If your latest blood test showed you have healthy levels of bad LDL cholesterol, you may want to hold off on celebrating for a bit.
That’s because standard tests for LDL levels don't assess very low-density lipoproteins (VLDL) and intermediate-density lipoproteins (IDL) — both of which can raise your heart disease risk.
And a study in JAMA Cardiology found that while your LDL cholesterol levels may seem healthy, you can still have high levels of undetected VLDL and IDL.
On top of that, meta-analyses of multiple studies found that even if you get your plain old LDL cholesterol down to a healthy level, you could still be at risk for serious cardiovascular complications. The research showed that almost 23% of patients who achieved recommended LDL levels had a major cardiovascular event within two years.
How can you find out if your levels of VLDL and IDL are in the danger zone? With a blood test that looks for apolipoprotein B (ApoB), a protein found in all forms of LDL.
If your ApoB is high, you want to lower it to below 80 mg/dL. And some guidelines recommend aiming for 65 mg/dL if you are taking a statin and are 40 to 100 years old.
You can lower ApoB by exercising at least 30 minutes daily, adopting a plant-based diet, eliminating red and processed meats and full-fat dairy, and taking an LDL cholesterol-lowering medication (sometimes two or three are needed).
To jumpstart the process, take a bit of the advice in Dr. Mike's books "What to Eat When" and the "What to Eat When Cookbook."