If you’ve had your cholesterol levels checked, your doctor most likely tested your total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. But we now know those are not accurate predictors for cardiovascular disease risk. According to Kresser, a much more accurate predictor is testing your LDL particle number. He explains:

“To use an analogy: if you imagine your bloodstream’s like a river, the LDL particles are like the boats that carry the cholesterol and fats around your body. The cholesterol and fats are like cargo in the boats. Right now doctors are usually measuring the amount of cargo or cholesterol in the LDL particles. But what we should be measuring is the number of LDL particles, or the number of boats in the river, so to speak, because that’s a much more accurate risk factor for heart disease.”

As mentioned, it’s possible to have normal total or LDL cholesterol yet have a high number of LDL particles. This is completely missed using the conventional testing. On the other hand, you may end up being prescribed a statin drug to lower your cholesterol when in fact your LDL particle number is normal, placing you in the low risk category for heart disease. (As a general rule, regardless of your LDL particle number, chances are you do NOT need a statin drug to address high cholesterol. The only people who may truly benefit from a statin drug are those with the genetic defect called familial hypercholesterolemia.)

So an optimal number of LDL particles is below 1000, upto 1600 is borderline risk and 2000 and above is high risk. However this is not the end of the story. Its not just number, but also size of particles that matters. So if particle size is small, then they can slip behind the arterial wall, build up plaque, and eventually become inflamed to the point that serious problems develop. That’s why you want more of the large, fluffy kind of LDL particles because they cannot penetrate the arterial wall. So even if the number is high but the particle size is large, the risk is low. 

And these are not measured by conventional testing. 

Want to know how to prevent your LDL from becoming predominantly the small, dense and dangerous kind and transform them into the large, fluffy and protective ones instead? Yep, you got it — eat a high-fat, low-carb diet.

When you choose to consume a large amount of fat as a percentage of total caloric intake, moderate amounts of protein, and very few carbohydrates, then three things almost assuredly always happen:

1. Your HDL “good” cholesterol will rise above 50.
2. Your triglycerides will dip below 100.
3. Your LDL particle size will be mostly the large, fluffy kind.

These three indicators are a tell-tale sign if someone is eating low-carb correctly or not. If you are consuming too many carbohydrates, then your triglycerides will bear that out by remaining above 100. If you aren’t eating enough fat, then your HDL will dip below 50. And if both of these numbers are significantly off course, then you better believe your LDL particle size will be leaning in the direction of more of the small, dense ones. EEEEK!