinjaAirBike]

What was his LDL? This seems the perfect person to be on a statin… it would have been worse if he wasn’t eating that way; maybe a heart attack at age 30

[@frankiegunnz8066]

I'm 46 now, and while I was on a 1.5 year of Keto I suffered a heart attack. Be careful!!!

[@JustMe-he1rm]

I had a heart attack at 41 on keto​@frankiegunnz8066

[@harbingerbk1]

"Ask them why they're not showing you the evidence. Demand better content and vote with your clicks." Such a strong ending!! I enjoy your content so much, thanks for everything you do!

[@mrmacguffin6886]

Absolutely agreed! If there is no evidence, there should be a dislike. If this absence of high-quality evidence - as opposed to singular low-quality studies - is consistent, unsubscribe and don’t take them seriously. Anecdotes such as ‘I did this and it helped’ or the opposite - ‘I only eat meat and have 400 mg/dl LDL levels and my arteries are doing great’ are poor sources in information if longevity and health are your goals.

[@YourDeKay]

I love the summary at the end of the video, that not only talks about what not to eat, but also focuses on what to actually eat. Thanks a lot for making the research accessible!

[@alfonso365]

It was great!

[@chrism9037]

Agree. There is so much info out there, that it is helpful to distill it all down to a simple summary

[@hidden909]

I have familial hyperlipidemia, and I was treating it with a WFPB SOS free diet for about 10 years. But I could never get to normal lipid levels. 3 months ago at age 69 I had a heart attack and 4 stents. I’m doing well now, still on the same diet, but with the addition of 2 cholesterol drugs, a drug for triglycerides and blood thinners and a beta blocker, and the results with the drugs are amazing. I have low blood lipid levels now, normal blood pressure and my CRP is very low. I’m also doing cardiac rehab and it’s going great. So I was so happy to hear you promoting drugs as well as lifestyle for those of us who are genetically predisposed to heart and vessel disease. I wish I had done both drugs and lifestyle before, but I was afraid of the drugs. I’m feeling much more optimistic about my future now. Thanks

[@MarilynMayaMendoza]

I also was afraid of medication for many years and I have genetic hyperlipidemia according to the test, not off the charts. I am 74 and in 19 I was diagnosed with peripheral artery disease. I now take a small dose of meds and eat a mediterranean diet. My diet prior to my diagnosis was pretty much awful. They just tested me again and all my lipids went down and my plaque in my leg did not increase. I am glad I caught it in time. One thing I do is eat one nut a day. I picked Brazil nuts because I don’t like them so I won’t eat the whole jar😊. I lost 70 pounds before I started medication and it did not affect my lipids or the peripheral artery disease. Fear is powerful and I’m glad we both are better. Sending healing vibes from hawaii.

[@hidden909]

@@MarilynMayaMendoza Thanks for your comment, I’m glad your lipids are mostly controlled with diet and a few meds. I hope in a year or so I can reduce some of my meds too. But it’s amazing to see my LDL down to 44, from about 275, and my triglycerides down to 148 from 650. So I know it’s super helpful to keep lipids low after stents so they don’t get all full of plaque again. I’m happy to still be here and mostly living a normal life again.

[@marksmith8942]

I had the same issue. Plant based diet, 6’ tall, 160lbs, high cholesterol. 2 doctors resisted request for statin and literally said “you might as well eat what you want”. ! Went on low dose rosuvastatin and cholesterol dropped to low end normal range in 6 weeks. I have familial high cholesterol. So, yes, if you’re eating garbage, overweight and not exercising, fix all that but statins can help

[@tomedwards1879]

@@marksmith8942 Congratulations on reducing your cholesterol. There seems to be this anti statin theme on social media. Whilst it's true that statins are not always required, there are patients who do need them, in order to bring their cholesterol levels to the normal range. No shame it that. Many people are not aware that statins also provide an anti-inflammatory benefit. "Well done" to you.

[@DrProfX]

Meta analysis shows that regression/reduction of 1% of plaque leads to 20% risk reduction

[@Dan16673]

Cra cra right?

[@jedinxf7]

crazy

[@kathleenkulp240]

As expected, we got a well-documented, thoughtfully presented composite video that examined and extracted the BEST information available. You are a master at distilling and presenting without the fluff or nonsense. Thank you yet again for doing the work to bring us valuable, useful information.

[@stnln2180]

Hmm... No Ketone based diets?... I would say all of those diets have not much difference between each other.

[@VeganWellnessTribe]

I appreciate you using an older trial as your first example to show that this information has been around for a decent amount of time.

[@rojodiver3344]

That smoking and alcohol cause cardiovascular disease?

[@Starchface]

I tremendously appreciate your focus on actual data and results instead of stories. *This* is why I watch the channel and place a lot of weight on your conclusions. Stories are nice but not when I am contemplating my continued existence above ground. Thanks so much Dr. Carvalho.

[@marclevesque7257]

Same here!!

[@yassennikolov3519]

You are a level above all other KZbinrs and influences! Thank you for your time and effort!

[@jacbeme]

I anxiously awaited a study that was between a low carb group who were in a state of nutritional ketosis and who burn fat for energy vs a low fat group that was not in nutrition ketosis and burned glucose for energy. Alas none of the studies met that criteria. Why? Benefit of the doubt is that one does not exist in the scientific literature as of 10/2024. Hopeful that may change in the future. Thanks for the video. Carpe Diem.

[@revivecleaning399]

"a low-fat group that was not in nutrition ketosis" is this usually what happens? I've never heard of this before it's new to me. Genuinely asking

[@mikeywallis4085]

@@revivecleaning399 Ketosis requires a high fat low carb diet, you can't achieve it if you are eating low fat

[@nimblegoat]

This is more an intervention diet plus also very new so longitudinal info is missing (cardiac events /cancer/ alzheimer's ). Plus I think is not suitable for world populous and ethical reasons . Hugely costly and impractical for most of world. also hard to achieve if travel a lot. Most people worldwide rely of wheat ,rice, sorghum , soya , potatoes to just get enough calories. Putting this diet on young children is tantamount to child abuse with just trust me vibes . But yes seems to help some coming from a bad place ( overweight , diabetic etc ). We now have enough info that Kids if eat well without all the hidden sugars/salts , substituting for more complex carbs and keeping active can still have a very varied and flexible diet. The keto diet is very very restrictive and not easy for many people. Only really works when gets calories right down ( where maybe a lot of the benefit is coming from , ie big weight loss ) . Better to have a more flexible diet then eat 1200 calories for a week once every 2 months to get a similar cleaning.resetting effect IMHO

[@dj.h7424]

@@revivecleaning399 Yes, ketosis generally only occurs when eating no, or very few, carbohydrates. As an n of 1, my angina became worse when I used a ketogenic diet for weight loss. I only beat it with exercise and a fairly low fat plant-only diet.

[@tarabooartarmy3654]

@@dj.h7424same for me. I tried keto and carnivore, and I lost over 100 pounds, but I got so much worse from a health standpoint. Arrhythmia, high BP, sky high cholesterol, migraines, type 2 diabetes, and other issues. Went low-fat, WFPB and everything has resolved or vastly improved. I get that keto apparently does well for some, but it definitely did not for me.

[@HealthyEveryDay-22]

10:51 A plant-based diet combined with proper exercise is truly the golden key to heart health Thank you for the valuable insights

[@karolinaeigenmacht5433]

.....one of my favorite , real doctors on KZbin. Excellent content. Thank you for what you do for us❤❤❤❤❤

[@Fair-to-Middling]

As for eggs, it has been shown that one egg or 10 (or 100) doesn't make a different with MOST people's cholesterol numbers. For some, like me, any speck of cholesterol (and plant sterols) is absorbed into my body like a sponge. I am a hyper absorber of both of those sterols. We need to understand that we are all different and a one size fits all dietary plan does not make for a great 'individual' dietary plan, but it's a start.

[@aaronbr2001]

Eggs do increase cholesterol but the effect can be hidden by selecting participants that already consume a high cholesterol diet. If you watch this channel’s interview with a cardiologist he stated that 20% of dietary cholesterol is absorbed 👍

[@sci-life-art-ru]

Because their LDL was already high.

[@The123fiona]

How was your hyper- sensitivity to cholesterol identified?

[@karynstouffer3562]

The fact that general guidelines don't work for all humans gets tossed by most healthcare providers. It's like they are so trained in "the research shows" that they forget that we are individuals. We react differently to to the same stimuli.

[@YaYippieYeah]

How did you learn this? I'm recently doing a 2 month 2 egg a day test on myself to test how much impact it has no on me. I think eggs are probably the least harmful animal product, unless you are an hyperabsorber.

[@BobPritchard]

Excellent video and great channel. So many vloggers push fads and not facts. This channel is my most trusted KZbin source of health advice. Thanks Gil!

[@DamonWard-h4u]

Male 60 here. 2 and a half years ago I had crippling angina. Being a hunter I was a big meat eater. Over night I went to a whole food plant based diet. The chest pain stopped after only 4 months and my LDL went from 5.8 to 1.9 . Today I run 4 km each morning, Row 1 km, walk my dogs 5 km and MTB plus do resistance training twice a week. I got my life back. BP is 115/70. heart rate 55 BPM, BMI is 20 and the A-fib I was having stopped. No meds as I am skeptical about any possible adverse effects long term. I eat Natto beans, 5 gram of creatine, B12, Vegan EPA/DHA and grow my own garden. Lots of greens, fruit, nuts, sweet potato, mushrooms, grains and nothing processed. No salt, caffeine, sugar, dairy or oils. Works for me. Good luck if you are on a similar journey.

[@ellenm1937]

Your numbers and results are very impressive. Your diet is basically the diet I am starting now. I was diagnosed with whats typically called metabolic syndrome: prediabetes, high cholesterol, high triglycerides mild high blood pressure. I'm not overweight though. I was concerned that the higher carbs in a low fat vegan diet would not be good for high blood sugar but a study I read suggests otherwise. So I'm doing a vegan diet with no refined carbs, no added seeds or plant oils, high fiber low sodium. So I guess that's a similar diet to McDougall, Orrnish, Khambatta, Esselstyn. Good thing there's not a vegetable I don't like. Just gave away about 12 lb of meat from my freezer..

[@ck2136]

I truly believe that this video alone should serve as advice for anyone interested in arterial health. There are so many videos with (not real) doctors talking about eating or not eating this or that, but nowhere is there any science behind it. So many people get confused or just believe what these (not real) doctors say on social media. I'm glad I found your channel because I was sick of these non-medical videos like everyone else. :)

[@98lincolnmarkviii]

Vegan for animals for 15 years and will be for life. Im healthier than ive ever been in my life. Its amazing when you do things for others the things you get in return ✌️❤

[@terryjackson9395]

15 Years here also. Age 60 with perfect bloodwork. There's no healthier diet than WFPB

[@someguy2135]

Kudos! Like most vegans I wish I had started sooner. I'm only about 8 years so far. I'll never go back.

[@_kardus]

@@terryjackson9395 Sure there is. A whole food animal-based diet.

[@jmw-q4u]

​@@terryjackson9395lol

[@98lincolnmarkviii]

@terryjackson9395 awesome brother stay well 🤘❤️

[@sourav8813]

I hope I could like it 100 times to help with the algorithm! Thanx for what you are doing doc. 🙏

[@mcanultymichelle]

Love how you simplified at the end. if it was my health, or a loved one, this is what I would do.👍👍👍👍

[@naderdehghani1894]

Thanks for your scientific approach to nutrition. I appreciate your worthful time , energy and patience to make these precious videos 🌸🌸🌸👏👏👏

[@rabeyhusini6006]

Thank you for these impactful and meaningful videos that not only help clear the noise, but are solely fact-based. People don't appreciate how much work this takes. Grateful 🙏🙏🙏

[@Lydian804]

Thanks for this channel. I like the way it rids me of unconcious fears I developed around food throughout the years because of this endless stream of information I am exposed to.

[@DenisMacDougall-hu5ep]

An outstanding video summarizing the latest in the science of diet and its relationship to cardiovascular disease. For my money the best you tube channel on the internet. Cuts through all of the confusion with succinct, practical advice for those of us suffering from the disease.

[@fixintoboltfreely7360]

A whole food, plant based diet, walking 3 miles/day made the varicose veins in my feet and legs shrink down and soften. I can’t afford angiography, so I’m going by what I can see happening and staying on it.

[@ShoppingEmail-dr1fs]

plant based is what we all eat anyway. do you mean vegan? what do you mean. Most humans eat about a 70 percent plant diet anyway.

[@xmonikerhotmailcom]

Yup, 23 years for me and I am uber healthy at 53. Perfect blood work and high normal testosterone.

[@irfanmohd091]

You can eat chicken and fish

[@pauljansen6650]

You increased activity and ate less calories....thats why

[@afoxnamedmulder]

Can I ask what plan you've using specifically? My mum has been wanting to start a wfpb diet, but we're not sure where to begin?

[@Laurenski67]

Thank you again for your balanced and intelligent analysis. You keep us sane!

[@antiquelady60]

My conclusion for my health needs is: 1. Focus on whole foods. 2. Slightly reduce overall calorie intake. (It wasn't mentioned in this video, but comes up in most studies I've read or heard about.) 3. Don't be afraid to use a little oil if that increases vegetable consumption. Don't be afraid to eat nuts, fish, eggs, or poultry if my body seems to be asking for it. 4. I will reserve the consumption of sweets and processed foods for Christmas and birthdays (about 3-4 time a year). Also, I find that I feel better when I avoid cooking with oil, but drizzling it on salad and cooked vegetables doesn't seem to interfere with energy levels or weight loss efforts. I wouldn't recommend that to anyone else; that's just how my body and mind react.

[@mikafoxx2717]

Seems pretty balanced and healthy. Oil isn't the devil, it's just added to a lot of junk and the calories add up, meaning less room for more nutritious ones, or weight gain.

[@michaelberman3648]

I would strongly recommend also measuring the degree of chronic inflammation in each subject! In my opinion, it’s the inflammation process that initiates the addition of plaque with the addition of an induced immunological response to these sites within the blood vessel linings. The amount of inflammation alone should also be measured by measuring highly sensitive C-reactive protein and perhaps other red flags indicating the degree of inflammation.

[@NutritionMadeSimple]

hi, some of the trials did measure CRP. Inflammation is a risk factor for heart disease, although not a necessary precondition, see kzbin.info/www/bejne/hIaao5mefM5gipY

[@leer.2137]

thank you; 2day just got a good bill of health from My cardiologist, (2 yrs. ago mitral valve repair). I got a mini lecture on why I should be taking My atorvastatin as prescribed. I don't like being on it. (from genetics & smoking tobacco since a young age, quit since 2017) I have some plaque in my system. My cholesterol levels are within normal range. My chart reads; 2nd degree AV aorta block. I had no symptoms/I trucked through a post winter storm on foot about 4 miles to do some errands, pick up scripts 2 days b4 My surgery. Slowly but surely working My way out of a major depression. I am so happy to hear you saying some of these factors can possibly be reduced? !!! ~ thanks for your informative posts, I watch most when I can

[@sapperstang]

After a high calcium score for my age (I’m 46) I radically changed my diet. I’ve seen improvements across the board. I also exercise far more now. I typically eat whole foods and lots of fish, fruits, vegetables, and healthy fats. My macros are typically around 20% carbs, 45% fats, and the rest protein. I do allow myself a cheat day once per week because it helps keep me on track. The only thing I haven’t done is start the statins. After doing my own research my doctor agreed to let me do 5 mg every other day of the statin. I know it’s probably necessary but dreading the side effects.

[@novypam]

A hundred thumbs up. 👍🏽👍🏽 Very important to watch video, practical and factual. The color coded summary was also very cool. Thank you.

[@DrProfX]

💯 It’s all about commonalities among different diets! Thanks for yet another great video!👍👍

[@KevsArtStuff]

Interesting. My question is... what were they eating before the new diets? And did the fact that they were not eating that anymore, have an impact? So was the results because of the new diet or the lack of the old diet? Thanks... great video.

[@TC-by3il]

That doesn't really matter though, as they defined what to exclude from the diet as well. So either is accounted for.

[@KevsArtStuff]

@@TC-by3il Surely it matters. If I had a diet of junk food for thirty years and I stop eating that and eat all healthy food instead, there would be an impact due to the fact that I don't eat junk food anymore. So is the impact from not eating junk food anymore, ot eating the healthy diet.

[@davidrenz5886]

Great point!...

[@TC-by3il]

​@@KevsArtStuff They were compared to a control groups of similar cohorts. Whether or not they ate junkfood, both groups likely had similar dietary patterns before the intervention, so we can compare them. In addition to thay, regardless of their previous diet, the _change_ is what made the difference. Whenever you stop eating junkfood, you have to replace it with something else. Lastly, many of the studies showed that those with higher adherence to the healthy diet had better outcomes, which leads us to believe that there may be a dose-response towards the healthy diets. So based on all that, I fail to see the importance of knowing exactly what their previous diet was like.

[@jozefwoo8079]

That is such an obvious point that is missed in so many studies and it's frustrating!! Thanks for bringing this up, hopefully this gets addressed one day. I believe that for instance EVOO might also lose some of its glamour if we control for that.

[@Mattheo76]

This is really high value content, thank you. I changed my dieat since last year into vegetarian with low fat dairy, only joghurt and Skyr, lots of fruits, whole grains, tofu, legumes, olive oil, nuts canola oil, lots of vegetables and dark chocalte. No smoking no alc, 3-4 times a week exercising. I lost weight from 90 kg to 73. My blood pressure from 130 to 110, my total cholesterol from 202 to 142. LDL from 146 to 106 but HDL is only 36. Before it was 56. Should I be concerned about that HDL? Longtime sugar is 5. Before I eat normal diet but with just white meat, also fish, olive oil and exercise, but sometimes crap. Now fat is 40-50 grams saturated 5 grams maybe. Before fat was like 80-90 grams an more saturated.

[@pinkpig8091]

The only trustworthy source

[@swimbait1]

A consistent theme from health experts is a diet high in fruits and vegetables, some grains, small amounts of dairy combined with strength training and cardio type exercise (walking, biking, etc.)

[@geminicls446]

Great information, as usual!! Love your wrap up at the end with the foods that should be avoided for heart health - no matter what dietary pattern you follow, everyone can agree on that point! Thank you 😊

[@earthmamma85]

So basically you should eat a natural, unprocessed diet. ❤

[@billdublewhopper3064]

Low fat

[@agk1511990]

The most level headed nutritionist. Just based on facts and data and no BS

[@thomas2782]

Good vid. I've followed Dr Essy's pretty much for about 15 years. So far so good. I have not followed up with another angiogram. Nobody does that if they don't have to.

[@judyg2889]

I always appreciate you researching all the studies. I totally agree. I think too many variables to just say one diet fits all. also like Dr, William Li's take on what foods to heal & why. Moderation I believe is one of the Biggest factors in all diets. Again ,Thank you so much for doing the work for us ,so we can make the best choices for our over all health 👍

[@peterfaber7124]

Food definitely is a factor in relation to risk factors. Maybe we should ask how the body reduces plaque. What does the body need to do maintenance. And, in my opinion, it's 2 things: 1) Absense of foods that cause hypertension and inflammation. 2) Being in the fasted state. The body does maintenance in the fasted state only. In the fed state it's busy with other things. So a diet that normalizes blood pressure and reduces inflammation, combined with intermittent fasting, is the best approach to reducing atherosclerotic plaques. You decide which diet(s) are best for reducing hypertension and infammation.

[@mesterferenc2688]

Thank you very much for your very useful, life saving work. However, I am disapponted by the tiny results. The risk reduction is of course relative...However, it is better to face reality, without false expectations.

[@sf3413]

Yeah, with such a wide variety of preferences/tastes in patients, I lean toward offering whole food options that align with what they like/gravitate towards. Otherwise, they'll just revert back to ultra-processed junk.100% agree about exercise. Meds are beneficial, though getting patients off meds asap is the aim. Acute care, not chronic care. Great video Gil- thianks!

[@AndrewPawley11]

Extremely valuable information. Thanks for doing this Gil.

[@lmqs94]

I enjoyed this video. Practical in real life.

[@trubrit5036]

I needed this. I spoke with my Cardiologist today, and we're battling medications. While I am definitely not willing to do Repatha or Leqvio, I am taking a Statin 3 times a week, due to side effects. But after watching this, I might see if upping my Statin gradually, might cut down the return of the side effects. At the end of the day, diet is what I feel will work, but I love my food - which is what got me into this situation to start with. I love your videos. They have helped me, no end.

[@eugenefirebird8938]

Dr Carvalho: Please interview Dr Joel Fuhrman on this topic. I believe he would love to do it.

[@brinnon9073]

Good sir. You rock. Thanks for caring and sharing!

[@Randsurfer]

I'm watching and am just on the first trial. Something seems obvious to me. It needs to be known what happens with the control group. For example, if they get 3% worse and the trial group gets 3% better, then the true benefit is 6% better, because without the trial lifestyle changes, they would have ended up as the control group.

[@rajnz]

You are missing the point. Better or worse than what? Answer the control group. The measure or the yardstick is the control group.

[@ParadymShiftVegan]

​@@rajnz Precisely; hit the nail on the head. Ty kindly for sharing!

[@ParadymShiftVegan]

@Randsurfer @rajnz explained thoroughly. This is an example of a very fundamental, basic tenet of experimental human research. I recommend studying the scientific method in order to become familiarized with at least the fundamentals of the system it uses so that you have a stronger grasp on how and why we structure these systems in this way.

[@GeorgeT370]

Great video....great analysis....great conclusion....thanks !

[@BobSmith-fx9sz]

17:58 is the most important bit if you're in a rush 😊

[@werewolfcountry]

Your point about the names of the diets being less important and to look at the commonalities is a very good point that I think more healthcare professionals need to emphasise. I feel like some of the names (especially Mediterranean) tend to take the conversation off topic into cultural and lifestyle anecdotes rather than concentrating on the overall formula that the diet follows that can be tailored to an individual's needs and location.

[@FloridaNative59]

Top notch content, best most comprehensive nutrition channel on You Tube.

[@jasontheworldtraveler]

Gil, thank you very much for presenting this very important video that will benefit so many people 🙂

[@MistyBell13]

Great overview, thanks! Interestingly Dr Esselstyn's patients with severe CAD on a whole food plant based diet (no oil OR nuts) saw huge improvements but this was reversed if they started eating nuts or oils again. So for some, nuts and oils may not be a good idea. Also, there's misunderstanding about the proportions of foods to consume in a true Mediterranean style diet, its 90 percent fruit, vegetables, wholegrains etc and the balance of 5 to 10 percent is the optional extras like fish or lean meat, nuts and seeds, dairy, olive oil ❤

[@earllemongrab7960]

Fantastic breakdown. Thanks to you and your Team! You did a great job!

[@kevinreed69]

Dear Gil, Thank you for your informative content. I'm 41 years old and recently received my lipid profile results: HDL - 77.0 mg/dl, LDL - 253.7 mg/dl, triglycerides - 163.0 mg/dl, and total cholesterol - 363.1 mg/dl. My fasting blood sugar was 100.8 mg/dl. My doctor prescribed Atorvastatin (40 mg) for three months. After researching cholesterol, I have a few questions: 1. Should I consider additional tests beyond ApoB for an accurate assessment? 2. Can ApoB and LDL levels diverge (e.g., high ApoB with low LDL or vice versa)? If so, does this imply different dietary approaches for managing LDL and ApoB? Would low ApoB levels justify stopping statin medication? 3. What test detects arterial plaque and provides detailed information about it, if present? Thank you for your expertise. Best regards

[@azdhan]

Many thanks for another awesome video Dr Carvalho. Much appreciated as always!

[@ellocodos]

I already do your dietary recommendations, except NO dairy, red meat only maybe 3-4 times a year(grass fed only), 4 eggs a week & very low fats. Lots of whole grains, chicken breast ,and Norwegian or Tasmanian salmon. Green salads almost daily and lots of cooked veggies for dinner.

[@i2sky532]

What an excellent video

[@joerockhead7246]

100%

[@tr1ckster726]

Cant wait to watch this after work. Gil is the GOAT 🐐

[@Patrick-pw1cr]

Great video, however if the question at the beginning is 'has this ever been done before on social media?' the answer is yes. Physionic. I follow eight health, lifestyle, nutrition, molecular medicine channels including this channel and physionic. At this level of excellent coverage there is room for more than a few.

[@stevelanghorn1407]

Excellent presentation. Now it’s down to us!

[@smtonlinevideos]

Thank you for this! I'm grateful for your channel. It is such a huge help in making informed lifestyle choices.

[@j.m.9263]

Many thanks for your high efforts in bringing us great quality content! Much appreciated 👍

[@jacko3423]

You're awesome, Gil! The same questions I ask my physicians: What would you do if you or your loved one is in my situation? And not what the guidelines say.

[@CristinaAcosta]

You are the BEST!!! Thank you ❤

[@jasonwayne4917]

Absolutely your BEST video you have made to date, thank you very much for all your presentations, your the BEST!!

[@johncrondis4563]

I would really like a low fat WFPBD mixed with exercise RCT to see if the difference is bigger or similar to these results.

[@DrTomaszJezewski]

We as doctors wait and expect such trial too...but there is huge problem with financing ...Dean Ornish haf the same problem to gather bugdet before 1990... Nobody makes good bussiness on effective prevention...

[@RC-qf3mp]

Or, eat lots of small fatty fish, keto anti inflammatory whole foods diet with regular exercise.

[@johncrondis4563]

@@RC-qf3mp Im going to let other creatures remain alive :)

[@RC-qf3mp]

@@johncrondis4563 nothing remains alive. Everything is part of various life cycles. To deny that or disparage it is nihilism.

[@johncrondis4563]

@RC-qf3mp I still dont have to end any creature's life early or pay for them to suffer, thus I wont.

[@missacgcassim9687]

Bonjour from France.. Great video...Great comparisons.. What macros would you recommend ... Merci

[@del7506]

Fantastic content once again. You're saving lives.

[@rodniki14]

Some specialists shout out "cut carbs to reduce belly fat". Others say "burn more calories than you consume". Fasting and exercise - do that!. In my case, I did all four and it works. Low carb, reduced calories, burn more calories than consumed, healthy food, don't eat anything between meals and daily exercise. My diet is fresh vegetables and meat/poultry/fish/dairy three times a day, an orange or an apple for breakfast and lunch, a portion of nuts at one meal. This regime causes a calorie reduction by default, at least for me. I am not going to eat more than a piece of chicken or a normal portion of meat for dinner. For breakfast, two eggs is all I can eat. Fresh greens have almost no calories, or carbs. Not eating for long periods increased my energy levels. I either walk for an hour or swim for a half hour and spend time fixing things around the house or in the yard, all of which I enjoy. Make food that tastes great. I love my swims and walks and my yard is looking great. Enjoy life, it doesn't last forever. As for this video, go to 19:00 to get the common sense results.

[@charlesdowning5899]

Please discuss which medications will reduce plaque. Thanks!

[@tspicks4360]

I appreciate the coda, stating a personal choice leaning toward what is essentially the Ornish protocol from all those years ago. Indeed, that was my personal choice after a heart attack 11 years ago ... having been told by my cardiologist that cvd is a progressive disease for which there is no cure, Ornish's book was a shining beacon of hope in a bleak outlook, and damn if it didn't deliver In spades! Cut sat fats!

[@maryhodges5904]

I have tended toward Esselstyns diet, which is harsh and difficult to maintain, causing me to have very unhealthy cheats when I do cheat, ( maybe once every month or 2) - like donuts or sweets. I think if i use an approach influenced by these additional studies it will help dxponentially with compliance which seems to create a sizeable benefit in EACH of the studies. Thank you for all of your research and help in this area!!

[@hannesforster1845]

Great job again! Many thanks Dr. Carvalho!

[@andygold-YT]

It's not about the macronutrient composition; it's about caloric intake. The key is weight loss.

[@greentree_]

Weight loss is about calories. Health is about calories AND quality of food AND wise balance of macronutrients (no weird extremes). And I’d even say “luck” too because some people seem to do everything “right” then something wrong appears, while others don’t worry too much and is alright to late age.

[@stefaniasmanio5857]

Hi dr Gil. Useful, clear and fantastic as always… well, even more! One question, did any trial look for correlation between frequency of daily meals and results? Or time of eating and results or events? Just a curiosity. Thank you so much! ❤❤❤

[@orflanch]

Fruits and starchy vegetables are good unless you have diabetes or pre diabetes. Same thing with whole grains. A continuous glucose monitor is important when deciding on what to eat because everybody is different.

[@sandyglover736]

Based on the green light foods, it appears to be pretty much in line with Dr. Esselstyn ‘s recommendations except for the inclusion of dairy

[@debbienorman3402]

So excited to watch this. Is there any research on full fat dairy vs nonfat dairy for those with elevated lipoprotein a ?

[@Jay-it9cg]

I have heard full fat dairy is better as long as you're not in a major calorie surplus. It is overall healthier and I do believe hearing about a study where full fat dairy had an improvement in LPa when low-fat did not. Sorry I don't remember the study offhand though.

[@alexandrustefan9059]

Non fat means heavily processed

[@YaYippieYeah]

@@alexandrustefan9059 Bullshit. Low fat milk is by no defintion heavily processed, and low fat yoghurt is just the product of low fat milk. In my region you can also find "Quark" with 0.1% fat which is also a low processed milk product with lots of protein.

[@rjmclean1979]

​@@YaYippieYeahlow fat greek yogurt has a lot more sugar than regular fat greek yogurt

[@YaYippieYeah]

@@rjmclean1979 If you buy the one with added sugar. Your fault.

[@darylfortney8081]

personally I have high CAC and am taking high D+K, Lumbrokinase, Nattokinase, and Serrapeptase while trying to walk at least 30 minutes per day. doc has me on 5mg rosuvastatin and 10mg ezetimibe and what was a total cholesterol of 250+ is now around 110 with LDL under 70

[@jahiddle]

Any specific brand(s)?

[@mesterferenc2688]

I do the same ( D+K, Lumbrokinase, Nattokinase, and Serrapeptase, plus quercetin, berberine, fermented black garlic extract, Mg etc.) but cannot take rosuvastatin, it causes horrible cramps. And WFPD with 3-5 % fat.

[@darylfortney8081]

@@jahiddle thorne d+k, arthur andrew medical neprinol, Canada RNA Boluoke

[@darylfortney8081]

@@mesterferenc2688 yep, also take those too. Have high Lp(a) and a genetic mutation that doesn’t allow my body to metabolize statins which is why I only use 5mg+zetia otherwise my CK levels shoot over 1000 and my body starts destroying itself. Zetia has really helped bring the ldl down in leau of higher statins without the side effects of bad joint pain and cramps. Might try swapping out the rosuv for bempedoic acid if my doctor agrees. Found out about the genetic mutation through 23andme of all things.

[@jahiddle]

@@darylfortney8081 Thanks!

[@AmyStruve]

Very helpful and simple, Glad i found this video

[@rogerbstl-n6c]

I like the recap at the end it was really helpful!

[@rogerbstl-n6c]

I wonder if there are studies on high fat diets and low carb diets like Atkins diet, or intermittent fasting diet plans with all kind of foods but with fasting as the commonality, or Dr Caldwell Essellstyn diet i.e. whole foods plant based and no nuts and high plant fat where there is more cardiovascular issues

[@mehmetcamat4458]

I fully agree with you basically eating a Mediterranean diet with exercise is the key to healthy heart. If you have plaques in your coronary arteries you need to be medicated in order to prevent more plaque happening and calcify the ones that are already been there

[@rn5697]

Best as always.

[@evanhadkins5532]

Science also deals in generalities. The bell shaped curve - with its tails. Science shows some people lose or gain weight on the same diet. How do we individualise?

[@jeffj318]

Great video and information. Low saturated fat and high fiber. 💪👏❤️

[@michaelvadney5803]

Great video, thanks! In terms of medication, what in general then is recommended?

[@paulo3011]

I started to laugh at the opening line before hearing the full statement. That said, I appreciate the thorough breakdownof the highest level of evidence. At 42 I've begun making adjustments to my diet in this direction before I experience events.

[@codeisforever]

Given that plaque accumulates over decades it’s probably not unreasonable to think it might also take many years to reverse the damage. So over 4-5 years of a study we shouldn’t expect dramatic reversals. I’d say a few percentage reduction is very encouraging.

[@hepgeoff]

Great information. Thanks, Gil!

[@AttilaM-p6x]

Thank you for another excellent video.

[@willbrink]

Excellent summary and big picture summary of the topic.

[@Eric3Frog]

Hi Will. Nice to see you here.

[@johnnymiller7786]

Excellent guidance. Screenshot the stoplight slide near the end and you have a heart healthy diet and add some exercise.

[@darylfortney8081]

The lifestyle study was way too many differences to know what worked... we need many trials that change as few things as possible for as long as possible

[@liciniooliveira-becas3618]

That's the problem, as always. So manu variables and they still get to some strong conclusion. The common element seems to always be exercise and weight loss! People who eat in moderation seem to always getting the best, no matter what fad diets they are.

[@andrewnorris5415]

In my view, the main commonality is unprocessed food and high phytonutrients. Low saturated fat helps (exception of cheese and nat yogurt - both of which appear neutral). Makes me think other probiotics may be beneficial. Not sugar in the yogurt of course.

[@eudemonia]

@NutritionMadeSimple Doc, I appreciate your channel and your opinion on selecting an optimal heart health diet. It sure would be nice to see an Ornish vs Mediterranean diet study. If the Mediterranean diet allows for more fat and more fun in the diet and if it is as good or better than Ornish, then that would be hugely beneficial to know!

[@pranjal86able]

Summary The video covers the best dietary strategies to help reverse plaque buildup in arteries, using evidence from six randomized controlled trials in humans. Here’s a summary of the key points and findings from each trial: Overview • The video aims to identify the best diet for reversing heart disease based on high-quality evidence from randomized controlled trials, not anecdotal stories. • Six trials were reviewed, each looking at dietary changes and their effects on plaque reduction and heart disease reversal. Trial Summaries 1. Lifestyle Heart Trial (1990) • Participants: 20 men on a low-fat vegetarian diet with exercise, stress management, and social support. • Diet: Low-fat (8% of calories), high-carb, low-cholesterol, vegetarian diet. • Results: A 3% reduction in arterial stenosis (narrowing due to plaque) over five years. • Outcomes: 60% fewer heart-related events compared to the control group. • Limitations: Small sample size, multi-pronged intervention, angiography technique limitations. 2. Stars Trial (1992) • Participants: 26 men, some on a diet intervention, others on diet plus medication. • Diet: 27% calories from fat with reduced saturated fat and increased fiber. • Results: 1% reduction in stenosis with diet alone, 1.9% with diet plus medication. • Outcomes: 70-90% fewer heart-related events in intervention groups. • Limitations: Small sample size, all male participants, and statistical insignificance in some results. 3. Scrip Trial (1994) • Participants: 118 participants, 80% male, with diet, exercise, and medical intervention. • Diet: 24% calories from fat, focus on weight loss and not smoking. • Results: Plaque progression slowed, but the average still showed plaque growth. • Outcomes: No significant difference in events over four years. • Limitations: Excluded participants with extensive plaque, multi-faceted intervention. 4. Predimed Trial (2013) • Participants: 103 participants (majority women) on a Mediterranean diet. • Diet: Mediterranean diet with either extra olive oil or nuts. • Results: Reduced arterial wall thickness in the group with extra nuts. • Outcomes: 31% fewer events with olive oil, 28% with nuts, no significant difference between the two. • Limitations: Small subset of participants had plaque measured, short follow-up. 5. CordioPrev Trial • Participants: Almost 400 participants, 80% male, diagnosed with heart disease. • Diet: Mediterranean diet high in unsaturated fats (olive oil, nuts, fatty fish). • Results: 13% reduction in artery wall thickness and maximum plaque height. • Outcomes: 28% reduction in events, 40% in high-adherence participants. • Limitations: High-risk participants, longest trial (seven years). 6. Disco Trial • Participants: 45 participants on a DASH diet. • Diet: Similar to Mediterranean with low sodium, high potassium focus. • Results: Shift from vulnerable soft plaque to more stable fibrous and calcified plaque. • Outcomes: No significant difference in overall plaque size. • Limitations: Short trial duration, small sample size, multi-pronged intervention. Commonalities Across Trials • Effective Foods: Fruits, vegetables, legumes, whole grains, some dairy. • Optional Foods: Healthy fats (nuts, olive oil), fish, eggs, and white meats. • Foods to Limit: Junk food, refined grains, sugary snacks, large amounts of butter, fatty meats, alcohol. Additional Recommendations • Exercise, stress management, smoking cessation, and medication were emphasized as crucial components for optimal heart health. • The speaker advises a comprehensive approach, combining dietary changes with lifestyle modifications for the best outcomes. Conclusion • The trials show a range of positive results from different diets, particularly low-fat and Mediterranean diets, although individual components cannot be isolated as the sole contributors. • The speaker encourages using the common themes from all trials and adopting a comprehensive lifestyle change for heart health improvement.