Cardiology Dietitian: The 5 Heart-Healthy Rules That Actually Lower LDL | Michelle Routhenstein

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In this episode of The Proof, I sit down with Michelle Routhenstein, a cardiac dietitian specialising in cardiovascular disease prevention and management. Michelle works closely with cardiologists and patients at all stages, from primary prevention to post heart attack care, translating complex lipid science into practical, sustainable nutrition strategies.

We unpack why heart disease remains the leading cause of death despite being largely preventable, and how confusion around cholesterol, saturated fat, carbohydrates, supplements, and dietary extremes is holding people back. Michelle explains how personalised nutrition, behaviour change, and understanding the “why” can dramatically improve cardiovascular outcomes and quality of life.

What We Cover
Why nutrition is still underused in cardiology, and the gap between guidelines and real-world application
The most common sources of confusion around cholesterol, ApoB, carbohydrates, saturated fat, and seed oils
How diet influences plaque progression, blood pressure, inflammation, and heart rhythm
Why soluble fibre, unsaturated fats, and gut health matter for lowering cardiovascular risk
The role of blood pressure as the most underrated and powerful heart health marker
What actually changes during perimenopause and menopause, and how nutrition should adapt
Why supplements rarely replace food or medication, and where they may still have a role
How sustainable habits, not restrictive diets, drive long-term heart health and health span

Michelle shares real clinical insights from working with patients who have reversed risk factors, stabilised disease, avoided procedures, and regained confidence in their health through evidence-based nutrition and lifestyle changes.

You can learn more from Michelle Routhenstein by following her on   / heart.health.nutritionist  , connecting with her on   / michellerouthenstein  , or visiting her https://www.entirelynourished.com/ 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)

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Enjoy, friends.
Simon

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Simon Hill, MSc, BSc (Hons)
Creator of http://theproof.com/