LDL Cholesterol: Size DOES Matter

Conventional wisdom tells us LDL cholesterol is bad and HDL cholesterol is good. A huge improvement from the days of "all cholesterol is bad," but still a far cry from adequate.
10/30/2015 11:55 am ET Updated Oct 30, 2016

Conventional wisdom tells us LDL cholesterol is bad and HDL cholesterol is good. A huge improvement from the days of "all cholesterol is bad," but still a far cry from adequate.

Chances are, your doctor has failed to mention that there are two types of LDL cholesterol particles, and only one is detrimental to our health.

  • Small dense (type-B) = Bad
  • Large fluffy (type-A) = Good

Small dense LDL cholesterol particles (type-B) are the harmful variety, as they are more likely to lodge themselves in arterial walls.

Research from 1988 in the Journal of the American Medical Association determined that type-B (small dense) LDL cholesterol particles were three times more likely to cause heart disease than type-A (large fluffy).

And more likely to oxidize.

A large prospective study in the journal Circulation in 2005 determined that participants with high oxidated LDL cholesterol had 4.25 times the risk of a heart attack than those with low oxidated LDL cholesterol.

Similar to the way saturated fat was demonized for raising HDL cholesterol in the Total Cholesterol equation, it's being unfairly blamed for elevating big fluffy (benign) LDL cholesterol particles in the Total LDL Cholesterol equation.

The real problem is excess carbohydrates, which promote the transition from type-A to type-B and raise triglycerides (the other critical biomarker for heart disease).

Those with High Triglycerides and Low HDL Cholestrol have a six times greater risk of heart attack, than those with Low Triglycerides and High HDL Cholesterol.

A 1994 paper in the Federation of American Societies for Experimental Biology (FASEB) Journal, discussed how North Americans are at a far greater risk of heart attack and stroke, because of a negative shift from a Pattern A to Pattern B cholesterol profile:

  • Pattern A -- low levels of small dense LDL cholesterol, and high levels of large buoyant LDL and HDL cholesterol
  • Pattern B -- high levels of small dense LDL cholesterol and triglycerides, and low levels of HDL cholesterol

This shift stems from the nutrition failure of the last 50 years that's had us filling the low-fat hunger gap with excessive high glycemic carbohydrates.

And it's been made worse, as we've replaced these beneficial saturated fats with polyunsaturated oils (which are prone to oxidation).

In an attempt to eliminate the one thing we were misled to believe was causing heart disease we supplied alternatives that were more detrimental.

Your best approach for living heart disease-free is replacing grains and starchy carbohydrates with healthful saturated fats. This not only reduces the two most significant biomarkers for heart disease (triglycerides and type-B LDL cholesterol), but it raises the protective one (HDL cholesterol).

Stay Lean!

Coach Mike

In Eat Meat And Stop Jogging, Mike explains how bad science and flawed advice has forced us to eliminate the foods we need most, while increasing the foods we don't need.