Cardiovascular risk factors include all the causes of inflammatory cholesterol plaque buildup and subsequent cardiovascular events. Doctors use the Australian CVD risk calculator to estimate your 5-year probability of death or hospitalisation from cardiovascular disease. The calculator combines classic heart risk factors like high cholesterol, high blood pressure, diabetes, and smoking to produce a total risk score. If you have had a previous major cardiovascular event – myocardial infarction, angina, coronary artery bypass operation or coronary artery stents – you already qualify as high risk. Small elevations in multiple risk factors can add as much risk as a single moderately elevated factor.
The current treatment paradigm centres on identifying high-risk patients and treating risk factors with pharmaceuticals. This approach is moderately effective in high-risk patients but is fundamentally flawed. It considers only a limited core of risk factors, primarily those with effective drugs, and fails to address the causes of elevated risk factors, particularly the patient’s diet. Animal products and processed foods increase most risk factors, while whole plant foods reduce them. A whole foods, plant-based diet addresses not only classic risk factors (ie., cholesterol, blood pressure, diabetes, obesity), but also non-traditional risk factors like oxidative stress, inflammation, insulin resistance, endothelial cell function and gut microbial products (eg., TMAO). This breadth of effect confers a greater benefit than medications alone.
Some risk factors cannot be reduced by drugs or lifestyle. You can’t go back in time and undo the damage already done by age and lifestyle. You may have a family history of early heart disease that’s not explained by traditional risk factors, or carry a known genetically determined risk factor like Lp(a). Lipoprotein(a) is an inherited blood protein that accentuates the risk of LDL cholesterol particles. Another common risk factor is elevated LDL cholesterol that responds only partially to diet. If you are stuck with a cardiovascular risk factor and wonder what to do, the solution is that you will need to do even better at reducing all the other risk factors to stay well.
WFPB and non-traditional risk factors
Whole plant foods protect our bodies against oxidative stress by providing plant (and mushroom) antioxidants that protect molecules like cholesterol from oxidation. Oxidised cholesterol damages arteries. Some phytonutrients in plants act by boosting our body’s own antioxidant defences. Meat, fried food and ultraprocessed foods increase oxidative stress. Haeme iron in meat, chicken, and fish is a pro-oxidant molecule and a heart risk factor.
Atherosclerosis (cholesterol plaque build-up in arteries) is an inflammatory process. (“A cauldron of inflammation”, Dr Esselstyn). Phytonutrients in whole plant foods downregulate inflammation. Changing to a plant-based diet has been shown to reduce CRP, a blood marker for inflammation and a cardiovascular risk factor.
TMAO (trimethylamine-N-oxide) is an artery-damaging substance produced by gut microbes from excess choline in eggs ( and other animal products) and carnitine in red meat (and sports supplements). A vegan gut microbiome does not produce TMAO. Multifaceted research has established TMAO as a cardiac risk factor. If there were a drug to treat TMAO, doctors would all know about it.
Other notable postbiotics include PAG (associated with heart failure) and short-chain fatty acids (SCFAs) like butyrate, which improve blood glucose control and enhance artery health. The gut microbiome produces SCFAs from dietary fibre and undigested starches in whole plant foods.
The nitrates in green leafy vegetables provide a substrate for endothelial cells to produce nitric oxide, a potent vasodilator and key supporter of artery health. See Endothelial Health
Insulin resistance is a cardiovascular risk factor that a low-fat, whole food, plant-based diet and physical activity can reverse. Even mild insulin resistance increases heart risk, long before it progresses to type 2 diabetes. Dietary saturated fat, excess calories, and sarcopenia (disuse atrophy of muscles) worsen insulin resistance.
Obesity, particularly the accumulation of fat within the abdominal organs, adversely impacts standard risk factors and overall heart risk. Switching to a whole foods, plant-based diet reliably leads to weight loss without restricting food quantity.
Page created 20th September 2026
Last updated 20th September 2026