Evidence and realistic goals for prevention

In this episode, I’m joined by cardiac dietitian Michelle Routhenstein to unpack why heart disease prevention is still so misunderstood. We explore cholesterol confusion, blood pressure, saturated fat, carbs, supplements, and why personalised nutrition matters far more than rigid dietary rules.

Michelle explains how food choices influence plaque progression, inflammation, gut health, and heart rhythm, and why sustainable habits, not extremes, are key for long-term cardiovascular health.

What We Cover

• Why heart disease is still largely preventable yet so common
• Cholesterol, ApoB, and the biggest nutrition myths patients face
• Blood pressure as the most powerful but ignored risk factor
• Soluble fibre, unsaturated fats, and gut health for heart protection
• Menopause, metabolic changes, and shifting cardiovascular risk
• Supplements vs food, and when medication still matters

A practical, evidence-based conversation on how to protect your heart for the long term.

You can learn more from Michelle Routhenstein by following her on Instagram, connecting with her on LinkedIn, or visiting her website for resources and ways to work with her.

• Intro (00:00:00)
• Nutrition Is Central to Heart Health (00:01:23)
• Prevention vs Treatment: Where Cardiology Gets It Wrong (00:04:20)
• Becoming a Cardiac Dietitian (00:09:47)
• Preventing Cardiovascular Disease Before It Starts (00:12:39)
• What a Truly Heart-Healthy Diet Looks Like (00:18:53)
• Carbohydrates & Heart Health Explained (00:23:40)
• Personalized Nutrition, Biomarkers & Omega-3s (00:30:35)
• Cholesterol, Fats & Fiber Explained Simply (00:46:32)
• Saturated vs Unsaturated Fats (00:48:17)
• Adjusting Diets Based on Cholesterol Response (00:53:20)
• Seed Oil Myths & Online Nutrition Controversies (01:13:28)
• Sodium, Visceral Fat & Cardiometabolic Risk (01:24:56)
• GLP-1s, Menopause & Individualized Heart Care (01:32:27)
• Real Patient Transformations & The Future of Cardiac Care (01:42:43)
• Supplements Can Support But Not Replace Nutrition (01:49:59)
• Dietitians & Cardiologists Working Together (02:05:39)

This episode is brought to you by:

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AirBnB

Right in the heart of the city, I’ve been hosting a hands-on Airbnb Experience at Little City Farm that’s all about plant diversity, gut health, and delicious food. For more information, or to find other experiences on your next trip, check out airbnb.com/experiences.

Simon Hill, MSc, BSc (Hons)

• Creator of theproof.com
• Host of The Proof with Simon Hill
• Author of The Proof is in the Plants

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