Atherosclerosis is a life-threatening condition, characterised by fat deposits on the inner walls of the arteries. This causes them to harden and narrow, subsequently restricting blood flow.


Atherosclerosis has no symptoms and can gradually get worse over the space of years, without the sufferer knowing, making it very dangerous.

If atherosclerosis is not identified early on, it can lead to a myriad of serious health issues, under the umbrella term of cardiovascular disease. Cardiovascular disease is comprised of:

  • Angina: feelings of heaviness or tightness in the chest, which can be very painful
  • Coronary heart disease: the build-up of fat in the arteries of the heart, and the leading cause of death in developed countries [51]
  • Heart attacks: a lack of oxygen-rich blood flowing to the heart due to a blockage. Causes intense pain and can result in death
  • Peripheral Arterial Disease (PAD): a build-up of fatty acids in the arteries, which restricts blood flow to the legs
  • Stroke: a lack of blood flow to the brain, resulting in brain cell death
  • Transient Ischaemic Attack (TIA): a lack of blood flow to the brain, which doesn’t result in brain cell death


The layer of cells that line the arteries, known as the endothelium, are quite vulnerable to damage due to their thin nature. This damage can occur from high blood pressure or from cigarette toxins. Once the endothelium is damaged, low-density lipoproteins (LDLs) start to amass at the site of the damage, carrying fat and cholesterol.

This causes atherosclerotic plaque to form at the site of damage, narrowing the arteries’ width and allowing less blood to flow through them. This is known as an atheroma, and is the start of a vicious cycle, because the plaque makes it harder for the heart to pump blood through the arteries, increasing blood pressure, and subsequently increasing the chance of further atherosclerosis.

Who’s at risk?

Most risk factors of atherosclerosis can be controlled, helping to slow the formation and even prevent atherosclerosis completely. Modifiable risk factors include:

  • Bad cholesterol levels: Low HDL and high LDL
  • Type 2 diabetes
  • High blood pressure: This is defined as 140/90 mmHg for an extended period of time
  • Smoking
  • Overweight or obesity
  • A lack of physical activity: this can exacerbate other risk factors
  • Excessive alcohol intake

Uncontrollable risk factors include: age (as you age, the risk of atherosclerosis increases), family history of atherosclerosis, and being of African, south Asian or African-Caribbean descent.


Heart-healthy lifestyle changes are not only an excellent prevention technique, but can also be used as a treatment to stop further damage and decrease the likelihood of other health-related issues.

One of the main goals of dietary treatment is to get HDL and LDL cholesterol levels within a healthy range. Many healthcare professionals will give you what now appears to be outdated information, by advising you to lower your fat consumption and raise your carbohydrate consumption in order to raise HDL and lower LDL.

Various studies have shown the damaging effects of high-carb, low-fat diets on HDL and LDL, making it an ineffective treatment model for atherosclerosis. [22]

It is now being increasingly advised to follow a lower carbohydrate, Mediterranean-style diet, ensuring that any carbs that are consumed come in the form of healthier, unrefined whole grains. Instead of lowering total fat intake, as advised by many healthcare professionals, focus on lowering your intake of saturated fat and trans fats, whilst increasing your intake of monounsaturated and polyunsaturated fats. [52] Fruits and vegetables should also be a staple in your diet, aiming for at least five portions of different fruit and veg per day[53]

What to eat and avoid

Although it is not set in stone, here is a general guide for low-carb, healthy-heart eating:

  • Meat: poultry, beef, pork and game meat (grass fed and organic are best)
  • Fish: salmon, mackerel, herring, cod and haddock (wild fish are best)
  • Organic eggs
  • Vegetables grown above ground: cucumber, broccoli, cabbage, asparagus, zucchini, eggplant, spinach, olives, mushrooms cauliflower, lettuce, avocado, Brussels sprouts, onions, peppers and tomatoes (organic is best)
  • Full-fat dairy: cheese, butter, cream and Greek yoghurt (drink milk in moderation, as it contains sugar)
  • Low-carb nuts: macadamia nuts, brazil nuts, pecans and walnuts (hazelnuts, almonds and peanuts in moderation)
  • Once per day: Fruit (as fruit contains sugar and too much can be detrimental)
  • Once per week: Grains and veg grown underground: pasta, bread, rice, potato, sweet potato, porridge, breakfast cereal and other treats such as raw dark chocolate (treat these as occasional indulgences

Avoid the following:

  • Sugar: sweets, chocolate, ice cream, soft drinks and fruit juice
  • Chips and crisps
  • Trans fats, vegetable oils and omega-6 fats: hydrogenated oils, sunflower, safflower, soybean, cottonseed and corn oils
  • Processed meats: bacon, salami, luncheon meat and sausages

Despite the many claims that low-carb diets are unhealthy as they actually raise cholesterol, this claim has been disproved in various studies lately. The confusion comes as low-carb diets have been shown to increase HDL (whose main function is actually to remove LDL from the arteries, decreasing the likelihood of atherosclerosis), whilst lowering LDL and triglycerides. [54]

Daily exercise is also advisable. Around 30 minutes per day, five days a week, will be sufficient. This can be in the form of walking, running, swimming, cycling, dancing or resistance training.

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