How I Cleaned 20 Years of Arterial Plaque

0:00 What if I told you that your arteries might be building up plaque at this very moment, even with a good diet and plenty of exercise? Really? It happens all the time. At age 57, I was doing everything right. Or at least everything that I thought was right. Marathons on the weekend. Low-fat diet. I even ran the preventive medicine program at Johns Hopkins. I taught the doctors there preventive medicine. If anybody should have had clean arteries, it would have been me because I practiced what I preached. And then, when I finally got scanned, the results said I had the arteries of a 73-year-old, and I was 57 at that time. I had serious risk of heart attack in the next few years, and after changing just a few things, though, about my lifestyle, I was able to reverse my own arterial plaque. That's very unusual. I'll tell you the story about it in this video.

1:01 Exactly how I did it. The clear, step-by-step plan you can follow, too, to heal your arteries and avoid a heart attack. At the end, I'll show you my latest results, the ones that show decades of following this same plan. But, in order for you to understand why the plan works, you need to understand what led me to build up that plaque in the first place, and why it might be happening to you, too. I was at a medical conference in Las Vegas when a colleague introduced me to a test called CIMT.

1:37 It's just a quick ultrasound of your neck, the arteries here. There's no radiation, takes 5 minutes, and I expected to get a clean result and do a victory lap for being in such good shape because I practiced what I preached. I I wrong. The scan showed two discrete plaques in the arteries of my neck. My arterial age was even more of an issue. It came back at age 73. Arterial age of of 73 when I was 57.

2:12 That was a gut punch. Once the shock wore off, and that took weeks, I researched further and found out that a bigger driver of arterial plaque, even more more than cholesterol, is actually metabolic disease. What you know is prediabetes and diabetes. Now, we always knew that this was the case. We just didn't know how common metabolic disease actually is. So, I came across a book from Dr. Joseph Kraft, and I decided to run an oral glucose tolerance test. It's the best test to find metabolic disease, prediabetes, diabetes. What you do is you drink a set amount of glucose, measure how your blood sugar was before the glucose, after the glucose an hour, and then 2 hours, and sometimes 3. My blood sugar peaked at over 160.

3:14 And that meant one thing. I had enough prediabetes to be building cardiovascular plaque, and I never knew it. This was age 57. The low-fat diet that I thought was protecting my arteries was actually full of glycemic carbs. I ate a lot of bread and grain products. Mhm, those were spiking my blood sugar every day. Sometimes three times a day. I hadn't been doing everything right.

3:47 Maybe you could say I'd been doing the wrong version of right on that low-fat, high-carb diet. If you noticed, for me, the first step was finding that I had a problem. But, how can you test yourself in the same way? Now, let's go and talk about my full plan here. Step one, test, don't guess. You can't fix what you don't measure. And the tests most doctors are running are not measuring what's actually killing and disabling people. And there are other useful tests, too, like the CIMT, which I started off with. The CIMT is what I now recommend as a starting point. It can show soft, unstable plaque, the kind that causes heart attacks years before any symptom appears. On top of that, there are inflammation markers that tell you whether that plaque is unstable or hot and dangerous, at risk for a clot.

4:46 tests like C-reactive protein and LP-PLA2. Both of these are blood tests that your doctor can order. The inflammation tests tell you if your plaque is stable or about to cause trouble. And there's just one more thing to begin with, and that's visceral fat. Not exactly body weight or even BMI, body mass index, visceral fat is the fat inside your abdomen, wrapped around your organs. It drives insulin resistance. One of the best ways to actually measure it is with a DEXA body scan, body composition scan.

5:23 The body composition version tells you exactly how much visceral fat you have. Again, you cannot fix what you don't measure, and the tests that matter are almost never the ones your doctor's already running. Feel free to download my free ebook about this problem with cholesterol and how to actually test for hidden markers that predict heart disease years before symptoms appear. Just click on the link or scan the QR code on the screen. Once you know what your problem is, step two, cut the right carbs. The diet question changed completely once I knew the root cause was blood sugar. It wasn't how do I eat healthy, it was what's my blood sugar doing after I eat. I switched from low fat to low carb after that glucose tolerance test and when it showed a spike to 160, I realized I need to be careful about carbs that can raise my blood sugar. That was really the single biggest change I made.

6:29 I made others. We'll talk about them, but that was the single biggest change I made. I stopped spiking my blood sugar. It drove more of the reversal than anything else and it does drive more of the reversal of risk than anything else, especially including medications. Now, not all carbs are the same. And this is where a lot of people go wrong. I had a patient tell me just today he was worried about carbs in Brussels sprouts and it's like don't worry about carbs in Brussels sprout sprouts.

7:05 Fiber-based carbs, non-starchy vegetables, these aren't going to spike your blood sugar. The problem carbs are what we call glycemic carbs like grain products. Glycemic means glucose in the blood. So, these are carbs that can raise your glucose in your blood. Most people think the biggest one is sugar and desserts. It's not for most people. For most people it's grain products, bread, rice, pasta, and yep, even oatmeal. I know oatmeal's got that big heart on the label and it tells you it's heart healthy. Eat a bowl of of oatmeal, and then 30 minutes later check your blood sugar. You'll see what I mean.

7:50 These things are the the bread, the pasta, the oatmeal, the rice. These are the things that drove my blood sugar over the threshold. And the threshold is 140 mg per deciliter if you're into the units. 140 after a meal. That's where inflammation begins in the artery wall. Now, you can sustain that once or twice, but when you do that day after day, two and even three times a day, every time your blood sugar goes over 140, your arteries are starting to take a hit in terms of inflammation and damaging that lining, and creating the space for plaque. This is not a once-a-year thing at your checkup. Twice a day, every day, or three times a day, and quite often even four for your typical person eating three meals, starting with pancakes, then going to a sandwich, a hoagie, and then eating pasta like spaghetti at dinner, plus snacks in between. A lot of people have blood sugar going over 200 and staying there most of the 24-hour period. Now, what did I replace these foods with? Some people need to close your ears. Eggs fried in butter. Bacon.

8:59 Yep, bacon. Avocado, salmon. Non-starchy vegetables like those brussels sprouts and broccoli and cauliflower and asparagus. Big Caesar salads with olive oil. Foods that kept my blood sugar flat for hours and kept me satisfied. Fasting is another piece. When you don't eat, insulin drops, and it continues to drop. There's no other way to lower insulin as effectively as not eating. Even narrowing of your eating window from 16 hours down to 12 or even eight. You know, the time that you eat. Instead of start of starting eating at 7:00 a.m.

9:39 and finishing at 7:00 p.m., shrink that down. That makes a metabolic difference. And if you get a spike, a meal that goes over 140, don't panic. Just take a walk, do some calf raises, a few lunges. That pulls that sugar out of your blood where it can irritate the lining of the wall of your artery and and prep that area for a plaque. And it takes that sugar and puts it into the cells where the muscles where it's very safe. It doesn't cause any problem at all. The next step is to incorporate the best anti-aging medicine that there is.

10:19 Step three, exercise. And use intensity. I had been running marathons for decades. Half marathons most weekends, believe it or not. I was into basketball, indoor basketball, and I was practicing and I was dribbling with two basketballs, and that was my thing. And I got a lot better at basketball, but I wasn't really helping my diabetes, my pre-diabetes, as much as I thought. I still built plaque. The question wasn't whether I was exercising, it was whether the exercise I was doing was actually fixing the metabolic problem, and it wasn't. Long-distance cardio builds aerobic fitness, but it doesn't efficiently improve insulin resistance. And insulin resistance is the root of this whole problem. You can be incredibly fit and still have terrible metabolic health. Not so good.

11:16 I was living proof. The key is your leg muscles. Your legs are by far your largest muscle group. And when those muscles are working, especially at intensity, they pull glucose directly out of your bloodstream. Now, you can see even just a walk will help pull that out. So, while I'm running long distance, I'm pulling that out that glucose out of the bloodstream. But, you Something you got to think about. Have you ever looked at the legs of a of a long-distance runner? They're very thin. You get decreased muscle there. You've got less and less tissue.

11:53 The The less muscle you have, the less tissue you have pulling that sugar out of the blood. So, these leg muscles are the body's largest natural defense against rising blood sugar. You need to have muscles in your legs that are metabolically active. When these muscles are working, especially at intensity, they pull glucose directly out of your bloodstream. They're the body's largest natural defense against rising blood sugar. Now, the more metabolically active your leg muscles are, the better your body handles glucose. High-intensity interval training, short intense bursts at around 90% effort for 40 to 60 seconds.

12:36 Recovery, repeat. I added REHIT, reduced exertion high-intensity interval training. 20 seconds all out, only two or three times per session. Then you're done. You can do a full REHIT session in 5 minutes, and I do a lot of that. I do mine on a stationary bike or on a rebounder or running hill sprints. Those 20 seconds are at full effort. You find it about 15 seconds you're saying, " am I going to make it to full 20 at this intensity?" That's what you need to be feeling at 15 seconds. We're talking about intensity here, but only do it twice. The metabolic impact is real.

13:18 It's been demonstrated. And you're not so burned out the rest of the day as one of these sessions where you do like 10 full intervals, a full hit session. I also added resistance training. It's focused on legs, not hours in the gym. Resistance snacks. some intensity with the resistance training for my legs. One week a one day a week or sometimes two that I go to the gym. But when I come home, I'm also doing resistance snacks. So 1 minute of wall sits plus 1 minute of a deep lunge on one side and 1 minute of a deep lunge on the other side for a total of 3 minutes.

13:55 Calf raises makes it another 2 minutes for a total of like 5 minutes. Do once in the morning, once in the evening, or even once a day when you're getting used to that because you're unless you're used to doing these, you're not going to be able to do 3 minutes of those kind of wall sits, squats, and lunges. Do a one-legged step squat on the stairs if you're not ready for it. the the deeper longer squats and lunges. A longer gym session once a week, that's really all you need. The cumulative effect on blood sugar management is very significant. It's more than you're going to get from supplements or medication.

14:33 Start where you are. If you're walking right now, walk. Add short bursts of speed to that walk. And then add a weight vest or a weight belt. Now, those you can get some good workouts with those, especially as you start walking up a hill. Work toward a short intense efforts and leg-focused resistance over time. The goal is not fitness for its own sake, it's metabolic function. That's what the goal is. Short intense work on your legs does more for your arteries than hours of slow cardio. And I'm not saying don't do the slow cardio, I'm saying don't forget the intensity. Now, what you eat and how you move, that's really about 80% of the work.

15:19 But there's a remaining 20% and it still matters. In fact, for a lot of people, the one thing keeping them from truly lowering their risk can be addressed in the next step. Step four, address roadblocks. Diet and exercise drove the biggest changes, but there were things that I hadn't been paying enough attention to and they were quietly undermining the progress. Sleep is the first one. I told myself I was one of those people who gets by fine on five or six hours of sleep.

15:52 But I I didn't feel great and the the reality was I was wrong. Poor sleep raises cortisol and cortisol spikes blood sugar. Elevated blood sugar drives inflammation, that same inflammation that builds plaque. You see where this is going. Studies have already demonstrated one night of bad sleep increases insulin resistance for the next 48 hours, one night. I also discovered I had some sleep apnea. It was mild, but it had an impact. My dental arch was high and narrow, which pushed my tongue back into my airway while I slept. When especially when I slept on my back and I was waking up, this was waking me up dozens of times a night and I wasn't even realizing it. I addressed it with some braces called Invisalign. They widened my arch over time and it helped. I also trained myself to sleep on my side. That helped.

16:50 My apnea improved a lot. My blood pressure dropped. Both showed up directly in the labs. The other piece was breathing. I had tried slow breathing for years and really I didn't get much out of it. But what I didn't know was that I wasn't slowing it down nearly enough. Normal breathing is 15 to 20 breaths per minute. To activate the vagus nerve, that's the body's natural anti-cortisol switch. To do that, you need to get down to 7 to 10 breaths in a minute. Half your normal rate. I used to buy a feedback device and for people that are curious, it's called Respirate. It helps you learn exactly what it feels like to breathe that slow and to expand what what we call expanding that that expiratory phase.

17:44 Once I understood the target, I could do it without the device. Inhale for 4 to 5 seconds and then exhale for 6 to 8. For do that for 10 minutes. It's a big impact and it impacts your blood pressure. You can tell just by measuring your blood pressure, it'll drop it. The stress markers, these things the impact on those is real, too. Chronic stress runs the same pathway as poor sleep because chronic stress our poor sleep is chronic stress. You just don't know about it because you're sleeping through it. Cortisol, inflammation, plaque.

18:21 If your nervous system is locked in a fight or flight mode all day, all night long, either one or both, your body's in a low-grade inflammatory state all day, all night long. Environmental exposures like chronic stress in relationships, absence of purpose, all of these things activate the same inflammatory pathways as bad food. And purpose? What? I know I know that sounds like soft territory, but fear alone does not keep you going.

18:54 Fear gets you started, purpose keeps you going. For me, it was two things: staying physically capable for the people I love and most of all, for turning my own wake-up call into something that helps other people avoid a heart attack or stroke. If your nervous system never rests, your arteries never fully heal. Sleep, stress, and purpose are not soft lifestyle factors. They're metabolic ones. They're important. Now, after all of this, one of the most common questions I get from patients is this, Dr. Brewer, what supplement can I take to just clean out my arteries? Let's talk about that.

19:38 Step five, supplement strategically. For most of my career, I thought supplements were basically just expensive urine. That was the consensus among the people I trained with. Now, finding plaque in my own arteries forced me to actually look at the evidence about supplements, and I was surprised by what some of what I found. Let me be clear up front. You can't out supplement a bad lifestyle, a bad diet. You got to fix the diet, fix the exercise, and fix the sleep, but supplements can support what's already happening.

20:14 They don't replace it. For specific gaps, the right ones can make a real difference. I started with vitamin D3 at 5,000 international units per day. Low D3 levels are directly linked to increased inflammation, cardiovascular risk, even diabetes and prediabetes. Most people in developed countries are deficient. I pair that with K2, 400 micrograms daily, not the 100 micrograms that you'll see on these D3 K2 combination pills. K2 improves calcium metabolism and heals the artery walls. There's also emerging evidence suggesting that K2 plays a role in improving insulin resistance. I predict that's going to become a much bigger story as the research continues. Now, let's talk about something else, niacin.

21:09 Niacin is worth talking about separately. It's the only supplement that simultaneously raises HDL, lowers LDL, lowers triglycerides, and lowers LP little A. Now, I'm not convinced that all those things are real bad actors, but I am convinced that they're very important bioindicators. And niacin has a positive impact on every one of them. LP little A, you may not have heard of. It's I won't won't get too deep down that bunny hole other than to say there's some very strong medicines that are coming up that look like they might impact LP little A in a positive way, but the jury's still out. The bottom line is we've known that LP little A elevation was a risk factor for a very long time. We just didn't know that well how to impact it.

22:00 I can tell you doing the things that we're talking about with lifestyle and niacin, those things actually do impact it. Magnesium, it's involved in over 300 processes in the body including blood pressure regulation and insulin sensitivity. I take two different forms of it, magnesium L-threonine 8 for brain health and sleep and and magnesium glycinate for muscle function and relaxation and again like sleep. Omega-3 fatty acids, EPA and DHA, they have strong evidence for cardiovascular risk reduction. So, even even if you eat a lot of fish like I do, supplementing adds a measurable benefit. Two others specifically for arterial plaque, two other supplements, think about them, aged garlic extract and nattokinase.

22:51 Both have direct evidence for impact on plaque stability. Supplements don't replace lifestyle as we said, but the right ones matched to your specific gaps can measurably support what diet and exercise are already doing. This next part is something that a lot of people are going to turn off on because a lot of people want to believe doctors only prescribe medications to make money. I have to tell you the harsh truth. Medications can be a powerful tool to help heal your arteries and close some of the gaps. But you have to use them the right way. Step six, medicate when necessary. For most of my career, I've been anti-medication. Patients came in expecting a prescription like an antibiotic for a sore throat, and I'd say, "Let's wait 3 days and see if that doesn't change." Now that's still good antibiotic stewardship. So there's things that have changed though as I continue to get deeper and deeper in terms of helping manage people with metabolic disease. When I found my my plaque in my own arteries, for example, and re-reviewed that evidence and what it says. The first medication I added was, and again, a lot of people will hate this, but it was a low-dose statin, and I did add that. I know.

24:14 I get a lot of hater comments for that, but I was not taking that low-dose statin to lower my LDL. That was not the goal. The evidence is clear that low-dose statins reduce cardiovascular inflammation. Remember we talked about that earlier in labs? That was my target, the vascular inflammation, not the cholesterol number. There's a massive difference also between 5 mg of rosuvastatin two or three times a week and 40 mg or even 80 mg of atorvastatin every day. One is an anti-inflammatory tool used strategically only for people with plaque, and the other one causes diabetes and doesn't reliably address inflammation for people who already have metabolic disease, and you're taking it every day to lower LDL, which is 10 times the number of people that we're talking about if you're just giving it for people that already have plaque.

25:12 I only use rosuvastatin or pitavastatin low doses, and it doesn't need to be every day. Blood pressure medication, yeah, I had some blood pressure problems, and so that came next. When my blood pressure hit 130 over 90 and didn't come back down, I needed to address it. I started with ramipril. It's an ACE inhibitor. You know, they end with -pril, like lisinopril, benazepril, ramipril. ACE inhibitors do something beyond blood pressure control.

25:43 They reduce inflammation, vascular inflammation, which we've been talking about several times through this video. I later switched to losartan. It's an ARB. It's and it's similar to ACE inhibitors, but it's better for people that have that recurring cough that sometimes comes with the ACE inhibitors, and it became a persistent problem for me. Keeping blood pressure in the optimal range protects your arteries from ongoing mechanical damage. Aspirin, low dose, 81 mg here in the US, once you have confirmed plaque, I recommend you consider again the low dose aspirin and the low dose statin. Because you're no longer in what we call primary prevention. You're no longer somebody that doesn't have cardiovascular disease. You're a cardiovascular disease patient. You're in secondary prevention.

26:39 You don't want that disease that you already have to get worse. I later switched to Eliquis. It's another blood thinner besides aspirin. And I had to do that because at one point I developed atrial fibrillation. It could the the Eliquis covers stroke risk from atrial fibrillation or atrial fib in a way that aspirin simply doesn't. Another medication, metformin. Roughly a gram or usually a half gram three to four days per week. Not to manage blood sugar directly, but for insulin sensitivity. And that dose, the concerns about mitochondrial stress that I've heard from yes, Ben Bickman and Rhonda Patrick and others, you're just not going to get significant mitochondrial stress from those kind of doses, half a gram three or four times a week.

27:31 Now, again, you can't out prescribe a bad lifestyle. Every one of these medications is not a replacement for lifestyle. It's an adjunct to help fill gaps. Diet, exercise, sleep, stress, those are doing the heavy lifting. The medications support that work while the root cause gets fixed. The right medication at the right dose at the right time for the right reason reduces inflammation and buys time while your lifestyle changes continue to do the real work. Now that you have the complete plan to heal your arteries, let me show you what that strategy did and what it helped me to achieve. Before I do, let me tell you something very important. If you want to take what you just learned and apply it directly to your body with me and my team guiding you, call the number on the screen or click the link in the description below.

28:29 The majority of my patients come to us after watching a video just like this and we'd love to help you out. So, okay, let's go to my latest results. I've been re-scanning my arteries every year since. But recently, I decided to go further than a CIMT. I got a CT angiogram with AI analysis. It was done through a company called Clearly. It's the most advanced imaging available for identifying the character of plaque in the arteries of the heart. Not just how much plaque you have, not just where the plaque is. What you want is a plaque analysis, the character. Soft and dangerous plaque or stable and calcified and how much, what portions you have of each of these. Because most of us have at least some mix.

29:21 And here's what the report showed. Soft plaque volume .1 cubic millimeters. On a practical basis, I have no unstable plaque in the arteries of my heart. That's the number that matters most. Soft plaque is what causes heart attacks. Mine is essentially gone. Now, I still have plaque. Total plaque, 75.6 cubic millimeters. 31 of that is completely stable, calcified plaque, locked in, not going anywhere.

29:52 The rest is higher density, non-calcified plaque that behaves stably. It's It's stable when your metabolism is managed. Now, let's talk about stenosis or narrowing of the arteries. Most of mine is under 10%. The highest was 17% in the LAD. Oh my gosh, that's the the widow maker, right? The left anterior descending. For a 67-year-old man with a diabetes diagnosis, that level of narrowing is really typical of someone under 40 years old. The percent atheroma volume, if you want to get technical, was 2.5%. The plumbing's wide open.

30:36 And my arterial age on the CIMT, it's still 58. I'm 67. I carry a diabetes diagnosis and have for a decade. I have 9p21. It's a cardiovascular genetic risk variant. Those of you that have read Beat the Heart Attack Gene, that's the gene they're talking about, 9p21. I also have atrial fibrillation. And my arteries look like those of someone over a decade younger than me.

31:08 A 67-year-old with diabetes and cardiovascular genetic risk and who follows this plan can have the arterial profile of someone decades younger, just like me. And these scans confirm it. My team and I have helped thousands of people do exactly what I just described in this video. Now, if you'd like to know how we can personally help you, click the link in the description below or call the number on your screen now to talk to our experts. So, you know the full strategy that reverse my plaque. Knowing this is one thing.

31:47 Knowing the hidden causes that build the plaque in the first place is another. And it's not the cholesterol number that you hear everywhere and apoB that everybody's now switching from No, it's not cholesterol, bad cholesterol, it's apoB. Watch this video. I think you'll be surprised by the evidence. And remember, growing old's not for sissies, but it's a lot easier with healthy arteries.