How to hit reset after years of unhealthy living

By Naveed Saleh, MD, MS, for MDLinx
Published February 1, 2019

Key Takeaways

Is it too late to change your unhealthy lifestyle? Maybe you’ve eaten one too many hamburgers or made it a daily habit to buy salty chips from the vending machine. Maybe you’ve purchased a gym membership only to stop going after a month. Poor food and exercise choices over prolonged periods of time may lead to severe health consequences. But does that mean it’s too late to change? Can a history of inactivity and unhealthy eating be reversed? More specifically, can the damage done to your coronary arteries in the form of atherosclerosis be undone?

It turns out that successfully countering years of poor lifestyle choices and plaque buildup is complicated and requires plenty of elbow grease, but it’s not impossible.


According to the most recent report from the American Heart Association (AHA), nearly half of American adults suffer from some form of cardiovascular disease, and the number of related deaths in the US is on the rise, although it continues to drop globally.

Plaque buildup in the coronary arteries increases the risk of heart disease. Plaques can be shrunk and stabilized through intervention, but they can never be zapped out of existence.

Results from some studies indicate that intense lifestyle changes may shrink plaques. But a more realistic goal is to halt the progression of the plaque to decrease risk of heart attack and stroke. Preventive strategies have been linked to an 80% risk reduction in heart disease.

Statins, such as lovastatin and pravastatin, play the most important role in fighting plaques. These medications lower low-density lipoprotein (LDL) levels, and LDLs are what deposit cholesterol into blood vessel walls.


Changing your diet at any age to mitigate the risk of heart disease requires real dedication. The number one recommendation from the AHA is to lose weight and then maintain a healthy body weight. Here are some recommended steps to take to do so, per the AHA:

  • Eat plenty of fruits and veggies.
  • Eat fish twice a week.
  • Eat whole-grain, high-fiber foods.
  • Decrease saturated fat intake to less than 7% of calorie intake.
  • Decrease trans fat to less than 1% of calorie intake.
  • Decrease cholesterol to less than 300 mg/d per day.
  • Balance calorie intake with exercise.
  • Switch to lean meats and low-fat or fat-free dairy.
  • Minimize the consumption of hydrogenated fats.
  • Minimize the consumption of foods with added sugar.
  • Prepare food with little or no salt.
  • Drink alcohol only in moderation.

Dietary change can be simplified just by adhering to a Mediterranean-style diet. This diet on its own can drop heart disease risk by 30%. The Mediterranean diet is rich in fruits, vegetables, olive oil, nuts, and fish, while low in red and processed meats. It also includes modest amounts of cheese and wine. Ultimately, the diet is balanced and varied.


Regular exercise can increase high-density lipoprotein (HDL or “good cholesterol”), burn fat, and decrease blood sugar levels. Exercise can also decrease LDL levels when coupled with dietary changes. Strive for a total of 150 minutes of moderate-intensity exercise per week.?


Because smoking cigarettes damages arteries, smoking cessation is one key to mitigating heart disease risk. Moreover, smoking cessation increases HDL levels.

Blood pressure

The AHA now characterizes high blood pressure as 130/80 mm Hg or above, which is lower than the previous mark of 140/90 mm Hg. Hypertension is a big cause of heart disease, and if your blood pressure is higher than 130/80 mm Hg, it’s best to watch your diet and exercise more regularly to decrease your risk of illness, and perhaps begin taking antihypertensive medication.


Low-dose aspirin therapy might help mitigate the risk of heart disease in people aged between 50 and 69 years who have a 10% or greater chance of developing heart disease during the next 10 years. Please note that there are contraindications to aspirin use, including ulcers and bleeding disorders.

Understandably, it’s hard to make major lifestyle changes—even when faced with the stress of future heart disease. Don’t be too hard on yourself if you can’t make such changes immediately. The process of changing health behaviors has been proposed to occur in the following four steps: 1) contemplation; 2) preparation; 3) action; and 4) maintenance. In other words, once you ponder and prepare yourself, which can take some time, you’ll be ready to make lasting changes and counteract years of unhealthy choices at any age.

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