Unhealthy dietary patterns nearly double the prevalence of high-risk plaque in coronary arteries, potentially increasing heart attack risk. Digest
Diet plays a critical role in cardiovascular health, influencing disease risk and the biological processes underlying plaque formation in the arteries. However, emerging evidence suggests that not all plaque is equal, with some types more prone to rupture and trigger heart attacks. A recent study found that adults with the least healthy diets were nearly twice as likely to have high-risk plaque in their coronary arteries as those with the healthiest diets.
Researchers analyzed data from more than 24,000 adults aged 50 to 64, none of whom had been diagnosed with cardiovascular disease. They developed a dietary index to score how closely each person’s eating habits aligned with an anti-inflammatory diet—one rich in vegetables, fruits, whole grains, nuts, and healthy oils and low in red meat, processed meat, and sugary drinks. Then, they scanned the participants' heart arteries to identify plaque, including high-risk plaque that is more likely to rupture and cause a heart attack.
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The scans showed that people with the least healthy diets had coronary plaques more often than those with the healthiest diets (44% vs. 36%). They were also more likely to have substantial artery blockages (6% vs. 3.7%) and nearly twice as likely to have high-risk plaques (1.5% vs. 0.9%)—those that are non-calcified, cause major narrowing of the artery, and have characteristics such as low tissue density, all of which are associated with an elevated risk of rupture and heart attack. These differences remained even after accounting for age, sex, and smoking status. Measures like waist size, triglyceride levels, and high blood pressure appeared to partly explain the connection.
These findings suggest that diet influences not only whether plaque forms in the arteries, but also whether that plaque is the kind that leads to heart attacks. A diet rich in fiber and plant-based foods—and low in red meat and added sugars—may help prevent the buildup of dangerous plaque by improving metabolic health and reducing inflammation. Learn how exercise can help prevent the buildup of harmful arterial plaque, too, in this episode featuring Dr. Ben Levine.