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 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)
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More about Michelle Routhenstein
Michelle Routhenstein, MS, RD, CDCES, CDN is a preventive cardiology dietitian and the founder of Entirely Nourished, a virtual nutrition counseling practice dedicated to helping people take control of their heart health through personalized, science-based nutrition. With over 14 years of experience as a registered dietitian specializing in cardiovascular disease, Michelle takes a whole-person nutrition approach, considering all aspects of heart health including inflammation, blood pressure, heart function, heartbeat regularity, cholesterol, blood sugar, and other key factors. She helps clients improve their cardiometabolic risk profile, stabilize atherosclerosis, and support the prevention and management of heart failure and atrial fibrillation. Michelle translates the science into personalized, practical guidance and empowers clients to make meaningful, lasting changes that are enjoyable, sustainable, and life-enhancing. She earned her Bachelor’s and Master’s degrees in Clinical Nutrition from New York University, where she also completed her dietetic residency. Before starting her practice, she worked in New York City hospitals, including a Level 1 trauma center, managing complex cases and seeing firsthand the powerful impact of nutrition on recovery and long-term health. Michelle serves on the Forbes Health Advisory Board and the Medical Advisory Committee for the National Menopause Foundation. She is the author of The Truly Easy Heart-Healthy Cookbook and has been featured in Forbes Health, Fox News, Medical News Today, Prevention, Women’s Health, GLAMOUR, Health, Good Housekeeping, and VeryWell Health. Outside of work, Michelle enjoys exploring life with her husband and four sons through travel, biking, delicious food, and family experiences. She lives in New York and works with clients virtually. Visit www.entirelynourished.com to learn more.
