How Big’s Your LDL?

Conventional wisdom tells us LDL cholesterol is bad, and HDL cholesterol is good. Which is a huge improvement from the days of “All Cholesterol is Bad,” but still far from adequate.

Chances are, your doctor has failed to mention that there are 2 types of LDL cholesterol particles, and only 1 is detrimental to our health.

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


The small dense LDL cholesterol particles (type-B) are the harmful variety, because 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 unfortunately, more likely to inflict damage damage via oxidation.

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 LDL Cholesterol equation.


Meanwhile, the real problem is excess carbohydrates, which promote the transition from type-A to type-B (small dense) LDL cholesterol and raising triglycerides – the other critical biomarker for heart disease.

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 replacing saturated fats with polyunsaturated oils, and filling the hunger gap with excessive high glycemic carbohydrates.


Your best approach for living heart-disease-free is replacing grains and starchy carbohydrates with healthful saturated fats. This will not only reduce the 2 most significant biomarkers for heart disease (triglycerides and type-B LDL cholesterol), but it will raise the protective one (HDL cholesterol).

Stay Lean!

Coach Mike

P.S. If you’re interested in testing the composition of your LDL cholesterol particles, check out these tests: NMR LipoProfile, LipoPrint, Berkeley (from Berkely Heart Lab), or VAP (Vertical Auto Profile). And click here for a list of other important tests to ask your doctor for.