Let's discuss cholesterol.

[Knight9]

What I have gathered...

Test your Lp(a). This is genetic. You will likely never need to test for it again and you are either at risk or not. This is likley the single greatest driver of atherosclerosis.
Apo-b (much more reliable than ldl-c and less false positives than NMR)
NMR is the only way you can see your LDL-P and small dense LDL counts(that I know of). Usually, if LDL-P is elevated, it is due to small LDL particles.
Keep your triglycerides low via diet which in theory (and as strategy)--will lower your apo-b
Knowing your VLDL will give you a good idea of remnant cholesterol
Glucose
Insulin
Homocysteine
Crp
Uric Acid
Blood pressure in check

HDL metrics are not understood..and until (or if) they ever are..you should not waste brain energy or stress about these metrics. This doesn't mean tank your HDL with orals etc and don't worry.


I've been saying for years..look into Pomegranate, K2 (if you are not on blood thinners/clotting disorders), and Tocotrienols.
There are other things really peaking my interest such as Olive leaf(+stem) extract.

 

[Reno911]

What I have gathered...

Test your Lp(a). This is genetic. You will likely never need to test for it again and you are either at risk or not. This is likley the single greatest driver of atherosclerosis.
Apo-b (much more reliable than ldl-c and less false positives than NMR)
NMR is the only way you can see your LDL-P and small dense LDL counts(that I know of). Usually, if LDL-P is elevated, it is due to small LDL particles.
Keep your triglycerides low via diet which in theory (and as strategy)--will lower your apo-b
Knowing your VLDL will give you a good idea of remnant cholesterol
Glucose
Insulin
Homocysteine
Crp
Uric Acid
Blood pressure in check

HDL metrics are not understood..and until (or if) they ever are..you should not waste brain energy or stress about these metrics. This doesn't mean tank your HDL with orals etc and don't worry.


I've been saying for years..look into Pomegranate, K2 (if you are not on blood thinners/clotting disorders), and Tocotrienols.
There are other things really peaking my interest such as Olive leaf(+stem) extract.

On the NMR test, do you feel the Insulin Resistance Score (LP-IR) is a good valid marker? I have "heard" that the leaner the individual is, the less accurate the A1C test is. My last A1C was 5.1 and I've never tested below 5.0 while being in single digit body fat levels.

 

[old timer]

HDL metrics are not understood..and until (or if) they ever are..you should not waste brain energy or stress about these metrics. This doesn't mean tank your HDL with orals etc and don't worry.

I agree with this. Whether they're directly responsible for "good things" happening or rather are simply a biomarker that indicates that good things are happening, it's my understanding that we should strive for fairly high numbers. High but not too high (https://www.uscjournal.com/articles/u-shaped-link-between-hdl-cholesterol)

 

[Knight9]

Dr. Ron Krauss (you can also find a long talk/interview he did with Dr. Rhonda Patrick on youtube)

Dr. Ron Krauss on Peter Attia's podcast.

 

[Knight9]

On the NMR test, do you feel the Insulin Resistance Score (LP-IR) is a good valid marker? I have "heard" that the leaner the individual is, the less accurate the A1C test is. My last A1C was 5.1 and I've never tested below 5.0 while being in single digit body fat levels.

It seems valid and accurate. I don't see how that can be true about leaner individuals since it's just a 3 month count of glycated hemoglobin..but I could be wrong. The information you just gave makes sense if you are in a healthy lean dieting phase.

The issue Peter Attia brought up in one of the podcasts was basically mentioning that second generation NMR's almost became 'too sensitive' and would lead to more false positive/inaccuracies compared to apo-b. Again, I don't know how you would get LDL-P or small dense LDL count without an NMR though.

 

[Knight9]

An important thing I just learned was that a loaded up VLDL(which is full of triglycerides) becomes a small LDL over time.
But when your triglycerides are low in the liver..it creates a smaller VLDL(not loaded full) which in turn - turns into a large LDL.

 

[old timer]

. . . or are simply a biomarker (referring to HDL)

I just watched the Feldman video and, I never heard this before, but he claims that LDL might be a marker for what is happening.

In my case, if I eat less processed/sugary foods and eat more whole foods like oatmeal and legumes AND my LDL goes down, surely that's a good thing for my health (even though Feldman says that after age 50 all cause mortality is higher with lower levels of LDL). Right?