A new study, published this week in the Journal of Geriatric Cardiology, suggests that a diet low in animal-based foods and high in plant-based foods may lower the risk of atherosclerosis in people with type 2 diabetes.

The research team, headed up by Robert Ostfeld, presented the case of a 77-year-old woman with unstable angina, whose symptoms resolved while consuming a whole-food plant-based diet.

The information collated by the researchers highlight the potential of this lifestyle to help rapidly improve angina and to contribute to improving atherosclerosis, a common diabetes-related complication that causes most mortality in patients.

Until now, proven medical therapy for atherosclerosis wasn’t completely understood by the scientific community. These study findings suggest that this disease can, in part, be modifiable through changes in dietary behaviors.

The 77-year old participant suffering from chronic dyspnea prior to the study saw her symptoms dramatically improve after the adoption of a plant-based diet. The patient eliminated all animal derived products such as eggs, cow’s milk, yoghurt, chicken and beef. The rest of her diet included all vegetables, fruits, whole grains, potatoes, beans, legumes and nuts.

One month later, she was able to sustain physical activity for up to 50 minutes without chest discomfort. Over three months, her total cholesterol had gone down from 5.7 mmol/L to 3.2 mmol/L, and her LDL cholesterol – a surrogate end point for the evaluation of heart disease risks in people with type 2 diabetes – decreased from 3.67 mmol/L to 1.5 mmol/L.

She was, however, taking 80 mg of a high-potency statin (atorvastatin) daily, which could explain most of the dramatic decrease in LDL and overall improvement in her cholesterol levels.

In the second phase of the study, researchers tested the absolute effectiveness of the diet. Four to five months after changing her eating habits, she went back to consuming chicken, fish, low fat dairy and other animal products multiple times per day.

Subsequently, her anginal symptoms returned within four to six weeks and she had to undergo coronary artery bypass graft surgery (CABG).

These observational findings validated those of previous large population-based studies that had found evidence of the association between consumption of animal products with both increased mortality and incidence of atherosclerotic cardiovascular disease.

The multiple favorable mechanisms evocated by the authors responsible for the improvement of such a condition include beneficial effects to plasma lipids as well as better weight and glycemic control.

Elements of the report also have ramifications to other epidemiology, pathophysiolohy and therapy reviews of atherosclerosis involving highly regulated systems in the body, such as the absorption of cholesterol, another variable that can either improve or worsen cardiovascular outcomes.

One of them includes exogenous consumption – by way of eating – of phytosterols, from plants. People in the past have taken elevated doses of phytosterols as a way to prevent the absorption of cholesterol, but recent research show phytosterols on a molecule per molecule basis is far more atherogenic than cholesterol.

This calls the need for further research and controlled trials without statins to measure the risk factor associated with the induced elevation in phytosterols of transitioning to a more plant-based diet.

The possibility of receiving preventive interventions like removing animal protein from the diet to reduce cardiovascular disease is promising for most patients with diabetes who are at serious risks to die from complications of atherosclerosis.

Such a dietary therapy does not have evident adverse effects in a patient’s health, as opposed to inherent mechanisms of heavy lipid-lowering therapy or blood pressure control, for example.

The implementation of a meal plan more favorable that keep the risks of atherosclerosis at bay, like a healthy vegetarian-like diet, isn’t cumbersome either.

People with type 2 diabetes who are following our low-carb program get some similar benefits to a strictly vegetarian diet with an elevated intake of fibre and other important micronutrients that have been shown to partially positively influence factors in a metabolic disorder.

This discovery about animal protein being to some extent harmful to a population that has predispositions to atherosclerosis could inform changes in the guidelines of a typical low-carb program.

For instance, our low carb program – which consist in replacing carbohydrates with green vegetables and pulses along with other healthy swaps – can be tweaked accordingly to prefer plant-based protein as the recommended small portion of protein with every meal rather than meat.