A low-fat diet and cholesterol reduction. They were the prescription for heart disease in 1994, along with smoking cessation and activity. They were the prescription before 1994 and since then too, because they worked. The only thing that has changed in recent years is the influx of money from parties that would suffer: the meat industry, the dairy and egg industries, and other industries with a stake in Big Food. They advertised, they influenced USDA Dietary Guidelines, and, the most insidious? They published studies in peer-reviewed journals to sow doubt.

Here we go. 1994. How to avoid a heart attack without drugs or surgery:

Reversal of Coronary Atherosclerosis, Clinical Promise as the Basis for Noninvasive Management of Coronary Artery Disease, K. Lance Gould MD, Circulation, 1994

Angioplasty, stents, and bypass surgery fix local problems. But narrowing of vessels is a systemic problem, it doesn’t just happen in one or two places:

Coronary atherosclerosis is a diffuse process in the entire epicardial coronary artery tree, subject throughout to the risk of plaque rupture and associated coronary events in the absence of vigorous risk factor management.

So, what is vigorous risk factor management? Specifically:

Very low fat diets (less than 10% of calories as fat), tend to show greater benefit on regression or prevention of events than studies with less vigorous intervention.

These new approaches to the treatment of coronary atherosclerosis provide a relatively low-cost alternative to traditional invasive approaches that markedly decreases myocardial infarction, death, balloon angioplasty, or bypass surgery in patients with moderate or severe coronary artery stenoses.

For optimal probability of partial reversal and preventing coronary events with a certainty comparable to or better than invasive alternatives, a reversal regimen should achieve lean body mass, total cholesterol of 140 mg/dl or below, low-density lipoprotein below 80 to 90 mg/dl, HDL 45 mg/dl or above, and absence of smoking. At these goals, coronary events are simply uncommon.

Here’s a hearty low-fat vegetable soup to get you started, or to keep you going, or just because it tastes good:

Lentil Vegetable Soup, Forks Over Knives, May 2014

(I like these sped-up videos. You can get the whole idea in less than a minute.)