Cardiologist, lifestyle medicine physician, and longtime PLANTSTRONG partner Dr. Brian Asbill joined PLANTSTOCK to unpack what’s changed—and what still matters most—when it comes to preventing and reversing heart disease.
Fun fact: Dr. Asbill is part of the PLANTSTRONG Clinical Research Team and serves on the medical team at our in-person retreats, where he helps attendees safely reduce risk and, when appropriate, work with their clinicians to de-prescribe medications.

Here are the big learnings from his session.

1) “Reversal” isn’t theoretical—it’s personal

Dr. Asbill’s turning point came with George, a patient headed for a third bypass after two prior failures. Given Prevent and Reverse Heart Disease and a whole-food, plant-based plan, George returned 3 months later 27 pounds lighter, with LDL down ~100 points—and, most importantly, angina resolved (not just improved). He avoided the third surgery and lived ~13 more years. Cases like George’s cemented Brian’s mission: lifestyle first, meds when truly needed.

2) The pillars that move the needle (and how he ranks them)

Dr. Asbill’s “circle of truth” has many entry points. Start anywhere—just get in.

• 1A. Social connection. The most under-valued “vital sign.” Robust relationships predict longer life and better quality of life.
• 1B. Food. A low-fat, whole-food, plant-based pattern remains foundational for prevention and reversal.
• Exercise. Trains the endothelium, improves insulin sensitivity, lifts mood.
• Stress mastery. Chronic stress drives risk; build daily practices (breathwork, meditation, nature, journaling).
• Sleep. Recovery is medicine; aim for consistent, high-quality nights.
• Release harmful habits. “Toxin avoidance” in plain English: reduce or eliminate smoking, excess alcohol, and ultra-processed foods.

“Where you enter the circle doesn’t matter. Just enter.”

3) Why inflammation is the hidden accelerant

For atherosclerosis (the plaque that causes heart attacks), chronic inflammation:

• Erodes the glycocalyx (the gel-like protective lining on the endothelium), making arteries leakier to cholesterol.
• Invites immune cells into the arterial wall, escalating a damaging cascade.
• Weakens the plaque’s “fibrous cap,” raising the chance of rupture and clot—i.e., heart attack.

Lifestyle (food, movement, sleep, stress, connection) is the master switch that cools inflammation.

4) The two lab markers he wants you to know

ApoB (Apolipoprotein B)
Think of ApoB as the particle count of all atherogenic lipoproteins (VLDL → IDL → LDL). It’s often a better risk marker than LDL alone.

• A reasonable target for many: ApoB < 80 mg/dL
• With established cardiovascular disease: aim < 70 mg/dL (some clinicians push < 60)

Lp(a) [Lipoprotein(a)]
An LDL-like particle with an added protein that makes it more clot-prone. It’s genetic—so get it checked once. If it’s low/normal, you’re done. If it’s very high (e.g., ~300 nmol/L), you carry extra risk and should intensify lifestyle and work with your clinician; emerging therapies are on the way.
Note: Lab units and cutoffs vary—use your lab’s reference range and your clinician’s guidance.

Can lifestyle move these?

• ApoB: Yes—responds well to plant-strong eating, weight loss, and exercise (meds may still be warranted for some).
• Lp(a): Largely not lifestyle-responsive; knowing your number still helps personalize your plan.

5) Medications: how Dr. Asbill thinks about de-prescribing (safely)

Whole-food, plant-based living often lowers blood pressure and blood sugar quickly. That means some meds can become too much—fast.

• Never taper alone. Partner with a clinician (ideally lifestyle-medicine trained).
• Prioritize safety: Identify which meds affect BP/BS, reduce high doses first, avoid abrupt stops that risk rebound, and consider cost and side effects when choosing what to taper.
• Be your own advocate: If your provider isn’t open to lifestyle-first care, seek one who is.

6) Parting wisdom from the trail (and a silent retreat)

Fresh off sections of the Camino de Santiago and a five-day silent retreat, Dr. Asbill left us with three simple practices:

• Be curious. Loosen your grip on what you think you know.
• Go inward. Sustainable change starts inside, not “out there.”
• Be of service. Ask: Where can I add to this big equation in my small way?

Why this matters at PLANTSTRONG

Beyond the lecture circuit, Dr. Asbill is hands-on with our Clinical Research Team, helping us shape studies that measure real-world outcomes. At our in-person retreats, he’s part of the medical team supporting attendees as they implement change—safely, joyfully, and for the long haul.

Your next step

• Haven’t had an ApoB and Lp(a)? Ask your clinician at your next visit.
• Choose one pillar to elevate this week—add a daily walk with a friend, cook a plant-strong dinner, or guard your sleep like a prescription.
• Want guided support? Join us at a PLANTSTRONG Retreat—you’ll learn directly from physicians like Dr. Asbill while you experience the lifestyle, plate by plate.

Plant strong. 🌱