Many studies have shown that around half of all men in their 20's have significant arterial plaque (atherosclerosis). This plaque buildup causes all kinds of problems and one of the first major signs is often erectile dysfunction. There is good news though: you can actually clear out your arteries!
I personally believe that most of you can actually clear out ALL of your plaque or at least make significant improvements. The will lead to nice gains in blood flow and nitric oxide in the process.
So how do you do this? No, the correct answer is not by taking massive doses of statins (in my opinion)! There are actually studies showing that statins can reverse plaque in some cases. However, they personally make me uncomfortable for reasons I outline in my article on The Potential Dangers of Statins. But, if you have existing cardiovascular illness, you and your physician have to decide what is best for your situation of course.
In the meantime, I want to outline Six Natural Ways to Clear Out Your Arteries. Most of these strategies come from the men that I call the Plaque Reversers - clinicians that have built up a substantial practice and reputation for actually reversing plaque with many patients. All of them have written extensively about their experiences and are apostles for heart health. The significant of their work cannot be overestimated in my opinion, because plaque is the #1 killer of men (in modern societies). In addition, unchecked atherosclerosis can lead to:
1. Less nitric oxide and, therefore, worse erections and increased heart disease.
2. Hardening of the arteries
3. Increasing blood pressure, a risk factor for erectile dysfunction, stroke and many other medical conditions.
4. Great risk of a heart attack, triggered by "pieces" of plaque breaking off (coupled with coagulation)
5. Surgeries, stints, angioplasties and countless office visits and drugs.
6. Angina (heart pain)
I constantly say "testosterone affects everything." I could just as easily say "artery health affects everything." Decreased blood flow and/or calcifiicatrion, for example, have been linked to dementias, Parkinson's and Alzheimer's.  There is evidence that calcification of the smaller vessels is responsibe for a lot of lower back pain that Westerners experince.  Many tissues require good blood flow to deliver nutrients. This list could go on and on, but the key point is that clearing out your arteries (and smaller vessels) can be a key factor in improving endothelial and general health.
Let's look at some of the natural and semi-natural strategies out there:
1. Dr. Gould (Heal Your Heart). Few men have heard of Dr. K. Lance Gould, but he has written a must-read book that I discuss in my Review of Heal Your Heart. If you need motivation to get started on an anti-plaque journey, this is probably the best book to do so, because it is just packed with data. Dr. Gould includes studies showing how our meals create plaque, the age at which plaque begins to form and the consequences of what happens as the plaque begins to grow and take on a life of its own. Of course, he also carefully carves out his methodology for reversing plaque:
The advantages that I see with his diet is that he allows men to have some low fat meat and dairy, which would make a low fat diet much more palatable for the typical man that has grown up in a modern lifestyle. The disadvantage is his use of statins, which many men feel uncomfortable with, for many of his heart patients, i.e. those with significant existing arterial plaque. In addition, I personally feel uncomfortable with too much dairy as this can potentially increase prostate and other cancer risk.
2. Weight Loss. One of the best to regress plaque is to just lose weight according to one study. This study showed that it didn't matter how the participants ate: as long as the lost weight, their atherosclerosis receded equally. I cover this very interesting study on this page: Arterial Plaque and Weight Loss . Most men reading this are probably 20-50 pounds overweight. If they gradually lose that weight over a couple of years, it is very likely that they can achieve several years of plaque regression and get their arteries back. This is very important for erectile strength and, well, survival. (I have a lot of additional information on the subject here: My Weight Loss Pages, Testosterone and Weight Loss and A Study Showing That Reducing Calories Too Much Can GREATLY Lower T Levels.
3. Prevent and Reverse Heart Disease (Dr. Esselstyn). Some of you health veterans may remember that the first researrcher to really prove that you could regress plaque was Dr. Dean Ornish. Dr. Ornish emphasized an almost entirely plant-based diet but did allow some non-fat dairy. He also insisted on some exercise, stress management, etc. A physician with a similar protocol was Dr. Caldwell Esselstyn, who is now very well-known for his work at the Cleveland Clinic. As I discuss in my Review of Prevent and Reverse Heart Disease, Dr. Esselstyn's program is probably the most simple and striaghtforward of all the Plaque Reversers. He basically asks men to follow a strict whole foods, low fat vegan diet and does not like dairy, nutrs/seeds or meat (including fish). Furthermore, he does not emphasize supplements and basically wants all men to target low LDL-C levels.
His philosophy is that if you get your LDL-C low enough, below about 80, then a whole foods vegan diet will take care of all the other issues, such as lowering inflammation, that are required for plaque reversal. And, if he can't get that LDL low enough through diet, then he will sometimes give a man a low dose statin.
Also, I want to mention, because there is so much misinformation out there from the Low Carb and Paleo crowds, that all carbs are not bad. Just as there are "good" fats and "bad" fats, there are good carbs and bad carbs. Vegetables, fruit, legumes and beans are all excellent low glycemic choices. In my opinion, whole grains - like quinoa (which isn't a grain actually), brown rice (which boosts nitric oxide) and non-GMO whole corn - can be used in moderation.
The other key thing to remember is that low fat carbs do something beautiful: they clear out lipids from liver cells. I cannot emphasize how important this is. This is one of the reasons that cultures that eat a lot of lower fat carbs are so healthy and long-lived: their liver cells are drained of lipids. The root cause of insulin resistance is extra fat getting packed into the liver cells. This is why low fat diets, if done correctly, can actually reverse diabetes. Dr. Bernard proved this in a landmark study, which I discuss in page on How to Reverse Diabetes with a Low Fat Diet.
By the way, it is tragic that a Low Fat Diet is called "low fat", because it is really not low in fat at all. The typical person on a Low Fat Diet will consume between 20-40 grams of fat per day and 5-10 grams of saturated fat which is plenty. Even "dry" foods like whole grains, legumes and beans will supply a significant amount of saturated fat, more than enough to trigger ample production of cholesterol for the body's needs. (I believe you should avoid wheat however, because it is GMO'd and spikes blood sugar levels.)
My personal take on Dr. Esselstyn's program is that it will definitely work for about 80% of men reading this. However, I do have concerns that some men in maintenance mode, i.e. neither gaining or losing weight, could have their LDL Particle Counts go too high. The reason I say that is that Dr. Davis and Dr. Gould have observed that some men on low fat diets actually increase LDL particle counts and small particle LDL, which usually leads to an increase in plaque. Furthermore, studies show that signficant numbers of men with low LDL, even lower than Esselstyn advocates can end up with atheroslcerosis and heart disease. This is going to mostly be men who are insulin resistant, i.e. prediabetic. If you don't know what I mean by that, please read this all-important page on Understanding LDL-P Particle Count Levels to Reverse Plaque.
So the bottom line is that Dr. Esselstyn's program is an excellent one, but I would pull your LDL Particle Count about a month into your program and just double check that you are handling the increased carbohydrates properly. An additional test is your triglyceride levels. If those go too high - say above 100 - then you may need to figure out a way to ramp down the carbs.
4. Dr. Davis (Track Your Plaque). Dr. William Davis is probably the most popular and well-known of the Plaque Reversers. He resonates with many in the Paleo community in particular, because he advocates eating only small amounts of carbs, rails against wheat and most grains and allows a significant amount of fat. Originally, he preached against to saturated fat, but I heard from a member on the Peak Testosterone Forum that he now actually encourages saturated fat. Saturated fat can slow down blood flow, so that's not my favorite idea, but many guys do not feel that that is an issue for them.
Here are some of the key aspects of his program as outlined in his book Track Your Plaque:
His book, Track Your Plaque, is a must-read for every English-speaking male on planet earth over the age of 20 and you can read about here: A Review of Track Your Plaque by Dr. William Davis. This is not my favorite way to try to regress plaque as I feel uncomfortable with decades of high dose niacin. However, Dr. Davis makes a strong case that it is generally safe if under the care of a knowledgeable physician. Even if you don't accept that premise, the book is an absolutely invaluable source of information.
5. My Attempt (Pritikin-like, Tarahumara-like Program). Now I am not a clinician or researcher, so keep that in mind: I am a sample of one. However, I can tell you that I had a Calcium Score of zero at age 53, something I discuss in my article My Heart Scan Results. My personal opinion is that I very likely had some plaque a few year earlier, based on all the issues with erectile dysfunction that I was having. And I believe that going on a low fat diet about five or six years ago reversed that (along with HRT of course). I also know that I sure felt better. However, I cannot prove that I reversed plaque, because at the time I did not know enough to get an IMT or Heart Scan. I have, apparently, kept the plaque off tho, no small task in a Western culture at my age, so I am proud of that achievement.
In addition, I have always been intrigued with the story of Nathan Pritikin, who definitely had significant plaque and heart disease and died with perfectly clean arteries per a coroner's report. My personal program is to try to take what I consider to be the best of the above three Plaque Reverers and essentially follow a Pritikin-type program. Here is my summary of what Nathan Pritikin did for example:
Now notice the beautfy of Nathan Pritikin's Program. The low fat diet will dramatically lower his LDL levels and the exercise will dramatically lower his triglyceride levels and increase HDL. All of this would have greatly lowered his LDL Particle Count as well, so no wonder he died with no plaque! And this kind of lifestyle - a low fat diet plus exercise is what is consumed by the most long-lived, ultra heart healthy cultures around the globe. The supreme example of this is something I have written up in my page on The Diet of the Tarahumara.
CAUTION: There are a few unusual markers that can trip up any diet. Again, read the book Track Your Plaque above to make sure you don't accidently miss one of these.
And here is how I am implementing the above:
I also am implemmenting some LDL-lowering strategies as well, including oat bran. For other ideas, you can read my page called How to Lower Your LDL. Of course, I am trying to achieve good plaque-regression numbers without taking niacin and/or a statin. Time will tell if my strategy works, but I believe if it worked for Pritikin, it can work for me.
How can a Low Fat Diet clear out arteries? The research shows that it does it by hitting almost every major pathway that leads to arteriosclerosis:
a) Lowered Cholesterol. A Low Fat Diet brings saturated fat consumption down to more natural levels and this, in turn, almost immediately drops LDL into the range where there is little to no heart disease. (Actually, it is possible to have a heart attack with low LDL, but it is much less common.) CAUTION: Some men have low LDL for reasons that can be detrimental to their health potentially, such as certain genetic conditions, GI / digestive disorders, cancer, addictions, etc.
b) Increase LDL Particle Size. Many of the experts consider the baddest of the bad boys are the very small LDL particles. LDL, as many men now know, is the "bad cholesterol" of the lipid world. However, it is really the small particles that do the most damage according to one school of thought. Well, one study showed that a Low Fat Diet increased LDL particle size.  Now, if you do a low fat diet wrong, this will not be the case, so play it safe and avoid wheat and all refined carbs. And test to make sure that you are doing what you think you are doing.
c) Decreased Oxidation.. Again, small, bad cholesterol particles need to be oxidizied in order to do their damage to arterial walls. The above study showed very significant decreases in oxidation levels as well from a Low Fat Diet. 
d) Decreased Blood Pressure. Hypertension is a plague in modern society and high blood pressure damages arteries, capillaries and surrounding tissues throughout the body, especially as the years and decades go by. A Low Fat Diet has been shown to decrease blood pressure levels significantly in a number of studies and I document this in my link on How to Lower Your Blood Pressure. (See #2.)
e) Diabetes Reversal and Blood Sugar Control. Again, Dr. Neil Bernard, outline how easily a Low Fat Diet can actually reverse diabetes. He shows how it can lower glycated hemoglobin (A1C) levels and normalize blood sugar. This also helps heal and restore your arteries (and about a 100 other tissues.) CAUTION: The key point here is to make sure that you eat low glycemic Low Fat foods, i.e. not cheating with sugars and a bunch of wheat, corn starch and other refined carbs. In my opinion, a solid amount of daily exercise and activity is also crucial to make sure you do not go insulin resistant.
Right now low fat diets are the ugly stepchild in the health blogosphere, but the fact is that low fat diets have done very well in the research and you can check out this link for more details: The Many Benefits of a Low Fat (Ornish) Diet. I do tweak a Low Fat Diet, though, to include more protein for building muscle and a few other things.
6. Pomegranate Juice. It is hard to believe but just a little pomegranate juice could actually clear out arterial plaque, but this is exactly what one study showed.  The group of pateints in this study had advanced arteriosclerosis. However, almost anyone reading this article wondering how to clear their arteries is likely in that category or close. And in those with more normal narrowing of the arteries, other research showed that pomegrante likely slowed arterial plaque buildup even if it didn't actually clear it the arteries. Keep in mind, though, that this is just one study and the methodologies of the Plaque Regressers is much more well-developed.
In fact, pomegranate juice is a wonder worker for your arteries in many ways: it lowers blood pressure, boosts nitric oxide, protects against oxidized LDL and lower cholesterol levels. In short, it does everything you could possibly want a foood or supplement to do to protect your cardiovascular system. (Talk to your physician if you're on any medications as it can alter absorption rates of other medications.) For more information, see my links on The Power of Pomegranate Juice and The Benefits of Pomegranate Extract.
Personally, I would not rely on just pomegranate juice to clear out plaque, but I believe it can be an additional tool in your arsenal.
7. Gum Disease. One small study showed that by reversing gum disease patients actually reversed arteriosclerosis. This may seem implausible at first, but researchers have noted that "infections" of the mouth raise inflammation levels throughout the body and correlate to heart disease.  Again, keep in mind that this is one study and the fact that it was small and on patients with some periodontal disease. Read my links on How to Control Inflammation and Inflammation and Erectile Dysfunction for some related information.
Again, I would not rely on just correcting your dental hygene to reverse atherosclerosis, but this is interesting information nontheless and emphasizes the importance of controlling inflammation.
CONCLUSION: Get started! Here are the basic steps:
a) Start by find out your personal plaque levels through an IMT (carotid ultrasound) for $70 as of this writing with Lifeline or a Heart Scan (usually around $99) at a local heart institute. A Heart Scan does involve some radiation, although it is relatively low level. You do not need a doctor's orders here in the U.S. for either procedure in almost all states. (There are a few Control Freak States that do not allow you to do any personal medical testing without a doctor's orders. These states decide who is a doctor and what is best for your personal health.)
b) I urge you tread Track Your Plaque and Heal Your Heart - mentioned in the links above - to understand how to monitor plaque, how rapidly it progresses and how it can lead to angina, stroke and heart attack.
c) Learn how to monitor your lipids and inflammation. This is an involved subject. I have good (imho) summaries here of HDL, LDL and Triglcyeride Levels and the all-important LDL-P Particle Count. But reading the books in b is critical: these should be on your nightstand and you should read and study them like a bible.
d) Of course, pick a diet and exercise program. Davis, Gould, Esselstyn, Pritikin - pick one of them and get started. The benefits are huge and, by the way, will pay off in the bedroom as you clear out penile plaque, boost blood flow and increase nitric oxide.
1) Arteriosclerosis, Thrombosis, and Vascular Biology. 1996, 16:201-207, "Effects of Diet and Exercise on Qualitative and Quantitative Measures of LDL and Its Susceptibility to Oxidation"
2) Clin Nutr. 2004 Jun;23(3):423-33, "Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation"
3) The American Journal of Cardiology, Oct2009, 104(7):936-942, "Effects of Consumption of Pomegranate Juice on Carotid Intima Media Thickness in Men and Women at Moderate Risk for Coronary Heart Disease"
4) Neurology, Oct 1 1977, 27(10):905, "Cerebral blood flow, oxygen utilization, and blood volume in dementia"
5) Journal of the American Geriatrics Society, Oct 2007, 55(10):1613 1617, October 2007, "Assessment of Endothelial Function in Alzheimer's Disease: Is Alzheimer's Disease a Vascular Disease?"
7) FASEB J, 2009 Apr, 23(4):1196-204. "Treatment of periodontal disease results in improvements in endothelial dysfunction and reduction of the carotid intima-media thickness.