Eating Plant-Based for Your Heart? These Are the Best Lab Tests to Track Your Progress

Adopting a whole-food, plant-based (WFPB) diet is one of the most effective lifestyle changes a person can make to reduce cardiovascular disease risk. As a physician who specializes in using lifestyle medicine to prevent and treat cardiovascular disease, I’ve seen firsthand how this way of eating can improve heart health via multiple angles, including cholesterol levels, arterial function, inflammation, blood sugar control, and overall metabolic health. Lab testing can be a useful tool for objectively tracking these changes, to understand how your body is responding and whether any additional adjustments may be helpful. But with so many possible tests available, it’s not always clear which ones provide the most meaningful data. Below is an overview of the most informative lab tests for assessing your heart health, along with guidance on how to interpret them in the context of a whole-food, plant-based diet.

A standard lipid panel is the logical place to start and is widely available. It measures:

These markers provide a general snapshot of cholesterol and triglyceride levels in the blood. However, in some cases they don’t fully capture cardiovascular risk. For a clearer picture, additional testing can be helpful.

Apolipoprotein B (apoB) is one of the most valuable tests for assessing cardiovascular risk. ApoB reflects the total number of atherogenic (plaque-promoting) lipoprotein particles in the blood. Each ApoB particle has the potential to penetrate artery walls and contribute to plaque formation. Two people can have the same LDL cholesterol level but very different numbers of apoB—and therefore very different levels of risk.

Compared with LDL alone, apoB is more reliably linked to cardiovascular outcomes and is especially helpful for refining risk.

Testing lipoprotein(a), or Lp(a) is also very important. Lp(a) is a potent, genetically influenced risk factor for cardiovascular disease. Unlike many other markers, Lp(a) doesn’t respond much to diet or currently available medications, but knowing your level helps put the rest of your results into proper context. If Lp(a) is high, being especially diligent about all other modifiable risk factors can still make a big difference, even if Lp(a) doesn’t go down.

High-sensitivity C-reactive protein (hs-CRP) measures systemic inflammation, which is an independent contributor to cardiovascular disease. Elevated inflammation can increase risk even when cholesterol markers appear well controlled.

Hs-CRP is often very responsive to a whole-food, plant-based diet, making it a useful way to track how your dietary changes are reducing your inflammatory burden over time.

Metabolic health also plays a major role in cardiovascular risk because it impacts the environment surrounding the blood vessels and how vulnerable they are to damage from cholesterol particles. Poor blood sugar control and insulin resistance can amplify cardiovascular risk—even when LDL or apoB levels are only moderately elevated.

Two key markers help assess risk in this area:

Thyroid-stimulating hormone (TSH) helps assess thyroid function, which can significantly affect LDL cholesterol and apoB levels.

Elevated homocysteine may contribute to cardiovascular risk. Homocysteine is influenced by B-vitamin status, particularly vitamin B12 and folate.

Blood tests offer valuable information, but they don’t directly show whether plaque has already formed in the arteries. While it is not yet a standard guideline recommendation, I often recommend considering a one-time coronary artery calcium (CAC) scan in midlife (around ages 45 to 55 for men, 50 to 60 for women).

A CAC scan can reveal calcified plaque in the coronary arteries and help refine risk assessment beyond blood markers alone.

In addition, blood pressure should be monitored at least yearly starting in adolescence and continuing throughout adulthood.

These targets are provided as general reference ranges; individual goals may vary based on personal risk and medical history.

Lipid Panel

apoB

Lp(a)

hs-CRP

Hemoglobin A1c

TSH

Homocysteine

A WFPB diet can meaningfully reduce cardiovascular risk, but lab testing can help confirm that improvements are occurring across the pathways that matter most.

If only two or three blood tests are feasible, focusing on apolipoprotein B (apoB), high-sensitivity C-reactive protein (hs-CRP), and hemoglobin A1c captures a large proportion of cardiovascular risk from complementary angles.

Combined with non-lab metrics that are free and readily available (such as blood pressure, waist-to-hip ratio, and family history), this approach provides a surprisingly comprehensive picture of heart health.

Used thoughtfully and reviewed with a clinician, these tools can help guide adjustments and ensure that a whole-food, plant-based diet is delivering its full cardiovascular benefit.