“Bad” cholesterol isn’t always bad—and 5 more cholesterol facts you need to know
It never ceases to amaze (and distress) me that my patients still get concerned about cholesterol. Why does this upset me so much? Because, for years, I’ve been pleading with everyone on the planet—my patients included—not to worry about their total cholesterol score. In fact, that number doesn’t actually tell you anything about your risk for a cardiac event…whether it be a heart attack or stroke.
But, as I have been telling my patients for years—just because total cholesterol isn’t a big deal, that doesn’t mean you should ignore it entirely.
So, forget about that one number and let’s take a more in-depth look at your complete cholesterol profile.
Redefining “good” and “bad”
Most people are aware of the traditional cholesterol roles: HDL is the good guy and LDL is the bad guy. But, as a new study shows, there’s a whole lot more to it than that.
In fact, this study questioned whether oxidized LDL (you know, the supposed “worst of the worst” in terms of cholesterol) is, in fact, harmful after all.
The widespread belief has been that oxidized LDL moves rapidly into arterial walls and engorges them with cholesterol, which ultimately converts into plaque. That plaque then blocks the arteries. Or, in a worst-case scenario, ruptures and sends clots into the bloodstream, causing heart attacks and/or strokes.
The new research appears to indicate that oxidized LDL might, in fact, be a good guy in the process. Instead of increasing the amount of cholesterol uptake and accumulation, mildly oxidized LDL actually prevents increases in cholesterol.
This theory is encouraging for those of us who believe the cholesterol hoopla is a myth. One based solely on selling billions upon billions of dangerous medications known as statins.
I lambast statins on a regular basis in my Reality Health Check e-letter, so I’ll skip that part of the cholesterol discussion (at least for now). Instead, I’m going to give you a detailed rundown of all the important blood fats (lipids) you should be keeping tabs on. And I’ll also tell you how you can make a positive impact on these markers at the cellular—and, ultimately the genetic—level.
Yes, you can change how your genes affect your health: This is fun, life-altering 21st century medicine, folks. But it’s not stuff the mainstream medical community will ever bother to tell you about (often because they simply don’t know).
The devil in the details
Let’s start with LDL. As I mentioned above, classifying LDL cholesterol as “bad” is a bit of an oversimplification. You see, LDL is made up of particles. These particles come in both large and small sizes. And as it turns out, large LDL particles are quite normal—even healthy. Small, dense LDL particles (very-low-density LDL, or VLDL), on the other hand, can be problematic.
It sounds a bit counterintuitive, I know. But studies show that people whose LDL cholesterol is predominantly small and dense have a threefold greater risk of coronary heart disease. And other studies suggest that determining the number of small, dense particles in the blood predicts the risk of heart disease more accurately than simply measuring total LDL cholesterol.
Your overall VLDL level should be below 40 mg/dL. But there are actually three subclasses of VLDL particles—VLDL1, VLDL2, and VLDL3. VLDL3 is the smallest, most dangerous type. Your level of VLDL3 should be below 10 mg/dL.
The same holds true for HDL—it comes in both large- and small-size particles. Large HDL particles are called HDL2, and the small variety are called HDL3. HDL2 is the most protective form. So the more of them you have, the lower your risk for cardiac events. You want your levels above 10 mg/dL.
But even these details are only a fraction of your overall lipid profile. As I mentioned above (and as I’ve said many times before), there’s more to it than just cholesterol.
Two blood lipids more important than cholesterol
In my opinion, triglycerides are even more important than cholesterol. Triglycerides are a type of blood fat (lipid) that occurs when you take in more calories than you can burn. Your body converts these excess calories into triglycerides. And if your liver isn’t operating at the top of its game (which is frequently the case these days, thanks to the Standard American Diet), it can’t process those triglycerides. Which means they build up—and wreak havoc in your body. You want your triglyceride level at or below 100 mg/dl.
There’s also lipoprotein (a), or Lp(a), to consider. Lp(a) is a substance that builds on the inner lining of arteries, promoting inflammation and damaging artery walls. Lp(a) also contains a blood clotting component, which compounds the risk for heart disease and stroke even further.
This is one of the strongest indicators of heart disease risk. So you should have it checked every year. You want your level to be below 10 mg/dL. Though keep in mind, if you have a family history of heart disease, you’re genetically predisposed to have an elevated Lp(a) level. The good news is, this is yet another instance where you can “outsmart” your genes. And all it takes is two simple supplements. More on those in just a minute. But first, there’s one more blood lipid I want to tell you about.
The most dangerous kind of cholesterol (and chances are, you’ve never heard of it)
The last risk factor you should be keeping tabs on is one you’ve probably never heard of. It’s called intermediate-density lipoprotein (or IDL) cholesterol. IDL is the “sticky” kind of cholesterol that clogs up blood vessels and arteries. So, really, it’s the most important cholesterol number of all.
Keeping IDL low (at or below 20 mg/dL) greatly reduces your risk for cardiovascular events. Like Lp(a), IDL has a genetic component to it, especially if you have a family history of diabetes.
Luckily, you can keep track of all of these lipids with one simple test, called the Vertical Auto Profile, or VAP test. Chances are, your doctor won’t order it for you unless you specifically request it. But it costs about the same as a regular, routine lipid profile. And it’s covered by Medicare and most insurance carriers.
Once you have your results, you can work with your doctor on a specific action plan for getting your scores where you want them. And despite what Big Pharma would like you to believe, chances are, you can do that without resorting to a single drug.
Your foolproof plan for a perfect lipid profile—NATURALLY
Of course, the first step towards reining in these lipids is to focus on your nutrition. A diet that’s low in processed, refined carbs and high in fruits, vegetables, lean protein and healthy fats will put you on the fast track towards a better lipid profile. But there are also a few supplements that can help you perfect your scores.
Niacin and L-cysteine. These two nutrients help keep Lp(a) in check. Start with 500 mg of niacin per day and work up to 3,000 mg per day. It may take a while, but it’s worth it. (And, if you can tolerate it, it’s best to opt for regular niacin here instead of the flush-free varieties. In my experience, the flush-free versions just aren’t very effective.) As for L-cysteine, I typically recommend 1,000 mg twice per day.
Pantethine (not pantothenic acid) is very good at lowering IDL. I recommend 300 mg, twice per day, for my patients. Omega-3 fish oils also help in this situation, keeping the blood from getting “sticky.” As you know by now, I recommend taking a quality fish oil supplement that contains 1,500 mg of DHA and EPA twice per day.
And there’s one more supplement in particular that offers “one stop shopping” in terms of your lipid profile. It’s a citrus bioflavonoid called bergamot from a specific tree grown in Calabria, Italy (where my family is from). I mentioned it briefly back in the December 2012 and May 2014 issues.*
Studies have shown that bergamot can lower total and LDL cholesterol, triglycerides and blood glucose, all while raising HDL (basically, everything you wish to accomplish). It actually works in a similar matter to statins. But without the side effects.
Because of its bioflavonoid properties, bergamot is also an antioxidant and an anti-inflammatory, both of which have very beneficial effects on endothelial cell lining function, inhibiting clot formation.
Obviously, keeping your heart functioning at peak performance is a big topic—and I could go on and on about it. I covered it in even more detail in my special report The World’s Easiest Heart Disease Cure (which is available at www.drpescatore.com if you don’t already have a copy). But when it comes to cholesterol, the bottom line is this: If you really want to stay healthy, you need to break the numbers down and look at the bigger picture, so you can attack the real problems—and plan your nutritional supplement regimen accordingly.
Pinpointing plaque build up
There’s another new test worth asking your doctor about at your next appointment. It’s called the LPAC-2, and it gives an overall assessment as to whether a plaque build-up exists somewhere in your body.
Remember, you don’t necessarily need to worry about the plaque itself. Plaque is there to protect us by indicating that something isn’t right in your body and that you’re experiencing oxidative stress. But knowing it’s there means you can take action to eliminate this stress. And the easiest way to do that is to eat healthfully (lean, organic proteins and plenty of vegetables and healthy monounsaturated fats).
Healthy lipids, by the numbers
|HDL||60 mg/dL or higher|
|LDL||110 mg/dL or lower|
|HDL2||10 mg/dL or higher|
|VLDL||40 mg/dL or lower|
|VLDL3||10 mg/dL or lower|
|Triglycerides||100 mg/dL or lower|
|Lipoprotein(a)||10 mg/dL or lower|
 “Minimally oxidized LDL inhibits macrophage selective cholesteryl ester uptake and native LDL-induced foam cell formation.” The Journal of Lipid Research 2014; 55(8): 1,648
 “Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men. Prospective results from the Quebec Cardiovascular Study.” Circulation 1997; 95(1): 69-75