"According to Dr Paul Saladino and Dr. Nadir Ali, high total cholesterol and/or elevated low-density lipoprotein (LDL) cholesterol may not cause atherosclerosis
Low levels of high-density lipoprotein (HDL) cholesterol are associated with both atherosclerosis and insulin resistance, and insulin resistance appears to be the foundational cause of heart disease. As such, the fasting insulin test is one of the best predictors of atherosclerosis
Insulin resistance is primarily driven by excessive consumption of the omega-6 fat linoleic acid (LA). High LA intake is also associated with elevated levels of oxidized LDL — found in atherosclerosis plaque — further confirming this link
One theory is that oxidized LDL protects your body from oxidative damage by sacrificing itself. If true, it may be beneficial to have higher, rather than lower, LDL levels
The apoB test can also be helpful in assessing your atherosclerosis risk. As mentioned above, apoB is the primary carrier for LDL, and research over the past decade shows it’s an accurate predictor of cardiovascular risk when apoB is high and LDL is normal." J.M
The Washington Post:
“The standard cholesterol panel calculates the total quantity or concentration of ‘bad’ cholesterol or LDL in the blood, in milligrams per deciliter (technically, LDL-C). Because cholesterol is a fatty substance and thus not water-soluble, it must be carried around in little particles known as lipoproteins.
Testing for apoB, a protein on the outside of LDL-carrying particles, counts the number of these lipoprotein particles in the blood. In addition to LDL, it also captures other types of cholesterol such as IDL (intermediate-density lipoproteins) and VLDL (very low-density lipoproteins), which carry triglycerides.
Why is this important? As our understanding of heart disease improves, scientists are recognizing that apoB particles are more likely to become lodged in the arterial wall and cause it to thicken and eventually form atherosclerotic plaques. Thus, the total number of apoB particles matters more than the overall quantity of cholesterol that they carry.
In a majority of people, apoB and LDL-C track fairly closely, says Allan Sniderman, a professor of cardiology at McGill University in Montreal. But some people have a ‘normal’ amount of LDL-C, but a high concentration of apoB particles — a condition called ‘discordance,’ which means they are at greater risk.”
"According to Dr. Eric Berg, https://www.drberg.com/dr-eric-berg/bio, the small-dense type of LDLs are indicative of inflammation inside your arteries, which is a hallmark of atherosclerosis. Berg points to potential causes of this inflammation to include:
Seed oils
Processed foods and junk foods
Smoking
Low vitamin E
High glucose levels
Sources and References
Comments