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The Diet-Heart Myth: How to Prevent and Reverse Heart Disease Naturally


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This is the final article in the Diet-Heart Myth series I’ve been writing over the past several weeks. If you missed the previous articles, you can find them compiled into an eBook on the Diet–Heart Myth.

Ben Franklin said, “An ounce of prevention is worth a pound of cure.” Heart disease is no exception. According to the INTERHEART study, which examined cardiovascular risk factors in 51 countries, 9 out of the 10 strongest risk factors for heart disease are modifiable by changes in diet and lifestyle. (1)

While taking action now does not guarantee that you’ll never get heart disease (as age is perhaps the strongest risk factor), it does vastly improve your chances of avoiding it or at least delaying it significantly. In this article, I’ll teach you how to do that in three simple steps:

  1. Eat a heart-healthy diet
  2. Live a heart-healthy lifestyle
  3. Boost your heart-healthy nutrients

3 simple steps to living a heart-healthy lifestyle that your doctor has never told you about.Tweet This

Eat a Heart-Healthy Diet

When most people hear the phrase “heart-healthy diet”, they think of egg-white omelettes, a salad with no dressing or similar low-fat, low-cholesterol fare. But if you’ve been reading this series, or my blog in general, you know better.

The “Paleo Template” approach I’ve written about here is an excellent starting place to improve your heart health. It includes all of the necessary micronutrients in their most bioavailable form, emphasizes an optimal balance of fats, eliminates highly processed and refined foods, and reduces other food toxins that interfere with nutrient absorption. On the other hand, the American Heart Association’s “heart-healthy” diet emphasizes nutrient-poor foods such as whole grains and vegetable oil, and unnecessarily restricts nutrient-dense foods like red meat, animal fat and cholesterol.

But which version of the “Paleo Template” is best for preventing heart disease? In this series we’ve been focusing on LDL particle number as one of the primary drivers of atherosclerosis. We also discussed the five main causes of elevated LDL-P, including insulin/leptin resistance, genetics, poor thyroid function, infections and leaky gut. If you have elevated LDL-P while on a Paleo diet, the key is to first discover what’s causing it and then tailor your diet accordingly. In this article, I’m going to focus on insulin/leptin resistance and genetics, since those are the two most common causes of elevated LDL-P that I see in my practice.

Insulin/leptin resistance

In this case, the best approach is often a low-carb Paleo diet. When I say low carb, I generally mean between 50–100 grams of carbohydrate per day in the form of fruit and starchy vegetables like sweet potatoes, potatoes, plantain, yuca and taro. I do not count non-starchy vegetables toward the carbohydrate intake, because I don’t believe they make a significant enough contribution to matter. The purpose of this approach is to improve insulin and leptin sensitivity and promote weight loss, which will in turn decrease LDL-P.


If you have high LDL-P, but normal triglycerides, HDL, small LDL-P and your lipoprotein insulin resistance (LP-IR) score on the NMR LipoProfile is normal, and you’ve ruled out thyroid problems, infections and leaky gut, than it’s very likely that you have one of the many genetic variants that can lead to increased LDL particle number. In this case, a low-carb Paleo diet will often increase—rather than decrease—LDL-P. In my practice I will often recommend what I call a “Mediterranean Paleo diet” in these cases. This means following the basic Paleo approach, but reducing intake of fat and increasing intake of fruit and starchy vegetables. You can still eat fat as it naturally occurs in food, but try not adding as much additional fat to meals, and using more monounsaturated fat than saturated fat. In many cases this will decrease LDL-P quite significantly.

The trickiest situation is when someone has both insulin and leptin resistance and a genetic issue. A low-carb diet will usually drive up LDL-P in that situation, but it will improve many other markers that are also risk factors for heart disease, including triglycerides, HDL, fasting insulin, fasting glucose, etc. So I will usually recommend a low-carb diet for these patients, and if their LDL-P goes up, try to use natural therapies to bring it down.

Live a Heart-Healthy Lifestyle

Physical activity

Exercise has been shown to reduce LDL particle concentration even independently of diet. (1) Regular exercise prevents the development and progression of atherosclerosis, improves lipids, and reduces vascular symptoms in patients that already have heart disease. The benefits of exercise are related to maintenance of body weight or weight loss, blood pressure control, return of insulin sensitivity, and beneficial changes in lipids, all of which in turn promote endothelial stabilization and vascular health.

In addition to distinct periods of exercise, it’s also important to sit less and stand and walk more. In fact, some research suggests that this “non-exercise” physical activity may have a greater impact on our cardiovascular health than exercise. Dan’s Plan has some fantastic recommendations for physical activity, as well as a great software and hardware-based tracking system.


I have come to believe that chronic sleep deprivation is one of the most pernicious—yet under-recognized—contributors to the modern disease epidemic. Sleep deprivation has been associated with weight gain, insulin resistance, increased appetite and caloric intake, overconsumption of highly palatable and rewarding food, decreased energy expenditure and a reduced likelihood of sticking with healthy lifestyle behaviors. Sleep duration and quality are inversely associated with blood pressure in epidemiological studies, and high blood pressure is one of the strongest independent risk factors for cardiovascular disease (CVD). (2) Finally, the Nurses Health Study found that those who reported fewer than 5 hours of sleep at night had a 38% greater risk of coronary heart disease (CHD) than those reporting 8 hours of sleep. (3)

For tips on how to improve your sleep, see my article “Sleep More Deeply“.

Stress management

Stress increases the risk of cardiovascular disease in numerous ways. It increases intestinal permeability, impairs blood sugar control, depresses immunity (which increases the risk of infection), contributes to fat storage in the liver, and promotes consumption of comfort and junk foods. But perhaps the most significant contribution stress makes to CVD is that it promotes inflammation. Stress has been shown to increase circulating inflammatory markers like C-reactive protein (CRP) and interleukin-6 (IL-6), both of which are associated with heart disease (4). On the other hand, stress management can have a profound impact on heart disease risk. One recent randomized trial showed that regular meditation decreased the risk of death from heart attack, stroke and all causes by 48%—a much greater reduction than what is observed with statins even in the highest risk population. (5)

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Boost Your Heart-Healthy Nutrients

In addition to the basic heart-healthy versions of the Paleo template I mentioned above, there are several specific foods/nutrients that have been shown to improve cardiovascular health.

Cold-water, fatty fish

Cold-water, fatty fish are an excellent source of EPA and DHA, long-chain omega-3 fats with several cardiovascular benefits. An analysis of randomized trials since 2003 suggests that regular fish consumption or consumption of fish oil would reduce total mortality or deaths from all cause by 17%. (6) This is remarkable when you consider the fact that statin drugs only reduce total mortality by 15%, and even then, only in certain populations.

Monounsaturated fat

Monounsaturated fats have been shown to reduce LDL and triglycerides and increase HDL. They also decrease oxidized LDL, reduce oxidation and inflammation in general, lower blood pressure, decrease thrombosis, and they may reduce the incidence of heart disease. (7) The best sources of monounsaturated fat are olives, olive oil, macadamia nuts, and avocados.

Antioxidant-rich foods

Antioxidant-rich foods protect against heart disease in a number of important ways. Our antioxidant defense system is what protects us from oxidative damage, which as you now know is a major risk factor for heart disease. Strengthening this system has two sides: reducing our exposure to oxidative stress and increasing our intake of antioxidant-rich foods. When most people think of antioxidants, they think of fruits and vegetables like dark, leafy greens and fruits like berries. But while it’s true that these foods are rich in antioxidants, what a lot of people don’t know is that red meat and organ meats are also very rich in important antioxidants that aren’t found in significant amounts in plant foods, like CoQ10 and retinol, which is preformed vitamin A. A good rule of thumb is to eat the rainbow, choosing a variety of colors of fruits and vegetables, as well as organ meats, meats, eggs, and grass-fed dairy.

Polyphenol-rich foods

Polyphenols are a diverse class of molecules made by plants, certain fungi, and a few animals. They serve a lot of purposes including defense against predators and infections, defense against sunlight damage, chemical oxidation, and coloration. The color, in fact, of many fruits and vegetables like blueberries, eggplants, red potatoes, and apples comes from polyphenols. Some of the best studied polyphenol-rich foods are tea, especially green tea; blueberries; extra-virgin olive oil; red wine; citrus fruits; hibiscus tea; dark chocolate; coffee; turmeric; and other herbs and spices. Polyphenol-rich foods have been shown to have a number of beneficial health effects. For example, dark chocolate has been shown to lower blood pressure and LDL cholesterol and improve insulin sensitivity, red wine has been shown to prevent the increase in oxidized fats that occur after consuming a meal high in oxidized and potentially oxidizable fats, several studies have shown that hibiscus tea lowers blood pressure in people with hypertension, and blueberries have been shown to lower blood pressure and oxidized LDL in men and women with metabolic syndrome. (8)

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Some studies have shown that nut consumption may reduce the risk of cardiovascular disease. In a recent analysis of NHANES data from 1999 to 2004, investigators found that nut consumption was associated with a decrease in a wide range of cardiovascular disease risk markers, including body mass index, waist circumference, and systolic blood pressure, compared to non-consumers of nuts. (9) This is observational data so we can’t be sure that it was the nuts, rather than some other factor that wasn’t adequately controlled for, that led to the improvements. That said, a review of five large prospective studies (including NHANES) as well as clinical trials examining the effects of nut consumption on lipid parameters found similar results. (10) I favor macadamia nuts, almonds and hazelnuts because they are lower in omega-6 linoleic acid, which research suggests may contribute to CVD when consumed in excess.

Soluble fiber

In the NHANES study, subjects followed for more than 19 years with the highest quartile of dietary soluble fiber intake had a 15% lower risk of heart disease and had a 10% lower risk of cardiovascular events. (11) Soluble fiber binds bile acids or cholesterol; upregulates LDL receptors in the liver; increases clearance of LDL; inhibits fatty acid synthesis by producing short-chain fatty acids like acetate, butyrate, and propionate; improves insulin sensitivity; and increases satiety with lower overall energy intake. (12)


I hope you’ve enjoyed the Diet-Heart Myth series, and that the information I’ve presented will help protect you and those you love against heart disease. I’ve done my best to cover the most important steps you can take, both in terms of diagnosis and treatment. 

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Join the conversation

  1. The article is a dis-service to the public related to reversing heart disease. I doubt the Paleo diet has one case that they can prove reversed heart disease where as doctors like Pritikin, Ornish, Esselstyn and others have proof that they can do it.
    They all limit animal protein and those that promote additional fats include nuts, seeds and avocado while getting over 80% of calories from whole plant-based consumption. They all limit or avoid dairy. After studying the diets of the five Blue Zones including Okinawa I believe they have it right.

    • Awful article with pseudo-bro-science. Disregard the majority of what you read in this paleo pablum.

    • Seems to me that Caldwell Esselstyn MD’s studies were anything but scientific and certainly not controlled.

      • Doctors like Esselstyn and Ornish choose not to have controls because to make someone a control is to condemn them to die. They prefer to put all patients on a plant-based diet. The number of patients they’ve treated successfully should not warrant a control. It’s not possible that it’s statistically insignificant.

        • There were so many variables that there is no way a cause never mind specific association could be drawn. The are plant based advocates so made the data fit their bias by saying saturated fat or anything else that went against a plant based diet was to blame for increased mortality rates. Doctors should not try to be scientists because most have no idea on how to conduct trials or look at date.

  2. I cannot have animal protein anymore. Causes inflamation for me. No eggs, no dairy, no sugar.
    I drink teas with honey.
    No oils except olive.
    No pasta. It Increases insulin. I can eat real bread with no preservatives. Potatoes bother me at times. What doesnt bother me is: nuts, fish, vegetables, and fruit.
    If I eat like this a lobg time then occasionaly introduced a dairy product or meat. I cant get by but I prefer to feel good all the time and not sacrifice my health for a temporary enjoyment of some food item.

  3. Does anyone know of any low carb/paleo studies that have been undertaken in patients with existing coronary artery disease or congestive heart failure (CHF)?

    • No, this article is terrible. All the doctors who have reversed heart disease promote low fat diets. Not high fat. I hope people with heart disease won’t get tricked by this…

      • They are wrong. Loads of problems come from low fat diets. If you don’t want to do your research, read The Big Fat Surprise. It’s heavily researched and annotated, so you can look up every bit of research yourself. Fat is necessary and beneficial. What matters is the quality.

  4. I was 250 pounds and had a lot of health problems while eating a high protein diet just like the one Chris describes. I counted calories, but continued to gain weight. I had extreme lethargy. After trying a plant-based diet, my weight plummeted, my energy went up, all my health problems disappeared.

    I follow a diet similar to Dr. Esselstyn whom Chris Kessler appears to be trying to mimic but without the street cred.

    I used to have trouble going up stairs, now I skin or hike up 2,000 feet of mountain starting at 8,000 feet almost everyday. All because I found the power of plants.

    • Your comment confuses me since I see almost no relationship between this article and what Dr Esselstyn has proven to be successful in reversing heart disease.
      I question that it is necessary to be as strict on fat from nuts/seeds and avocado as Dr Esselstyn used in his study so I follow Dr Fuhrman who also recommends focusing on vegetables, fruits and grains but allows some nuts/seeds, avocado and small amount of animal protein.
      Given that Esselstyn and Fuhrman have evidence of their methods I would recommend one of those two and not this article.

  5. What a load of bunk and junk. VERY BAD ADVICE for people with heart disease. VERY GOOD ADVICE for people who want heart disease.

    • I have no idea what your comment is referring to, the article or a particular comment, Smith…

      I like the comment by Sanders, although I think a big reduction in animal protein consumption is adequate as Dr Ornish suggest and not a total avoidance.

      However, what leaves me guessing is nut/seed consumption. It appears to me that the doctors that actually have experience reversing heart disease such as Drs Esselstyn and Ornish recommend very low fat diets and there is no room to have nuts/seeds or avocado. However, there are studies indicating that people consuming nuts/seeds have less heart disease…. Reason I am still guessing is that disease reversal is different than healthy people avoiding heart disease.

      Can anyone provide a cite on a study concerning heart disease reversal while consuming nuts/seeds? Sorry, I am not interested in opinions…

  6. Chris,
    At the top of page 19 in your excellent “Diet-Heart Myth” eBook you say, “normal triglycerides, HDL, small LDL-P.” I bet this is a typo, and you probably meant to say “small LDL-C.”

  7. Don’t eat fish – they are full of toxins and it harms the oceans due to the overfishing. I study nutrition at Rochester Institute of Technology, have been 100% plant based for almost 3 years and my cholesterol is 150 – no drugs. As an animal eater I went through early menopause and my cholesterol began to sky rocket. I changed my diet because of the harm eating eggs, drinking milk, and eating flesh does to these animals but I took classes at RIT to find out how to do it in a healthy way and I found out that simply leaving all animals and their products off my plate was all I needed to do. Just replace those calories with more of the pasta, grains, fruits and vegetables I was already eating. Voila – I am 100% healthy and I’m living by my values: don’t want to harm others or the environment, live a life of peace not just for myself but for the world.

    • While I appreciate your opinion and your right not to consume fish I will be continuing till there are non remaining without gross amounts of toxins. At this time I do not see anything unhealthy about consuming wild salmon or sardines….of course without added oil, salt or chemicals.

      No doubt the world will run out of fish in the sea not too long in the future. Enjoy while you can because you can be sure many nations are not going to reduce their fishing. Farm fish are not acceptable to me as currently produced but that could change…

      • Here in Alaska we have perfected salmon sustainability. The secret to our success lies in two basic principles: Responsible fisheries management and sustainable fishing practices take care not to harm the fish, other marine plants and animals, nor the environment. … In this way, Alaska promises to provide wild-caught for generations to come. Our salmon spawning waters are sacred, and treated as such. For the vegans keyboard warriors: my comment is directed at Richard and his concern for depleted oceans. I am not commenting on the ethical dilemma of eating nonhuman animals, because I deeply understand the problem. I was vegan from 9 to 55 yrs old, at which time, I added only salmon to my diet because quite frankly, after menopause I desperately craved protein which a truck load of tofu, beans, lentils could not satisfy. I feel so much healthier. The idea of eating loads of whole grains sickens me. My body doesn’t want grains.

    • Tried plant based diet and felt terrible. My triglycerides went up along with LDL and HDL dropped. Eating brown rice and beans and whole wheat pasta raised my blood sugar. Recently started low carb and sugar restricted diet triglycerides dropped from 268 to 131, LDL dropped to 130 without statins or other meds. HDL dropped to 29 on plant based diet and since changing to low carb rebounded to 56. Sugar under much better control. I eat lots of greens, seeds, nuts, fish, pasture raised meats, eggs and butter. When my sugar spikes I eat raw unpasteurized sheep cheese Roquefort from France and my sugar drops like a rock. recent studies support eating health fat to increase APO B particle size and reduce inflammation. Its thought that Roquefort cheese is the secret to the French longevity as blue veins in this cheese kill bacteria pneumonia chlamyedia which is believed to play a role in the development of arterial plaque.

  8. I’m late to the conversation but would love some advice! My husband and I follow the paleo diet. We just had a female friend who suffered a major heart attack. 2 complete blockages. Heart stopped multiple times. She’s back home and recovering. My question is– is there a paleo book that specifically addresses heart disease that I could offer her?

    • Please don’t do paleo when you have heart disease! Try Dr Esselstyn’s heart disease reversal program instead. He has many testimonials and it actually works.


    Chris, I am pretty confused about the conflicting advice on lowering LDL-P. I am currently reading “Your Personal Paleo Code” and stopped the 30-Day Reset in it’s tracks when I read your statement: “If you have high LDL-P, but normal triglycerides, HDL, …, than it’s very likely that you have one of the many genetic variants that can lead to increased LDL particle number. In this case, a low-carb Paleo diet will often increase—rather than decrease—LDL-P.” What is this based on?

    My LDL-P is 1733 nmol/L !! Total Chol is 202; LDL-C Direct = 127, HDL-C = 63, TG’s=104. My father has CAD. I took Lipitor for 40 days and developed severe, debilitating muscle pain in my wrists, forearms and biceps. After 2 weeks off it I can start to pick up my 6 mo. old son again. I’m desperate to lower my LDL-P but terrified of going back on statins.

    So many health professionals and other sources, including your book keep telling me to drastically reduce my CHO consumption and go full Paleo.

    I am an amateur road bike racer and think this lifestyle has allowed me to keep my other numbers low but a high CHO diet had always been a prevalent in my lifestyle. Please help?

  10. So…

    I’m currently in school for holistic nutrition. I love everything I’ve learned, and I’m always looking for more. But sometimes I feel like I just don’t know who to trust, as I know we all do. A major thing I’ve made a point in recognizing is who pays for the studies done, and how that would affect the outcome. While the meta-analysis is obviously an in depth study, and I know more and more information is arising, I can’t help but question it’s integrity based off the fact that the National Dairy Council sponsored it. I believe that fat is great. I know for a fact low-fat foods, vegetable oils, and all the like is crap. It’s just that….it’s hard to truly, really, whole-heartedly be confident in information, especially when it’s a matter of the quality and longevity of someone’s life that I make recommendations for. What do you think about the NDC sponsoring this study?

  11. Wow, Just ran into this website looking for evidence of antiaging with the rice diet. I know high carb works, because all of my life I have been told of the glories of high protirn, which hurt me as an athlete when I was younger, since mom firmly believed in high protein . Now that I am older,52.was on a high fat raw vegan, felt awful..fid paleo and primal..same thing. Actually all the fat was clogging my arteries and making things much worse. Been LOW FAT vegan for a year..huge difference. Can chug up mountainsides that most 20 somethings can’t take, never pout of breath and my brain is so clear…wish I knew about it in my 20s..In short, you are lying to people..

    • Erika, I agree 100% ! I’ve been on a similar regimen suggested by Esselstyn and Campbell’s work (which I find lacking here, with a prevalence of conjecture). And, I do find the authors name linked to several “buy me” sites, indicating not only a lack of information by the author, but a vested financial interest. Quack. Quack !

      • Erica and Bill, you are so right. I had been on a low fat primarily plant based diet for the best part of 30 years. It had served me well and I knew nothing but good health and vitality during this time. I took up bodybuilding, and was persuaded to add significant amounts of animal protein to my diet. 1g per lb of bodyweight they told me. OMG, after almost 2 years of this I had developed gout, felt terribly lethargic, in fact I felt absolutely awful. Then I discovered the works of Doctors Caldwell, McDougall, Barnard, and the rest of the wonderful PCRM doctors. I dropped all animal products and processed oils. Within days the gout had eased and I have since proceeded to get my life and health back on track. The change in my health and outlook is nothing short of miraculous

        • I do not think your gout is related to the amount of meat you consume but you need to check what purines you are consuming and maybe add cherries to your daily diet to lower your uric acid.

          However, less animal protein will likely help your arteries and heart.

          • Oh, I can vouch for increased meat intake bringing on gout attacks. I eat very little meat. If I want to bring on an attack all I have to do is increase my meat intake and it doesn’t even have to be excessive, I’ve been through this enough to know my gout trigger. Eggs and dairy are exceptions. Eggs actually are neutral foods and dairy has been shown to lower uric acid. I also use Black Cherry Extract.

      • This is the diet I am on, I cannot call it a diet but rather a way of life now! I feel great, cheers to Dr. Esselstyn and Dr Campbell. It has been life changing..

        • There are many that have almost the same diets, the primary focus on whole plant-based products and limiting animal products…Just like in the five Blue Zones containing an extra ordinary high number of people long-lived and over 100.
          I like to see more evidence that Dr Joel Furhman can reverse heart disease because his diet is the most flexible in my opinion and allows nuts/seeds and avocado. He is not a proponent of low-fat like Ornish and Esselstyn.
          No long-living cultures has totally eliminated animal products and kept fat at 5-10% of calories.
          Of course, with their diets they did not build heart disease so had no reason to reverse it.
          More studies are needed, anyone denying that knows little about nutrition.

  12. Hi Chris,

    Thank you so much for writing this article. I too just received my results and everything else seemed fine, except for the LDL-P. That was high. I also would like to thank Winslow Strong for bringing in the APOE4 allele into the conversation in conjunction with your findings/causes section in regards to how genetics can play a role in this predicament. Brain vs Heart!

    I was cooking with lard, using more butter for my brain (from the Grain Brain book) and taking in extra coconut oil like many others have been doing (for 3 yrs). I’m grateful that you brought this important information to our attention, as I too will have to adjust to less saturated fats. I’m guessing that it’s ok to still cook with coconut oil, but not to take the extra tablespoon that has been recommended by many. I printed out this article for my functional doctor as well. I hope this isn’t your last article on the subject, Chris. It seems that there are more of us out there that could use some advice. We a grateful for your work and research.


  13. I was just diagnosed with 60% artery blockage in one artery. Have started a drastic nutrition change. It is a tough start.

    • Ive just beem told i have a 30% blockage and i am only 36 yrs old

      How can I unblock my artery. Ive started taking fish oil, magnesium, VC and eating heaps of veggies and zero trans and sata fats. 1 hr per day exercise as well.

      Any advice will be welcome as I will do anything to reverse it…

      • There is only one diet that has been clinically shown to reverse atherosclerosis – a low fat vegan diet. Sounds drastic? How does progressing heart disease sound? Eating saturated fat like the people in this forum propose will do nothing but worsen the problem. Look at what Drs. Esselstyn and Ornish have accomplished with their dietary recommendations. I would also start drinking pomegranate juice. I drink a cup a day. Get exercise every day. A daily brisk walk is ideal.

        • I do not know where you get your information but Ornish and Esselstyn with low-fat diets are not the only doctors to reverse heart disease.

          Dr Joel Furhman recently and Pritikan decades ago have reversed heart disease with a less strict diet but 90% of calories being whole plant-based while allowing 15-30% fat calories but only 5% of calories from animal products.

          I am not trying to indicate that the final science on this is complete. I certainly think much more research is needed but it appears there may be more flexibility than only 5% fat calories…

          • Richard,

            Maybe I wasn’t clear. I was referring to *published* studies. Did Fuhrman or Pritikin publish their findings? Furhman may allow small amounts of lean animal foods but his ideal diet, the one he advertises and personally follows himself is a vegan diet. Even Ornish allows skim milk and egg whites in limited quantities but that’s about it as far as animal foods are concerned. He too recommends a VLF vegan diet. Esselstyn is stricter as his reversal diet is a VLF vegan diet.

          • Please provide the source(s) that show Pritikin and Fuhrman have reversed heart disease. I’d be interested in having a look at it.

          • If I provide the sources for Fuhrman and Pritikan reversing heart disease would I have to read it to you guys?

            BTW, Pritikan had heart disease and when he died (suicide) his arteries were clear and free of heart disease.

            • Yeah, it was that darned leukemia that got him in the end. Atkins’ arteries, not so clean.

              I’ll read your sources for myself. Not really interested in someone else’s interpretation.

            • Dr. Fuhrman lives in my area – I have seen phenomenal turn-arounds of all kinds of diseases, including heart disease among people in our area who go to him as patients.

              One sample publication is:
              Fuhrman J, Singer M. Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. American Journal of Lifestyle Medicine. 1559827615611024. October 15, 2015 doi:10.1177/1559827615611024.

              Hope this helps

  14. Thanks for writing this series. Heart Disease, Obesity, Diabetes… these are all things that can be avoided with the right diet, exercise, and smart supplementation as insurance against imperfect eating. We need more education, actually more wisdom when it comes to nutrition and health. It’s heartening to see the FDA’s recent ban on trans-fats.

  15. So glad to have found your website Chris.

    I had been on a very high carb diet and had low HDL and high triglycerides. TC was 185, so decided to try the Paleo diet. Right away my HDL soared to 67 within 2 months which was great. I always had a high carb, low fat diet and was always puzzled why everything was normal except my HDL which was under 40.

    Now a year after being Paleo, my results are not so good. TC was 240, LDL-156, HDL-57. But what was concerning was that my small diameter LDL was 56 and over 40 was high risk. The very thing Paleo is supposed to reverse? So maybe I went to much to the other side and getting an NMR profile done for baseline peuposes. Now Im going to try the Mediterranean version of the Paleo diet as for some reason my body is not liking the strict Paleo, Strangely I wasn’t really ingesting that much more saturated fat and most of it is already coming from olive oil and avocado.

    Will test again in 3 months.

    • I have been where you are Rory. After about 8 months on Paleo, my cholesterol went up to 14.2 mmol/L. LDL 12.14 , HDL 1.70, Trigs 0.8 mmol/L (as a vegetarian 10 years ago TC was quite high with over all Cholesterol of 6+ ,but HDL was high and protective, but I felt like shit as a vegetarian).
      It seems I need the carbs because my thyroid TSH was higher at 4.24 miu/L. Maybe hypothyroid is going on here for me, and I am slim at almost 10 stone so the doctor does not recognise a problem.
      I am trying the Ray Peat way this last little while and am hoping to get my numbers re-tested soon, and hope they are better.

    • Seriously? Are you actually surprised that eating more animal fat and protein was going to do anything but adversely affect your cholesterol? I hope you’ve learned your lesson.

  16. Looking at all these LP-IR scores – mine is 44. I’m at the 50th percentile in the reference population. I have a father on dialysis and an older brother who is diabetic. I’m seeing single digit numbers and mine is in the double digits. Is mine bad? I know my pancreas are a bit dysfunctional – I honestly believe that my pancreas just can’t produce enough insulin to handle the healthiest version of the SAD (out of 11 established genetic markers for T2D I have 6 increased and 5 decreased and the increased risk markers seem to center around the amount of insulin my body can produce and my beta cell health). I have a nasty Reactive Hypoglycemia response but I don’t have Metabolic Syndrome. I know I have the potential to become diabetic because I monitor my blood sugars and have seen some crazy numbers and fluctuations. This worries me a bit.

  17. This is a great article about heart health. But I would have liked to see some mention of oral health. There have been hundreds of studies done linking oral health and heart disease. If you improve your oral health, your outlook for heart disease is much better. A product such as the Beam Brush can improve your oral health literally before your eyes. The Beam Brush is a data collecting manual toothbrush with an Android/iPhone app to help engage, inform, and reward great oral health. Find out more at http://beamtoothbrush.com/

  18. Chris,

    Do you have specific recommendations about the type of meat people should be eating? obviously, nothing processed…What are your feelings about the studies indicating that those who eat red meat have a several fold increase in CVD risk over those who eat red meat sparingly or not at all–based on some supposed pro-inflammatory effect specific to red meat? There is so much contradictory information out there, hard to know what to believe.

  19. I have been on a low carb diet for 3 years now and on Paleo for about 6 months now. I got my VAP test results today and all of my numbers look good except for LP(a) which is 14 mg/dL and my doctor suggested taking niacin. However, everything I’ve been reading says that taking vitamin C, L-lysine, and L-proline will reduce LP(a). It doesn’t appear that there is any way to change LP(a) naturally. So what is the answer?

    My VAP Cholesterol Test results:
    Directly Measured LIPID

    Total LDL- C Direct – 90
    Total HDL – C Direct – 48
    Total VLDL-C Direct – 16
    Sum Total Cholesterol – 154
    Triglycerides – Direct – 60
    Total Non-HDL-C (LDL+VLDL) – 106
    Total APOB100 CALC – 74

    For Clinical Judgment in Setting LDL C Goal
    LP9(a) Cholesterol – 14
    ILD-C – 7
    Real-LDL-C – 69
    Sum Total LDL-C – 90
    Real – LDL Size Pattern – A

    Remnant LIPO (IDL + VLDL3) – 16

    Consider Insulin Resist/Metabolic Syndrome – No

    Sub Class Information
    HDL – 2 (Large, Buoyant) – 13
    HDL-3 (Small, Dense) – 35
    VLDL-3 (Remnant LIPO) – 9

    • It seems there is no definitive answer for the high LP(a). Some say that anything less than 30 mg\dL is okay while others say 20 mg\dL and my test says less than 10 mg\dL. The more I read about this the more confused I become. Since I have pattern A LDL, I’ve decided to do nothing about my LP(a). I think the treatment to bring down LP(a) is more risky that just leaving it alone, especially if you have pattern A LDL. I suppose I could be wrong about this but there is really no one for me to turn to for answers.

  20. Finally! Thank you, Chris – you have directly and concisely answered the question I have had for a year. Count me in as yet another Paleo eater who had LDL soar after transitioning to lacto-Paleo. I have high TC, high LDL, and high ApoB (which means high LDL-P), but all my other numbers and markers are excellent. In fact, you are describing me perfectly in the “Genetics” paragraph. Now to figure out how to transition to Mediterranean Paleo – I already eat a fair amount of fruit and starch, and mainly have to reduce dairy fat. Sigh.