Can You Reduce Heart Plaque? A New Study Found It Shrinks When LDL Drops

What you’ll learn:

• What the new plaque trial found, in plain language
• Why soft plaque matters more than hardened plaque
• How much can LDL be lowered with food
• Why food and cholesterol drugs pull the same lever and aren’t rivals

What the new study found

The trial, published in JAMA Cardiology on October 30, followed 104 people in Denmark, newly diagnosed with coronary artery disease. None had ever taken a cholesterol drug. Half received atorvastatin at a strong dose of 40 mg. The other half received an even stronger combination: rosuvastatin 40 mg (Crestor) plus ezetimibe 10 mg. Detailed CT scans tracked the plaque in their arteries at the start, at nine months, and again at 18 months.

Both groups improved, and the combination group improved by more. Their LDL fell from an average of 127 to about 43 mg/dL, a 65% drop. Soft plaque volume fell by 28%, total plaque by 21%. Soft plaque shrank in 51 of the 52 patients on the combination, which is where the 98% figure comes from.

Soft plaque is the kind to watch: the lipid-rich, unstable material that cardiologists worry can rupture and trigger a heart attack. Hardened, calcified plaque tends to be more stable, and in this study calcified plaque actually rose slightly in both groups — a pattern the researchers read as plaques getting firmer and less dangerous even as they shrank.

The study has real limits. It followed 104 people, it measured plaque on scans rather than counting heart attacks or lives saved, and most participants were men around age 64 who had just started treatment. It also fits a much larger body of evidence that the lower LDL goes, the better — and this trial found the relationship runs on a straight line. The lower the LDL, the more plaque shrank.

What this means for you

LDL cholesterol is the dial this trial turned, and the lower it went, the more plaque shrank. The drugs pulled it hard. Your doctor can pull it too. And so can you, three times a day.

If your last cholesterol test is more than a couple of years old, get a new one. Know your LDL number, and ask your doctor what your personal target should be.

What about the side effects?

With any drug that you’d need to take for the rest of your life — and statins are in that category — people often worry about side-effects, both short and long-term. For most people, statins cause little trouble. But they do come with real potential side-effects, which are dose-dependent. Rosuvastatin’s can include trouble sleeping, joint pain, constipation, headaches, and memory lapses or forgetfulness. The rare-but-serious risks include muscle injury, along with liver problems and allergic reactions. Ezetimibe adds diarrhea for some people, with rare muscle and hypersensitivity reactions of its own. (Rosuvastatin side effects · Ezetimibe side effects) These are prescription drugs precisely because the risk-and-benefit math belongs with your doctor.

Which raises a fair question. Is there a second tool that pulls the same LDL lever — one available without a prescription, whose side-effect list runs in the positive direction?

Yes: your fork

Losing weight is the best-documented (and food-based) move. A meta-analysis of 70 studies found that losing weight by dieting reliably brings down both total and LDL cholesterol. Fiber is the second: a meta-analysis of 67 controlled trials found that each gram of daily soluble fiber (the kind in oats, beans, barley, and apples) lowered LDL by about 2 mg/dL. Five to ten grams a day, which is a bowl of oatmeal plus beans or lentils at lunch, works out to roughly a 10-to-20-point LDL reduction for many people. (That range is our own arithmetic from the study’s per-gram average, and individual results vary.)

Food alone rarely matches what the drugs did in this trial. Pills are stronger, and pretending otherwise helps nobody. But the straight-line finding cuts both ways: every single point of LDL you lower with a fork moves the same lever the drugs moved. When researchers tested the iDiet program itself, a high-fiber, low-glycemic eating plan with behavioral coaching: 133 participants lost about 18 pounds (8 kilograms) in six months, and their fasting total cholesterol, blood sugar, and blood pressure all improved significantly. (How fiber pulls cholesterol out of circulation is a story in itself; we explain it here: A Weight-Loss Diet for High Cholesterol.)

And now compare the two side-effect lists. Most people do fine on these drugs — but on paper, the drug pages list muscle pain, sleeplessness, liver warnings, memory lapses. The fork route: weight loss, steadier blood sugar, better nutrition — and, in our programs, something people don’t expect: brain retraining. Within two or three weeks of eating this way, cravings shift, and the healthy food starts being the food you actually want.

Food and medication work the same lever. They’re not rivals. If your doctor believes you need the medication, take the medication and eat well too. The trial’s straight line means every point counts, whichever tool lowers it.

Curious to learn more? See our programs here. More about OnDemand. Read Results and Testimonials. More about the science here.

Sources

Batra P, et al. Lifestyle intervention reduces body weight and improves cardiometabolic risk factors in worksites. Am J Clin Nutr. 2013;97(4):667–676. doi:10.3945/ajcn.112.046995

Mortensen MB, et al. Intensive vs More Intensive Lipid-Lowering Therapy and Plaque Regression in Statin-Naive Patients: Prespecified Analyses From the FLOWPROMOTE Randomized Clinical Trial. JAMA Cardiology. Published online October 30, 2026. doi:10.1001/jamacardio.2026.4788

Dattilo AM, Kris-Etherton PM. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr. 1992;56(2):320–328. doi:10.1093/ajcn/56.2.320

Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr. 1999;69(1):30–42. doi:10.1093/ajcn/69.1.30