Can Diet and Exercise Lower Your Calcium Score?

October 12, 2025 •

4 min read

A coronary artery calcium (CAC) score measures the amount of calcified plaque in the heart's arteries, which serves as a predictor for future cardiovascular events. While lifestyle changes cannot reverse existing calcification, can diet and exercise lower your calcium score by halting plaque progression and improving overall heart health?

Quick Summary

Lifestyle modifications like a heart-healthy diet and regular exercise cannot reverse existing coronary calcification. However, they are highly effective at slowing plaque progression, stabilizing existing deposits, and dramatically reducing the overall risk of heart attack or stroke.

Key Points

No Reversal: Once formed, calcium deposits in the arteries cannot be reversed or removed by diet and exercise alone.
Halt Progression: Adopting a heart-healthy diet and regular exercise is highly effective at slowing down or stopping the progression of arterial plaque buildup.
Reduce Risk: Improving cardiovascular health through lifestyle changes significantly lowers the overall risk of heart attack and stroke, even with an elevated calcium score.
Dietary Strategies: Prioritizing a Mediterranean or DASH-style diet, rich in healthy fats, fiber, and nutrients like Vitamin K, is crucial for managing risk factors.
Exercise Benefits: Regular, moderate-intensity exercise improves heart function, manages weight, lowers blood pressure, and promotes stable plaque, dramatically cutting future event risk.
Holistic Approach: Combining diet and exercise with stress management, sufficient sleep, and prescribed medication provides the most comprehensive defense against heart disease.

Understanding the Coronary Artery Calcium (CAC) Score

A coronary artery calcium (CAC) score is obtained from a specialized, non-invasive computed tomography (CT) scan that measures the amount of calcified plaque in the coronary arteries. The presence of this calcium is a direct indicator of atherosclerosis, or hardening of the arteries, and a higher score signifies a greater risk of heart attack or other cardiovascular events. A score of zero is considered ideal and suggests a very low risk of a cardiac event over the next several years. Scores above zero indicate the presence of plaque, with risk increasing significantly at higher thresholds (e.g., above 100 or 300).

The Truth About Lowering Your Score

One of the most important takeaways for anyone concerned about their CAC score is that once calcium has been deposited in the arteries, it is generally considered irreversible through diet and exercise alone. The score itself is a measure of this static, calcified material. Therefore, the goal of lifestyle interventions is not to reduce the numerical score but to slow or stop the progression of plaque buildup and reduce the overall risk of a cardiovascular event. By managing risk factors like high cholesterol, high blood pressure, and inflammation, diet and exercise work to stabilize existing plaque, making it less likely to rupture and cause a heart attack.

The Impact of Diet on Arterial Health

A heart-healthy diet is one of the most powerful tools for managing the risk factors associated with coronary calcification. It helps to regulate cholesterol and blood pressure, reduce inflammation, and support overall endothelial function.

Here are key dietary strategies:

Adopt a Mediterranean-style or DASH diet: These eating patterns emphasize fruits, vegetables, whole grains, legumes, and healthy fats like those from olive oil, nuts, and seeds.
Prioritize omega-3 fatty acids: Found in fatty fish like salmon and mackerel, these healthy fats help lower triglycerides and reduce inflammation.
Consume leafy greens: Foods like spinach and kale are rich in vitamin K, which helps prevent calcium from depositing in the arteries.
Boost fiber intake: Oats, beans, and lentils are packed with soluble fiber that acts like a sponge, soaking up excess cholesterol before it can contribute to plaque formation.
Limit saturated and trans fats: Avoid processed meats, fried foods, and full-fat dairy, which can increase 'bad' LDL cholesterol.
Reduce sodium and sugar: Excessive intake of salt and added sugars contributes to high blood pressure and other metabolic issues linked to atherosclerosis.

The Role of Exercise in Managing Heart Disease

Regular physical activity is vital for cardiovascular health, even with an elevated CAC score. Exercise directly addresses key risk factors, strengthening the heart and improving overall circulatory function.

Exercise recommendations include:

Moderate aerobic exercise: Aim for at least 150 minutes per week of activities like brisk walking, swimming, or cycling. Studies show that maintaining high cardiorespiratory fitness with moderate intensity can lead to lower CAC scores over time.
Vigorous aerobic exercise: Higher-intensity activities, such as running or high-intensity interval training, can also provide significant benefits. However, some research notes a complex relationship, particularly in high-volume endurance athletes, where very intense exercise might correlate with higher CAC scores, but still provides overall cardiovascular protection by promoting a more stable plaque composition.
Strength training: Incorporate muscle-strengthening activities at least two days a week to support metabolism and weight management.

Beyond Diet and Exercise: A Holistic Approach

Effective management of heart health requires a comprehensive strategy that goes beyond just diet and exercise. This includes:

Medication: Based on your CAC score and other risk factors, your doctor may recommend statins to lower cholesterol, aspirin to prevent clots, or other medications to manage blood pressure or diabetes.
Smoking Cessation: Quitting smoking is one of the most impactful steps you can take to reduce heart disease risk.
Stress Management: Chronic stress can negatively impact heart health. Finding healthy outlets like mindfulness, yoga, or relaxation techniques is crucial.
Sleep: Aim for 7-9 hours of quality sleep per night, as poor sleep is linked to increased cardiovascular risk factors.

Actionable Steps for Heart Health: Diet vs. Exercise


Feature	Diet	Exercise
Primary Mechanism	Modulates cholesterol, blood sugar, inflammation, and nutrient intake.	Improves cardiorespiratory fitness, blood pressure, weight management, and circulation.
Effect on Plaque	Helps prevent new plaque formation and stabilizes existing plaque.	Promotes plaque stabilization, improves endothelial function, and reduces cardiovascular risk.
Timeframe	Changes can begin to affect risk factors within weeks to months.	Regular practice leads to sustained cardiovascular benefits over time.
Impact on CAC Score	Does not reverse calcified plaque, but halts progression.	Does not reverse calcified plaque, but halts progression and reduces event risk.
Key Outcome	Better lipid profiles, blood pressure, and reduced inflammation.	Stronger heart, better circulation, reduced event risk, improved fitness.

Conclusion

While the concept of reversing a coronary calcium score through diet and exercise is a common misconception, the reality is far more meaningful. These lifestyle changes provide the critical tools needed to stabilize existing plaque and aggressively prevent further coronary artery calcification. By adopting a heart-healthy diet, committing to regular physical activity, and addressing other risk factors, individuals can profoundly improve their cardiovascular prognosis, regardless of their current score. The CAC score is a call to action, not a final verdict, and effective lifestyle management is the most powerful response. For personalized guidance and the most effective treatment plan, consult your healthcare provider to discuss your specific CAC results and health profile. The American Heart Association offers comprehensive resources for taking proactive steps toward better heart health.

American Heart Association - Lifestyle Changes for Heart Attack Prevention

Frequently Asked Questions

No, a coronary artery calcium score cannot be lowered naturally because the calcified plaque is permanent. However, lifestyle changes can halt the progression of further buildup and significantly reduce your overall cardiovascular risk.

The primary goal is to stabilize existing plaque and prevent further buildup. By managing underlying risk factors like cholesterol, blood pressure, and inflammation, diet and exercise dramatically reduce the likelihood of a plaque rupture and subsequent heart attack.

Yes, research shows some differences. While both are beneficial, very high-volume, intense exercise might correlate with higher CAC scores in some individuals, particularly male endurance athletes. However, regular moderate-intensity exercise is consistently linked to lower CAC scores over time and fewer cardiovascular events.

Diets rich in fruits, vegetables, whole grains, lean proteins, and healthy fats are most beneficial. The Mediterranean and DASH diets are prime examples, as they focus on reducing risk factors like high cholesterol and blood pressure.

No, a high CAC score indicates a higher risk, regardless of your fitness level. While regular exercise provides major cardiovascular benefits, it does not fully negate the increased risk associated with the presence of calcified plaque.

Statins, like diet and exercise, do not remove or lower the existing calcium in your arteries. Their purpose is to lower LDL ('bad') cholesterol to help prevent further plaque buildup.

If you have an abnormal score, repeating the scan isn't typically necessary, as the score won't change. The focus should be on intensive management of risk factors. A follow-up scan is most useful if your initial score was zero, to see if new calcification has occurred.