Transcription
Today we're going to talk about the best meal to reverse heart disease, to help unclog those arteries. And this video is going to be a little longer than our usual fair. It's going to have a more conversational tone. Basically, this is the conversation I would have with a close friend or a close family member if they had plaque diagnosed. This is the conversation I would have with my own father if he had plaque in his arteries. So, I'm going to give you everything we know, everything I've learned in a few decades of studying medicine and biology and everything we know scientifically about this topic from decades of research. All the facts, no sugar coating.
So, I would sit him down and go, "Dad, you have plaque in your arteries. We have the scans. The result is clear. Here's what we can do about it." Now, in practice, this conversation would be in Portuguese, my dad is Brazilian, and he's actually a medical doctor so we could skip a lot of the basics, but otherwise the convo would be pretty much this.
So heart disease is the number one cause of death in humans worldwide. Nothing kills more than heart disease. And in your case, the mystery is gone. We already know you have it. So there's no question of whether the risk factors are going to affect you, whether you're going to get away with it. We know you have plaque. So that's the bad news. The good news is we have a lot of knowledge and a lot of tools on how to manage and even reverse this to some extent including dietary tools. So that's what we're focusing on today.
So the first thing, Dad, let's talk about what causes plaque and what causes heart disease because once we have a firm grasp of those factors, we can better understand how to put together a meal that optimizes those and reduces our risk and reverses the the condition. So there's a number of factors that we know cause heart disease and make things worse. Tobacco for example, we all know smoking makes things worse, increases risk of heart disease. And let's talk a little bit also about how we know this because it's one thing to just repeat these words, tobacco, blood pressure, diabetes, everybody knows that. But understanding a little bit without getting too much into the weeds, understanding a little bit how scientists know this, why scientists say what they say. So people who smoke have more heart disease, that's consistent across populations. And even when you account for other possible confounders, things like body fatness, BMI, some dietary factors, exercise, when you try to remove those from the equation, the effect still survives. So the relationship between smoking and heart disease is still there. We also understand why smoking worsens heart disease. We understand the mechanism as we call it. Tobacco damages the wall of the artery. And so that makes it easier for heart disease to progress. Now, smoking is not necessary. You can be a non-smoker your whole life and still get heart disease, get heart attacks. That happens. But smoking makes it worse. So dad, you don't smoke. You've never smoked pretty much since your wild years, very young. So, we're good there.
Next, high blood pressure. Similar logic, populations with high blood pressure have more heart disease, when you account for confounders like smoking or BMI or exercise the relationship still survives. We also have the luxury of having randomized trials. So you take people with high blood pressure and you split them randomly and you lower the blood pressure of just half of them and you follow them over years and you see who gets heart attacks and who dies. And you can do this with dietary tweaks. You can do this with medication. And we consistently see that the folks who get their blood pressure lowered have fewer heart attacks and strokes and death. And we have yet another line of evidence. We have genetics. So people who have genetically determined lower blood pressure, they're just lucky bastards. They have less heart disease. So these are very powerful lines of evidence. We put everything together, the level of confidence that blood pressure is what we call a causal risk factor, that it causes, directly causes heart disease, is very high. Just like we saw with tobacco, it's not necessary. You can have normal blood pressure and have heart attacks. It happens. But high blood pressure makes it worse. And we even understand how, high blood pressure increases the stress on the artery walls, what we call the sheer stress of the blood flowing, that can cause damage over the years and that can help precipitate, increase heart disease. So what's a good blood pressure? We actually have new guidelines based on the latest evidence and they suggest an optimal blood pressure is under 120 systolic and under 80 diastolic. And that's for anyone really, but especially for someone who has plaque already we want to be stricter. So, we definitely want to stay under that threshold. So, dad, let's measure your blood pressure. Everybody should have one of these devices at home. If you don't, let's get one and let's measure yours and see where you are and see if we can improve that or not.
Next, diabetes. Same general lines of evidence. We have the observational. So, populations with diabetes have more heart disease. Adjustments, it survives. We have randomized trials. We have genetics. We understand how it does that. It damages the wall. It increases lipoproteins crossing the wall. We'll look at what that is in a second. It causes inflammation. It causes all kinds of things. And again, not needed like we saw for the other risk factors. You can have normal, completely normal glucose levels and still have heart disease, happens a lot. But with diabetes, with high glucose, worse. What's a normal, what's a great, what's an optimal level? Well, you want your fasting glucose to be under 100. This is in milligrams per deciliter. And you want your hemoglobin A1C, your glycated hemoglobin under 5.7. And hemoglobin A1C is a an average of your glucose levels over 3 months. It's a pretty good blood test to get. There's also some stages before you get to full-blown diabetes that are kind of the road there and are already problematic. So pre-diabetes, and then before that there's insulin resistance. For pre-diabetes we already covered it because the values I gave you are for normal, so pre-diabetes is already over that, over 100 fasting glucose and over 5.7 hemoglobin A1C. For insulin resistance there's a couple measures you can use. There's something called homa-IR. There's another called TYG index. So these are things that can give you an idea of your state of insulin resistance or insulin sensitivity. So, Dad, let's get some blood work. Let's measure your fasting glucose, your hemoglobin A1C, and maybe your triglycerides and your fasting insulin. And with these four values, we can look at all these indices and have a good idea of where you are as far as diabetes, pre-diabetes, insulin resistance.
Next, ApoB. This is a big one. So, Apo B is a type of lipoprotein. They're microscopic golf balls that float around in our blood and they transport fats back and forth. And these little golf balls are called lipoproteins. There's different families. Some are not harmful, but the really nasty one is the ApoB family. And it's the number of these little golf balls, the ApoB lipoproteins, that is a risk factor for heart disease. And you can measure that. It's a blood test called ApoB. It's a count of those lipoproteins. Okay, real quick. There's always a million questions about cholesterol and we have probably 20 videos on that. But once you understand the basics, most of those go away. So cholesterol is what's carried inside these lipoproteins. And in general, people who have more apoB lipoproteins, apoB golf balls, have more cholesterol being carried inside. So there's a general correlation, but it's not perfect. Sometimes they mismatch. And so the cholesterol measures that you get in a typical blood work, your LDL cholesterol, your total cholesterol, those are guesstimates. And when those are very high, that's a red flag. But they sometimes get it wrong. So once we understand that, that they are a reflection of the real cause of the disease, but they're not a perfect metric, a lot of these questions and a lot of this confusion naturally dissipates away. Okay. How do we know ApoB causes heart disease? Same exact lines of evidence we covered for the others. We got the population data, we got the RCTs, the randomized trials, we got the genetics, and we got the mechanisms. So mechanism-wise, it's exactly these lipoproteins crossing into the artery wall and getting stuck in there that causes plaque, that causes aththerosclerotic cardiovascular disease. Without these lipoproteins in there, there is no plaque. And we know from a lot of research that people with higher APOB tend to have more heart disease. More of these particles get lodged in there. There's always individual variation. As with the other risk factors, some smokers never get lung cancer. Some people with very high blood pressure never get a stroke. But in general, populationally, the risk goes up. And you, dad, already have the plaque. We already know that. So we know you have the susceptibility. That mystery is gone. Now what's a good ApoB? So in general for a healthy young person under 90 milligrams per deciliter is a pretty good ballpark to shoot for. But for someone who has higher risk, for example, someone who has a lot of plaque diagnosed, it's better to be stricter. So the next cut off is under 70 milligrams per deciliter. That's actually where I try to keep my apoB. I don't have plaque diagnosed, but I have a high LPA. We'll look at what that is in a second. And then there's a third cut off which is under 60. Usually for people at a very high risk, what we call secondary prevention, people who have already had a heart attack or a stroke. So for you, Dad, you haven't had a heart attack or a stroke. Knock on wood, but you have a lot of plaque. We could start with trying to get your APOB under 70 and then look at imaging and see how your plaque is progressing. Is it growing? Is it steady? is it reversing? And go from there and see if we want to go lower, to under 60 or if we're good under 70. They've actually measured plaque growth and here they're looking at LDL cholesterol as a reflection of ApoB as we said and they found that around 80 milligs per deciliter LDL, so that corresponds to about 70 milligs per deciliter APOB, plaque stops growing. So plaque is steady at that level. Under that level, we start to see plaque shrinking. And the lower the LDL and the Apo B, the faster the plaque shrinks. And then above that level, plaque grows. And the higher the level, the faster it grows. Now, a little bit of caution with these results. These are from trials where they use medication to lower apoB. And this is a population with pretty high risk. So, individual results may vary. Your exact threshold might be a little different, but good to know that this has been done. And this is what they found. Okay. So that's APOB in a nutshell.
Before we go on to the rest of the risk factors, LPA and other things, inflammation, I want to touch on some frequently asked questions about APOB because this always comes up and I think there are valid questions that need to be addressed and my dad probably would ask some of these. For example, if Apo B is better than LDL cholesterol and HDL cholesterol and triglycerides and these things, why don't we get that in the basic lipid panel, right? How come when you go to the doctor, you usually get the basic lipid panel, and ApoB is not in there? It doesn't make any sense. It's for mainly historical reasons, these lipids were measured going back decades. And with time, we've gotten stronger and stronger evidence that the real epicenter, the real cause is the apo B, is the count of the lipoproteins. And that's now generally accepted in this field, in cardiovascular research and in what's called lipidology, all these nerds that study all of these topics in depth. But these institutions are pretty ossified and it takes a while for this to become mainstream. So there is now a push and it's becoming more common for these to be in guidelines, cut offs for Apo B. So I think that's what we're going to see going forward is more and more often you're going to see ApoB being looked at because it is more accurate, more reliable than LDL cholesterol. There is another measure that you can get that is maybe the poor man's Apo B which is a nonHDL cholesterol that doesn't cost anything because all you do is take your total cholesterol and subtract your HDL cholesterol. And that gives you an idea. It's almost as good as getting an ApoB. What about the triglycerides? What's the deal with those? So triglycerides don't cause heart disease per se. They get into the artery wall, but then they can get degraded and broken down and removed. But they're not useless by any stretch because they reflect things that cause heart disease. So people who are overweight, people who have diabetes, people who have insulin resistance, metabolic syndrome, they tend to have higher triglycerides. So this is why we see this relationship in general. Populations with high triglycerides, we see more heart disease. Triglycerides also reflect apo B because triglycerides are carried again in these apoB carrying lipoproteins and specifically in a subtype called the remnants, a little subfamily that is problematic, also causes heart disease. So, this is why a lot of these debates on the internet, is it the cholesterol or is it the triglycerides? Which one should I pay attention to and should I just ignore one of them? They largely miss the point. They're not very insightful. Both metrics can give you information. Both metrics are pretty imperfect because they're not the actual causes. So, that's why we focus on the actual causes. High APOB, high blood pressure, high glucose values. But yeah, a high cholesterol level or high triglycerides can be a red flag and can point the way that something is not right. Okay. Along the same lines, a common question is about HDL. What's the deal with HDL? Is it the good cholesterol? Does it protect us? So, we know now from a lot of research that it doesn't protect you. There's no protective role of HDL cholesterol. It is also a reflection of lots of things actually. It also reflects overweight, insulin resistance, diabetes. It also reflects ApoB. It reflects exercise. It reflects alcohol intake. It reflects a million things. But the problem is HDL is not reliable. This is also why we want to be careful with ratios that use HDL cholesterol. These are popular on social media, but pretty slippery. It's okay to look at them to get a first pass, but you want to be careful with those. At the end of the day, it's about the causal risk factors, the apoB, the glucose levels, the blood pressure, etc. Okay. Another common one, a lot of people have heart attacks with normal LDL. Does that mean it's a useless metric? No. It means it's an imperfect metric. Lots of people have heart attacks without smoking. That doesn't mean that smoking doesn't do anything. It means you don't need to be a smoker. And as we covered, we now understand very well that LDL cholesterol is an imperfect reflection of Apo B. Sometimes it gets things wrong. So, better to go by your APO B. Okay, last really common question and then we'll move on to the other risk factors. Can I just fix everything else? Can I just fix my blood pressure and my glucose and lose weight and you know, have exercise and not smoke but leave my cholesterol and my ApoB skyhigh? Is that still a problem if everything else is fine? So this question has been asked scientifically and in every test we've seen, every population that has high cholesterol or high APOB, we still see higher risk, more plaque growing or more heart attacks than people who have normal cholesterol or apoB, right? Everything else held equal. So our current understanding is that yes, even if everything else is fixed a population with high cholesterol and high APOB, there's still going to be heart attacks and strokes and things like that that could have been avoided. So, I still try to keep my Apo B and cholesterol in the normal range. I still try to manage that despite everything else. And dad, that's what I encourage you to do. That's what I suggest you do based on what we know scientifically. But the choice is yours.
All right. Next risk factor is LPA. And this is something we've learned a lot about over the last few years. And it's a type of ApoB particle, a subtype. And in most people it's a very small fraction of apoB particles and about one in three to one in five individuals have high LPA which is surprisingly common, right? And LPA, the evidence we have strongly suggests that LPA when it's elevated is going to increase risk of heart disease. So that's one thing that that we should measure, see if yours is high or not. And one caveat here is that there's not a lot currently that we can do to lower it. So it's determined genetically mainly and there's no way to really bring it down to normal in people who have it very high. So what we do in people who have high LPA, and I have it by the way, is we normalize everything else. So we control blood pressure, glucose, apoB, body weight, everything else to minimize overall cardiovascular risk.
Okay. Next risk factor is inflammation. So inflammation is a separate risk factor. It makes things worse. Now sometimes people will get into this debate on social media. Is it the inflammation or is it the cholesterol? Don't worry about your cholesterol. It's the inflam... This is just a misconception and a distraction because it's not either/or. The apoB particle once it's lodged in the artery wall, and the apob particle carries the cholesterol that's going to get delivered there, but once it's retained in the artery wall, it causes inflammation. there's an inflammatory response to the particles being lodged there and to all this cholesterol mass. So, one thing triggers the other. It's like a domino chain. So, you don't need pre-existing inflammation for plaque to start. The plaque process itself will cause inflammation. Now, if you have an inflammatory condition, there's some rheumatoid arthritis and things of that nature, some GI conditions like inflammatory bowel. In those settings, people have inflammatory markers that are elevated kind of systemically and those people have higher risk of heart disease. So yeah, it can be an add-on. It can be fuel to the fire. So it's not needed, but yes, it makes it worse. And by the way, you're not safe just if inflammatory markers are low. Unfortunately, this has been tested. And even in people with inflammatory markers like C reactive protein completely normal if other risk factors are elevated like apoB for example they still have higher risk of heart disease and heart attacks. So unfortunately we got to fix everything to minimize risk. So dad we can get, and I think it's a good idea, to measure C reactive protein, see if there's an elevation in inflammation and then go from there.
Okay. Next risk factor is body fat and specifically visceral fat. Fat that's deposited around and inside the organs. It´s a triggering factor for insulin resistance and diabetes and probably for cardiovascular disease. So there are ways we can assess that. There's some algorithms that estimate your visceral fat. They're not perfect, but they give you a ballpark. So dad, let's run some of those. We have a video covering how to do that. Let's take a look at those and see how yours is.
Okay. Next risk factor is actually a trifecta. The three S's. Stress, sleep, and sedentary lifestyle. Right. So, let's take a look at that, Dad. Your stress levels, your sleep, and your physical activity in general, exercise, but physical activity, moving around. I know you're pretty good on most of these, but let's assess whether there's room for improvement there.
Okay, that's about it for risk factors. Then, we have a couple of risk factors that are not modifiable, like age. Age is a massive risk factor for heart disease and a lot of chronic diseases, but we can't change it. So why worry about it? And genetics, obviously, huge for heart disease, but again, we can't change genetics. And we already know in your case, Dad, with the imaging, you have plaque, so you have the susceptibility at least for plaque growth. So the mystery is largely gone. There's even more risk factors for heart disease. Chronic kidney disease is one, pollutant exposure. There's a lot of other things that contribute, but this list is a pretty good start. So, those are the main factors that cause heart disease. Both preventing heart disease and managing and trying to reverse it goes through optimizing these, minimizing these, controlling these.
So, now that we understand them well, now we're in a good position to look at foods and see what effect different foods and different dietary patterns have on these guys. So, tobacco is pretty straightforward. It's not a food. is just reducing or eliminating smoking. Okay.
Blood pressure actually can be impacted very strongly by dietary tweaks. So we know weight loss consistently improves blood pressure. We also know that sodium in general, salt in general in food or added to food can raise blood pressure. This depends on the individual. There's salt sensitivity. Some people are more some people are less. And then potassium tends to lower blood pressure. And that's either the potassium in foods, naturally present in fruits and vegetables and whole grains and things like that and also the added potassium in potassium salts. Both have that effect. So dad, let's measure your blood pressure. If it's significantly over 120 systolic and 80 diastolic, let's take a look at what we can do. First line of attack is ultraprocessed foods, kind of junky foods because those tend to have a lot of sodium and they're low in potassium generally. And so can we remove some of those? In your case, I know you don't eat a lot of junk food, so that's probably not going to be major focus for us. And then we have the added salt at the table. Can we replace some of that with potassium? Even replacing just 25% of regular sodium salt with potassium salt has been shown in randomized trials to reduce risk of strokes and death. So, it's pretty powerful. And then we have specific foods that have been shown to have an effect on blood pressure as well. So, garlic is one. There's some compounds in garlic like allicin that can help reduce blood pressure. Hibiscus tea is another one that has some evidence for it. So, let's play with some of those and see how they affect you specifically. There's also a lot of medication and supplements and exercises that have a powerful impact on blood pressure. We have videos going over all that, but for the purpose of today, we're focusing on diet. Otherwise, this is a 10-hour video.
Next, diabetes and pre-diabetes and insulin resistance, this whole thing, and dad, we know you don't have this fortunately, otherwise we would focus heavily on trying to fix it. And the number one thing that fixes these conditions consistently is weight loss and specifically fat loss, losing some of the excess fat. And we know it's visceral fat that is the main problem here. So, losing some of the visceral fat is important for fixing these diseases. I'm not saying that explains 100% of cases. I know there are some lean individuals that have sometimes issues. There are medications that can increase risk of diabetes. But for 90 or more% of Westerners that become a little pre-diabetic or diabetic with age as they put on weight, this is the number one thing to address. And so the main weapons here are diet and exercise. By far. People have these wars on the internet. You have to go low fat. You have to cut the carbs. You have to be vegan. The truth is you can fix, you can reverse diabetes with 10 different diets. And my goal, Dad, is to get you to your target, to your goals. It's not to get into some kind of tribal internet battle. So, the truth is you can do this with low carb, low fat, and Mediterranean and vegan and non-vegan diets. They've all been shown to work in some people. So, if you had a little bit of extra weight, especially visceral fat, we're going to try to find a diet that you find satiating and sustainable long term that's going to help you lose a little bit of that fat. So, for example, if there's a lot of refined carbs, sodas, sugary cereals, cookies, and cakes, and candy, things of that nature, we're going to try to shift from those to more whole foods, either whole carbs or sources of healthy fats. That's a good transition that often helps lose a little bit of weight. So, swapping the soda for less caloric drinks, swapping cocoa puffs and sugary cereal with steel cut oats or some fruit or an egg. Those are all valid options. Fortunately, Dad, I know you don't eat a lot of junk food, a lot of highly refined carbs. So, if there are some tweaks, this will probably be pretty easy for us to do.
All right, Apo B. How do you bring ApoB down? Weight loss helps. Again, losing some extra fat. The type of fats in the diet matters greatly. It's probably the number one factor for most people. So, our so-called healthy fats tend to bring ApoB down. So, fatty fish, nuts and seeds, avocados, vegetable oil like olive oil, for example, and then things like butter and lard and fatty meats tend to raise apoB for most people. Another thing that helps bring that down is soluble fiber. So, apples, okra, oatmeal, berries, barley, lots of good sources of soluble fiber. So, let's take a look at your diet and see if we can make some of these switches. By the way, we have evidence that the same types of fats also improve insulin resistance. So, there are randomized trials looking at more unsaturated fats like olive oil or canola compared to more saturated fats like butter, looking at things like visceral fat, like liver fat, and even measuring insulin resistance directly. And in general, the unsaturated fats tend to be better, tend to induce insulin resistance less. Doesn't mean that you can't bring down insulin resistance on a diet with a lot of butter if you lose weight, for example, right? So, there's multiple moving parts, but everything else held equal, the evidence we have shows that unsaturated fats tend to be better for insulin resistance for most people. Okay, eggs. People have the all these debates on the internet, eggs are poison, eggs are superfood. None of that's true. In most people eggs can raise ApoB, but it's a modest effect. So, it depends on the individual, depends on the genetics. Some people, they can eat 10 eggs, 20 eggs, and ApoB doesn't budge. Others are what we call hyperabsorbers of cholesterol, and just eating one or two eggs a day, their ApoB can jump up. So, it depends a lot on the individual. Basically, dad, this would not be my first concern. If your apoB looks good and you're having a an egg here and there, I'm not too worried about it. But if you're eating a ton of eggs and your apoB is a mess, it's one thing we can try to reduce and see if it makes a difference or not. It wouldn't be the first line of attack to be honest.
Okay, inflammation. There's a lot of talk on the internet about this food is inflammatory, that food is inflammatory. A lot of that, to be honest, is influencers trying to scare you. A lot of that is not based on strong evidence. The number one trigger to raise or lower inflammation is going to be putting on weight, putting on excess fat. When people lose weight, basically on any diet almost, we see inflammatory markers come down consistently. Other than that, there are some foods that have some evidence for an anti-inflammatory effect, omega-3s. So, fatty fish like salmon or sardines, flax seeds, seaweed, those are some sources of omega-3s that we could play with and add to your diet. Other foods that have some evidence for an anti-inflammatory effect include nuts, virgin olive oil, and low-fat yogurt.
Okay, the body fat. We already talked about it. Main thing is going to be finding a satiating diet long term that you don't go overboard on calories. Main thing is replacing some of the ultraprocessed foods, the refined carbohydrates, the added sugars with more unprocessed varieties. We already touched on it. Protein can help with satiety. So increasing protein content can help people feel more satiated and not go overboard on calories. Otherwise, whether it's low fat or low carb, it's personal preference. Some people like these diets. Most people cannot sustain a very low fat or very low carb diet in the long run. We know that from endless trials. As long as the diet is low junk, the macro distribution is personal preference. For you, Dad. I know you eat a basically a Mediterraneanish diet. So, we wouldn't make massive changes. We would tweak, is there an improvement in fat quality or adding some soluble fiber and see how far we can go.
Okay. What about fasting? Well, we don't have trials specifically looking at fasting and plaque size, but based on what we know, I would expect it to be helpful, to be a a valid tool for people who like it. Fasting can help lose some body fat if we don't compensate, right? If we don't overeat during the eating windows, if the fasting helps us lower calories overall, yeah, it's a valid tool to help cut back and lose some fat. One good thing about fasting is it doesn't worsen anything. There's not a lot of downsides to fasting. Now, do we need it? We don't need it. If someone doesn't like it or prefers to lose weight some other way, that's fine, too. None of the trials looking at plaque reduction used fasting, as we'll see here in a minute. So, there's other ways to do it as well.
Okay, Dad. So now we understand the general effect of different foods on these risk factors on the causes of heart disease. Now let's look at the direct evidence of different diets and different foods on shrinking plaque. The randomized trials that we have on this. Not theories, right? Not pet speculations, actual evidence because this is your life. It's not a game. So there's half a dozen randomized trials that did this, put people on different diets and looked at plaque size and reported some measure of reduction of plaque size. And we have a video going over all that in detail, but I'll give you a summary. Some of those trials used a lower fat diet, some higher fat, some lower carb, some higher carb, some used a vegetarian diet, some used a Mediterranean diet, some used a DASH diet. But every single trial that saw a reduction in plaque size used a diet with fruits and vegetables, with fiber containing foods, with some dairy like yogurt or milk. In every case, the fats that they did give participants tend to be these healthier fats like nuts, avocados, olive oil. Some give fish, some give some eggs, some give legumes, some give whole grains, some give some meat, some don't. But they're all variations of this basic dietary pattern. None of the trials give a lot of butter or a lot of refined carbohydrates, added sugars. None of the trials give a lot of fatty meats or bacon or sausage or soda. Does that prove beyond all doubt that bacon increases plaque? Not really. Nobody's done a trial with or without bacon to compare. But based on what we know, I wouldn't do it and I don't advise it. If we're trying to reduce plaque in someone with high susceptibility or prevent plaque, I would definitely go easy on that type of foods. We know it raises ApoB, butter for example, compared to healthier fats in most people. We know it can even raise visceral fat and insulin resistance compared to healthier fats when compared calorie for calorie. So, I wouldn't go there based on what we know. That's my suggestion, Dad.
So, ideal meal. Let's put this together. Dad, I know you are an omnivore who tries to eat a healthy diet, a Mediterraneanish diet. So starting with protein sources, I would suggest either a piece of fatty fish or plant protein like beans or lentils or tempeh or a piece of white meat. So one option would be for example grilled sardines, let's say for lunch, side of wild rice, unprocessed, and some okra for example as a vegetable which is going to bring in that soluble fiber to help with lipids as well. And of course you can season this. No, it doesn't have to be bland. You can use olive oil, any spices you want. Garlic is a good idea. It helps a bit with the blood pressure as well. We can play with the salts. We can try a potassium salt that helps bring blood pressure down or a mix of potassium and sodium depending on your blood pressure. So, we'll personalize this. And then another idea for dinner, let's say, ideal meal also to reduce that plaque in your arteries. A lentil dahl. It has fiber. It helps with the lipids. It's flavorful. It's spicy. It's delicious. Pearled barley on the side is one option that goes really well with lentils and then a side of salad for example. Dessert: fruit, berries, an apple, both high in soluble fiber. Can't go wrong with that. So that is the meal or the two meals I'm recommending to you, Dad, or that I'm doing if I'm ever in that position.
What about exercise? What's the best workout to help unclog arteries, reduce that plaque? We covered all of that in a recent video. So check it out right here and I'll see you in there.