LDL A & B

Column #386 January 20, 2023

Cardiovascular diseases (CVDs) are the leading cause of death globally. An estimated 17.9 million people died of CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke—most of which were caused by clogging of the arteries. But the actual reasons for why arteries clog up is masked by mythology. Consequently, many of the prescribed treatments based on those myths cause harms and added costs rather than solutions. Nationally, about 5% of all medically-prescribed treatments cause harm.¹

What’s most alarming is that although symptoms of heart disease may not show up until a person is middle-aged or older, a study by the American Heart Association Scientific Sessions found that heart disease actually begins developing in childhood. This means that most likely all of us laid a foundation for heart disease in our youth!²

Dr. Aseem Malhotra is a prominent British cardiologist. He’s so famous that if you don’t recognize his name one must ask if you’ve been living under a rock? I’ve been flagging his work for many years because, as a proponent of “evidence-based medicine,” he shatters myths. Yet in spite of scientific evidence, Dr. Malhotra continues in a minority position in the medical profession. This column focuses on Malhotra’s science involving cholesterol, saturated, HDL, and LDL fats. Amazingly, when you visit a cardiologist today, in most cases you’ll find that his knowledge and prescriptions are based on the myths of the 1950s. What he doesn’t know about fat and its impact on heart health is quite astounding which gives me all the more reason for not trusting medical doctors generally.^{3 4}

Dr. Malhotra closely followed David Sackett’s research. Dr. Sackett is widely known as the father of the “evidence-based medicine” movement—arguably one of the most important recent advances in medical practice. Researchers like Sackett started to push the profession in a more scientific direction in the 1990s because a surprising amount of medical practice was simply rooted in expert opinion and whatever doctors learned in medical school. Here’s one of Sackett’s more famous quotes.

“Half of what you learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation; the trouble is nobody can tell which half. The most important thing to learn is how to learn on your own.”

Obviously, if that it true, then medical knowledge is constantly evolving. Most of us realize that it actually is evolving because the MSM comes out with new information about coffee, wine, or diet every month. But Dr. Malhotra counters that kind of “science” with two reports by Dr. John Ioannidis (a physician-scientist, writer and Stanford University professor) who has made contributions to evidence-based medicine, epidemiology, and clinical research. The two reports are “Why Most Published Research Findings Are False” and “How to Survive the Medical Misinformation Mess.” Consequently, not only are we fighting myths but bad science as well.^{5 6}

Before going further, everyone should watch “Optimize your Cardio-Metabolic Health with the Malhotra Method” (dated Feb 22, 2021). At the 17:15 minute mark of the video he explains why high cholesterol is nothing to fear since the concerns are based on myths. If you start viewing at the 17:15 mark you can always backtrack later for the lead-in to his analysis.⁷

A less detailed analysis can be found in Dr. Malhotra’s short paper titled “Saturated fat is not the major issue” where he says: “The aspect of dietary saturated fat that is believed to have the greatest influence on cardiovascular risk is elevated concentrations of low density lipoprotein (LDL) cholesterol. Yet the reduction in LDL cholesterol from reducing saturated fat intake seems to be specific to large, buoyant (type A) LDL particles, when in fact it is the small, dense (type B) particles (responsive to carbohydrate intake) that are implicated in cardiovascular disease.”⁸

In 1996, information started coming out that cholesterol levels had a poor predictive correlation with heart disease. In fact, it was found that high LDL cholesterol levels are inversely associated with mortality in most people over 60 years. It is actually protective? It turns out our bodies require cholesterol and total LDL levels are determined more by genetics than diet.⁹

If you’re a carnivore, most likely your total cholesterol number will be 280 to 350 or even higher. Your HDL could be close to 93. Your LDL could be around 250 and triglycerides (TG) might be 70. If your TG to HDL ratio is 0.75:1, that’s a strong indication of high levels of LDL pattern A—the large fluffy benign LDL fat. It doesn’t cause clogging of the arteries! A TG/HDL ratio above four is the most powerful independent predictor of developing coronary artery disease.

Anytime a doctor tells you that you must take a statin drug to lower your cholesterol count, first you must get the particle size test—a test for lipid subfractionalization by ion mobility. Your doctor is not your superior. Just tell him flat out that you require complete information before considering medication. If the doctor refuses, you have the wrong doctor. Quest Diagnostics and possibly other labs perform these tests for a cost of around $300 or so.^{10 11 12}

The bottom line is this:
● Dietary carbohydrates increase levels of small, dense LDL cholesterol (which is known to cause the formation of abnormal fatty or lipid masses in arterial walls).
● Dietary saturated fat increases levels of both HDL cholesterol (which is inversely correlated with cardiovascular disease) and large buoyant LDL cholesterol (which is not known to cause the formation of abnormal fatty or lipid masses in arterial walls).

Amazingly, we must eat meat for our health and we must avoid carbohydrates to protect our heart.¹³

To your health.

Ted Slanker

Ted Slanker has been reporting on the fundamentals of nutritional research in publications, television and radio appearances, and at conferences since 1999. He condenses complex studies into the basics required for health and well-being. His eBook, The Real Diet of Man, is available online.

For additional reading:

1. Medical Error Statistics from My Medical Score

2. Heart Disease Begins At A Young Age from Science Daily

3. Dr. Aseem Malhotra Articles

4. Will Aseem Malhotra’s Appearance Be the BBC’s Most Viewed Programme of 2023? by Nick Rendell from The Daily Sceptic

5. Why Most Published Research Findings Are False by John Ioannidis

6. How to Survive the Medical Misinformation Mess by John Ioannidis, et al.

7. Optimize your Cardio-Metabolic Health with the Malhotra Method Feb 22, 2021

8. Saturated Fat Is Not the Major Issue by Dr. Aseem Malhotra

9. Lack of an Association or an Inverse Association Between Low-Density-Lipoprotein Cholesterol and Mortality in the Elderly by Uffe Ravnskov, et al.

10. Is Your LDL Pattern A or Pattern B? by Stephen Pao from Time-Restricted blog

11. Ion Mobility Lipoprotein Subfractionation: Further Beyond Cholesterol by ODX Research from Optimal DX