Atherosclerosis Basics – Part 2 – Preventing and Reversing

Atherosclerosis Is a Preventable Disease – Preventable Without Drugs

Atherosclerosis is the buildup of rancid (glycated and lipoxidated) material behind the wall of the artery. It is a natural process, but the body has another natural process to undo this and keep the arteries clean. The buildup is primarily due to diet, but the prevention is primarily due to exercise. Both need attention to be optimized.atherosclerosis-cause-plaque

If you have high blood pressure, it probably means atherosclerosis, though there can be other causes. If you do not have high blood pressure, you are not home free. There can often still be a significant atherosclerotic load present even in people with a normal blood pressure.

Quantitative Medicine can help you reverse and prevent heart disease. This posts explains the steps. The first post dealt with the cause: Atherosclerosis Basics Part 1 – Cause

Preventing and Reversing Atherosclerosis

Simply put, ameliorating the cause and augmenting the repair will reverse atherosclerosis. We need to do both. One involves mainly diet and the other mainly exercise.  By diet, we mean eating the right sort of food, not ‘dieting’. The exercise must be of the ‘right’ type as well. However a high chronic stress level will also accelerate atherosclerosis. Poor sleep patterns are an expression of stress and bad habits and is also linked to atherosclerosis. Keep in mind that stress directly limits the benefits of both the dietary and exercise effects.

Let’s start with the cause. We have all heard of LDL, the so-called bad cholesterol. But, when is LDL cholesterol actually dangerous? A high concentration of very small LDL particles is a high-risk condition for plaque build up. This is called Pattern “B”. On the other hand your LDL might consist of larger particles, particle too big to get behind the artery wall in the first place. This is called Pattern “A” and is obviously very desirable.

But what determines particle size and these Patterns “A” and “B”? There is some genetic good luck possible here. Some people, perhaps 30%, have the larger size particles and are at low risk for heart disease. However, you can control your particle size. You can go from “B” to “A”. Smoking will decrease the particle size. This is one of the reasons smoking causes heart problems. Transfat also decreases particle size. Finally, a high triglyceride level is a cause for small particles too, probably the most important cause. This can be ameliorated with diet, and heart disease risk reduced 60%. This is a lot of reduction for just by eating properly.

The pertinent LDL size and pattern details can be directly measured. An expanded lipid profile blood test will determine the percentage of small particles, the diameter of the most commonly observed size, and several other attributes of LDL and HDL. Triglycerides are easily measured (and mastered) as well.

Triglycerides are the Dietary Key

Triglycerides are fat. Cells run on them. Some get into our body more or less directly from the food we eat. The liver produces a lot as well. Actually triglycerides aren’t soluble in blood, so they need to be packaged in particles that are. The ones from our last meal are called chylomicrons, and are packaged by our intestines and sent into the blood stream in the neck via the thoracic duct.(Hello, brain and hypothalamus!) Chylomicrons have only small amounts of cholesterol and are usually consumed by hungry cells within a couple of hours.

The liver makes and packages triglycerides into VLDL particles. Viewed from the outside, these are very similar to chylomicrons, but VLDL, however, has a center composed of cholesterol.

If triglycerides are high, the liver makes larger VLDL particles, and crucially, makes more of them. What is crucial about a greater number of particles is this: The amount of cholesterol the liver is going to put into circulation stays about the same, so if it makes more VLDL particles, each one is going to get a smaller ration of cholesterol. Later on, when most of the triglycerides have been picked off, the result is a much smaller LDL particle – Pattern “B” sized – just what we do not want.

This is the key:

  • High triglycerides=small LDL particle size=disease progression.
  • Low triglycerides=large LDL particle size=disease reversal

The Triglyceride Paradox

Since triglycerides are fat, you would naturally assume that eating a lot of fat would increase triglycerides. Strangely, this isn’t at all how it works. It is carbs, especially sugar and starch, that cause high triglycerides. This is because sugar and starch cause insulin to rise, and when insulin rises, triglycerides aren’t stored or burnt, so they circulate and build up in the blood.

Oddly, this ‘high carbs causes high triglycerides’ thing has been known since the 50’s, and further, that high triglycerides cause heart disease has been known almost as long. Makes you wonder how the high carb diet fad of the last quarter of the last century ever met medical muster. It’s done enormous harm.

Eating a high fat diet doesn’t increase triglycerides. If triglycerides were high from a high carb diet, they will usually drop, and drop fairly quickly. You will likely lose weight as well. If this carb-fat-store-burn is confusing, you might want to take a look at The Unified Theory of Fat.

Adult onset diabetics can have fasting triglycerides levels of 500 or more. Over 150 is considered high by most doctors. Actually you should shoot for something under 100, preferably closer to 50.  To get there, cut out sugar, cut out starch, cut out alcohol. Getting triglycerides below 100 usually will increase the size of the LDL particles, and thus reduce the amount getting behind the artery wall.Triglycerides

If triglycerides are low enough, LDL particle size will become Pattern “A”. But how low is low enough? This varies from person to person. Usually below 100 will do it, but some people need to get their triglycerides significantly lower. The only way to find the triglyceride ‘tipping point’ is to measure, modify, and measure again.  Almost anyone can get to life saving Pattern “A”.


HDLThe other side of the equation is HDL We need to maximize the HDL cleanup.

If there is no dietary overload, HDL is more than capable of keeping the arteries clean. To be effective, HDL must be active, and this requires that the person be active. The movement of exercise, pounding of the heart, and stretching of the arteries lets the HDL particles migrate into the areas where they are needed.


Intensity is the Exercise Key

The type of exercise is important. It should embody these attributes:

  • It should be intense, rapidly raising the pulse rate to its (safe) maximum.
  • It should be explosive, a sudden burst of activity.
  • It should be concentric, meaning the muscle should be shortening.

In sedentary people, HDL isn’t doing much. A typical HDL level for someone that does not exercise might be 30, but by far the more important issue is how much of that HDL is working, gathering up the junk. This can be measured. The measurement is called HDL2b and represents the percentage of the HDL that is returning to the liver loaded with junk. (Full disclosure here: there are several ways to measure the activated component of HDL. We are using, as a reference, the classification well described by Dr. Superko and first widely available from the old Berkeley Heart Laboratory.)

For a sedentary person, this might be 15%. Not a lot. A person doing the right concentric and explosive exercises will probably have a percentage above 35%. Plus HDL will probably go up 30-50% as well. This represents a large increase in garbage collection. Our exerciser’s HDL system is unloading a whopping 3.5 times more bodily junk than the sedentary individual. The benefit of this is hard to overstate. The short answer is a 50% reduction in heart disease risk, 35% reduction in cancer risk from exercise alone. (Warning: do not make the simple logical leap that sedentary people don’t need as much ‘clean up’ as active people and thus have lower HDL numbers. The statistics prove this leap a fatal one.)


If you get triglycerides down, don’t have many of the very small LDL particles, and get your HDL2b up, any heart disease you have will begin to reverse. It’s largely that simple. You have altered the tipping point of this disease. The immune system, including its HDL helpers, is more than adequate to control atherosclerosis. Any deposited calcium- one marker of atherosclerosis- will likely persist a long time, but this in its self is not harmful.

Step one is to reduce triglycerides, so as to boost the LDL particle size and prevent migration behind the artery walls. Even though they are fat molecules, high triglyceride levels are almost always the result of excess carbohydrates, i.e. excess glucose. This seems paradoxical, but, as explained above, is a result of the insulin boost from the excess glucose.

If a person can reduce his glucose to below 100, ideally to 80, and get his insulin below 10, triglycerides will fall, typically to below 100. Various guidelines call below 150 low risk, this is simply not true for most people and will result in a continued ‘B pattern’ until the triglycerides are lower. Measurements must be made to establish your personal target level, with lifestyle modifications and re-measurements on a regular basis until you know a stable relationship between behavior, triglyceride levels and your LDL pattern. People vary considerably but once you have achieved a stable “A” LDL particle profile, half the battle is won.

A person may have to almost completely give up carbs, or at least starches and sugars. This can be difficult, but it is not at all dangerous. For many, the transition is easy. For others, there will be a craving for carbs that lasts from 2-4 months. This is roughly the amount of time it takes cells to switch from a glucose diet and ‘re-program’ themselves to run on

The other side of the cure is to boost the HDL garbage collection activity. This one is more exercise driven. Two intense 45 minute sessions a week will probably do it.

Fix these two and atherosclerosis will reverse in most cases. If these numbers have been maintained throughout ones life, heart disease is never going to develop at all. This is the case with almost all hunter-gatherers.

  26 comments for “Atherosclerosis Basics – Part 2 – Preventing and Reversing

  1. Helene
    March 4, 2015 at 7:02 am

    Thank you for very valuable post. I need to take time out to think how to be fair and square, when writing my comments. There is a reason for me to write, but fairness and moderation is a ‘must’, because of my respect to the author of this post.
    So, I have to convert into a female monk for a time being. Sorry. I will be back.

    • Christian Olufsen
      April 21, 2016 at 8:33 am

      I wished instead of going through all this HDL and other stuff. Why not make it simple and tell what food is good and the others ones to stay from? I am interest in cure . ok.

      • April 22, 2016 at 8:54 am

        Hi Christian,
        We don’t make it simple because it is not simple. The idea that diet, even ‘the perfect diet,’ is all that one need pay attention to is wrong. I am sorry to say it is wrong. Proper exercise, an effective spiritual discipline leading to sleep and a quiet mind are also essential components of heart health. And cancer resistance. And repair of osteoporosis. And avoidance of dementia. And so on… The work is daunting but possible to do. Our book “Quantitative Medicine” addresses all of the components in great detail. Scattered in the articles on this blog site are discussions of many of the details and that is free to anyone with an internet enabled device. Read on; I hope you enjoy the process. Dr. Mike

      • Judy
        January 1, 2017 at 10:24 am

        CURES for Atherosclerosis…Fresh Royal Jelly 1/4 teaspoon AM/PM at bedtime it’s said it might takes two (2) years? the other Dark Unsweetened Pomegranate Juice eight (8) ounces everyday and to eat Cantaloupe.
        Organic Unrefined Coconut Oil 2 or 3 tablespoons
        everyday…STAKICH, Fresh Royal Jelly and Noni Juice 2 or 3 ounces everyday and the “POWER of PRAYER” .

  2. March 4, 2015 at 10:48 am

    Hi Helene,
    You are always gracious. Thank you for your attention and interest,
    Dr. Mike

  3. Sri
    March 7, 2015 at 2:21 am

    Thanks a lot for this fantastic Series Dr. Mike. It took me 45 days of exercise and nutrition to bring down my TGL from 500+ to 100 (without any support from drugs).

  4. Deanna Sweet
    September 11, 2015 at 11:35 am

    I just found out I have atherosclerosis and need help to reverse it

    • Judy
      December 8, 2016 at 9:36 am

      ATHEROSCLEROSIS…Try Fresh Royal Jelly, Noni Juice or coq10 200 mg SOFTGELS or Organic Unrefined Coconut Oil 2 or 3 Tablespoon everyday of the coconut oil.

  5. Jeannie
    September 23, 2015 at 8:56 am

    What should I be eating to help me reverse atherosclerosis

  6. Gloria Doody
    February 14, 2016 at 3:24 pm

    I too just found out I have Atherosclerosis of the Aorta. I was in the hospital and had several test. They thought I had a heart attack. Strange they never said anything about the Atherosclerosis, it showed up on my post hospital after visit summary, even my Primary Provider didn’t mention it. I’m thinking She thought they told me at the Hospital. Or it’s really minor and nothing to worry about. I have lost 130 lbs and kept it off for over 2 years. Also I don’t have diabeties any more and all my labs have been normal, so I don’t understand. Oh, all my test in the hospital were normal, they said. My admiting symptom was dyspnea on exertion. 2 day before that I had horrible abd pain that didn’t go away after taking 4 Tums. Anyway thats my story.

    • kevlynn
      March 10, 2016 at 8:49 pm

      Tums? You need your stomach acid…without your stomach acid, food literally rots…reason for your pain..lay off the tums, you’re neutralizing what is needed to break down food. Have you heard of Digestive enzymes? Please, this is the information age, look into it.

      • maryann mcculloch
        May 20, 2016 at 5:05 am

        what is digestive enzymes

  7. Charles
    February 25, 2016 at 8:11 pm

    I understand your feelings.
    I was sent to a cardiologist because I was hypertension. All he did was write up a prescription for hypertension. Then had an abdominal pain, which became saviour & commenced bringing up blood. It was Abdominal Aorta Aneurysm, which required urgent operation. Atherosclerosis was not mention & no information as to why I have hypertension. The drugs treat, but do not cure the problem.

  8. James A Chase
    March 9, 2016 at 9:22 am

    I just found out that I have a blood calcium of 1221. What does that mean?

  9. Vernita
    March 16, 2016 at 8:26 pm

    This is the best article that I have read on this topic as it breaks it down and explains it to the average person, It provides enough information to understand not only the disease process, its progression but what each of us can do to make immediate changes. The situation does not have to be hopeless if we educate ourselves and take control of our health.

    • November 14, 2016 at 9:41 am

      I’m so excited for you!! I’ve had trouble sticking to training plans as well, I normally switch them all up until they hardly resemble what I started with lol I’m proud of you for enjoying (almost) every mile – you’re my inspiriation girl! (:

    • November 14, 2016 at 9:20 pm

      Terrific letter by Cdr. Kerchner, and I thank him for that. Bettencourt would be a fool to ignore it or not act on it. Screw this "First in the Nation" or "special political culture" bullshit. I hope those who defend the Constitution, unlike this treasonous bastard, will raise holy hell when the primary rolls around. Then when the lid is blown off this charade, New Hampshire will be served poetic justice by having its "First in the Nation" status flushed down its granite toilet bowl.

  10. George Scarborough
    April 13, 2016 at 9:20 am

    This information is incomplete and inaccurate. Linus Pauling received a Nobel Prize for discovering the true nature of heart disease, the build up of lipoprotein a (Lp a) build up due to a vitamin C deficiency which causes the arteries to become brittle and hard. The body deposits Lp a as a band-aid to prevent the artery from breaking and causing internal bleeding. See the article on the Pauling therapy at

    That vitamin C deficiency causes this has been known since the 1940s. Curiously the medical community has totally ignored this. My wife went to Mayo Clinic and they never mentioned it and placed three stints. The only thing for maintenance suggested was plavix but nothing about C or Lysine.

    Pauling and Rath discovered that high levels of C and Lysine would dissolve the plaque and in 1989 patented a formula containing C, lysine and proline to disolve the plaque.

    My cardiologist told me I had 40 to 60% blockage in my carotid artery and I mentioned the Pauling therapy. She said it would not work. I told her I would be her guinea pig and give it a go. She told me not to. I did it anyway. Five months later at my next visit she said the artery was clear. When I mentioned the Pauling therapy I had used she made no response at all, like I was talking into the wind or to a brick.

    I was using 1 gram of C and 1 gram of lysine twice daily. Both are available at any drug store. Lisine is also called L Lysine.

    I mentioned this therapy to a friend who had a 90% blockage and he tried the therapy and in five weeks his artery was clear.

    What Pauling and Rath found was that when a diseased artery from a cadaver was placed in a weak solution of C and lysine the plaque dissolved. If it will clear a large artery what about the small ones in the heart and other organs?

    Why has this been ignored for over 50 years? Follow the money. 30 to 40% of the revenue of a clinic comes from invasive heart and artery procedures. Go figure.

    Doctors should have been telling their patients to take C daily and if you have a history of heart disease in your family add lysine. There should have been studies to prove the efficacy of this procedure. I don’t know what the minimum maintenance dosages are but I take 1 gram of each a day for maintenance. Pauling’s article says over 5 grams of each could be used in extreme cases. If a doctor tole me I needed open heart surgery I would sure thy this first.

    It still blows my mind that doctors don’t tell their patients about this and that my cardiologist told me not to do it. Boo!

    There is a more detailed expiation of artery disease at

    Cheers, George

    • April 13, 2016 at 11:56 am

      Hi George, Linus Pauling’s Nobel Prizes were for the nature of the chemical bond and for Peace. He did not receive one for anything related to heart disease. You are mistaken in this and several other things. I will post your comment but absolutely do not endorse your proposed ‘cure.’ I am glad you are well and hope you stay so. Dr. Mike

      • Max
        June 19, 2016 at 10:47 am

        Dr. Mike
        You said,”You are mistaken in this and several other things.” In what “other things” was he mistaken? Please help us to sort out the good information from the “incorrect”
        Thank you

    • Max
      June 19, 2016 at 11:39 am

      Hi, George
      I found your post very interesting, and will try your technique. With all due respect to
      Dr. Mike, nothing speaks so authoritatively as direct,
      personal experience.
      Thank you,

      P.S. You said, “There is a more detailed expiation of artery disease…”.

      I’m thinking that was,perhaps, a typo, and that you probably meant to say,”explanation” of artery disease.

      noun: expiation;
      the act of making amends or reparation for guilt or wrongdoing; atonement.


      • June 20, 2016 at 3:35 pm

        Hi Max,

        I confess that was a short-hand dismissal of his post. (Hi George!) Mr. Scarborough has bought whole-heartedly into an alternative medicine narrative for which there is little to no clinical trial proof. I suspect, you can see it in his post, there is a little bit of a conspiracy theory bias in his reading of the scientific literature. The idea, for example, that Dr. Pauling’s work received short shrift from the medical establishment defies my own experience when I was at Stanford. Without violating privacy issues I can tell you that there were many attempts to implement his protocols in patients in the University hospitals. (There is a little ‘direct, personal experience’ for you) His medical and health theories, dependent as they were, on anthropologic genetics have simply been disproven with tools he did not have at hand.

        So I offer the above as expiation for my dismissal of his post. For a further explanation read on in the blogs and the book. Max, more, I do understand the sense of conspiracy; an example just to hand is the recent BMJ article that linked higher cholesterol/LDL with greater longevity. You could not find a more direct refutation of the lipid hypothesis and it was a well done meta-analysis of the data. The whole medical world should be in an uproar. Nope; if you go by the medical profession’s reaction it did not even happen. Tough times for the truth? It has always been so. Dr. Mike

  11. Joan Quade
    May 12, 2016 at 9:07 am

    Thank you for all of this valuable information.

  12. Cyndie
    June 24, 2016 at 6:25 pm

    I appreciate all the info. I have several questions. I thought all foods have some kind of “carb” effect on our body. I know to cut out bread, potatoes and the like. Should I be concerned about any other foods? What about Ezekiel Bread (sprouted bread)? And is Stevia safe to use if I want to reverse the fat veins? Thanks for your help.

  13. Evelyn
    July 2, 2016 at 9:34 pm

    Dr. Mike,

    I am excited to discover your book ! I have a lot of education in holistic health care , eat a vegetarian diet , low in carbs and sugar. I do not have high blood pressure and my LDL/HDL ratios were optimal last time I had them checked as were my triglycerides . However, I have high stress levels and sleep 4 or 5 hours a night. Several years ago, after a divorce I did not want, I developed a deep vein thrombosis that went from my iliac nerve to the bottom of both of my feet. The only medicine I take is Warfarin. For several years I have had stomach pain, which my doctor and my exercise trainer attribute to my lack of sleep and stress levels. However, I recent x-ray because of to rule out a cracked rib( I have congenital scoliosis because I was born with cerebral palsy) revealed atherosclerosis in the aortic artery in my abdomen. I already dink a water lemon or lime mixture with cumin, cayenne, turmeric, ginger, and I take garlic as well. I will purchase your book. Does it have everything I need to know?

    Thank you.

  14. Stu
    July 11, 2019 at 8:43 am

    Have to say I feel you are very much presenting conjecture as fact here – just like the pro-statin lobby. Everything you describe as being a cure for heart disease – low triglycerides, regular intensive exercise, perfect blood sugars, describes me exactly. Yet here I am in my early 50s with 40-50% LAD stentosis. Let’s be honest and admit we have little to no idea what causes atherosclerosis.

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