There’s no doubt that you’ve heard of good and bad cholesterol. It’s been the leader of the “low-fat” campaign since its inception. Now with the rise in the high-fat diet, there’s question about fat’s true impact on cholesterol. And there’s news that not all LDL cholesterol is bad.
What Does Cholesterol Do?

It serves many purposes across a variety of systems throughout the body. Most notably, cholesterol makes up cell membranes such as in blood vessels. This is where most of the conversation around cholesterol centers. It’s the bad cholesterol in our cell membranes that lead to heart and vascular disease.

Beyond cell membranes, cholesterol functions as the structural foundation for hormones like testosterone and estrogen. And it serves an important role in the myelin sheath and nerve impulse conductivity for brain function.
The Two Types of LDL

All cholesterol is not created equal. We know this because we’ve been told that high-density lipoprotein (HDL) is good and low-density lipoprotein (LDL) is bad. But in recent years, the focus on “good” and “bad” cholesterol has waned. It’s not as simple as we once thought. Now physicians and patients are turning their attention towards pattern-A and pattern-B LDL.

Pattern-A LDL

Pattern-A LDL is best known as large, fluffy LDL. This is the good LDL cholesterol that lowers your risk of cardiovascular disease. If you eat a healthy diet and exercise often, then you’re more likely to have pattern-A LDL cholesterol, unless you’re genetically predisposed for pattern-B.

Pattern-B LDL

Pattern-B LDL is known for it’s small, dense particle shape and structure. These particles are associated with increased risk of cardiovascular disease. You are more likely to have pattern-B LDL if, as mentioned, you’re predisposed, but also if you’re overweight, lead a sedentary lifestyle, and eat a low saturated fat and high-carbohydrate diet.

What is it About Pattern-B?

Pattern-B LDL has a specific shape and structure that makes it more adherent than pattern-A LDL. On top of that, these particles don’t clear from the bloodstream as easily either. When you put those two problems together that leads to increased damage to blood vessels.

Remember that cholesterol plays an important role in cell membrane structure. If there are greater amounts of adherent, pattern-B LDL in the blood, then these will become the primary structure for blood vessels.

After pattern-B becomes a part of the cell membrane, the small, dense particles oxidize, which leads to inflammation and triggers the build-up of plaque on blood vessel walls and the onset of cardiovascular disease.

How Do You Find Out Your Levels?

Most of the time, when you visit your doctor for routine blood work and your annual physical, you’ll receive a cholesterol check. But this basic check doesn’t differentiate between the two types of LDL.

If you want a specific readout of your pattern-A and pattern-B LDL cholesterol levels, then you need to ask your doctor for the Advanced Lipoprotein Analysis. Whether heart disease runs in the family or you’re simply curious, your physician should be able to provide this test.

When you receive the results you’ll no doubt be curious about whether your pattern-B LDL level is normal or not. The exact measurement of pattern-B LDL to pattern-A LDL for normalcy will differ between offices and laboratories. But this physician suggests that less than 30 percent small, dense LDL is ideal.

What if Your Pattern-B is High?

There are many things you can do. First of all, is it genetic? If so, then you might want to talk with your doctor about realistic expectations. You may never have super low pattern-B levels. But that shouldn’t stop you from giving these other interventions a shot.

The number one way to convert pattern-B to pattern-A is to lose weight. If you’re overweight, even a little bit, you could see results from a weight loss program. You’ll see your pattern-B levels quickly convert to pattern-A.

Part of losing weight includes a healthy diet and an exercise program. These are the basics of healthy living. But it’s not always easy to do, especially when you’re not sure about what makes up a healthy diet.

Many people think they’re eating healthy, but they’ve been duped by marketing campaigns for “all-natural,” “low-fat,” and “low-calorie” products. Don’t fall for these tricks. These products often contain high amounts of sugar. And research shows, that a diet low in saturated fat and high in carbohydrates (sugar) leads to increased levels of pattern-B LDL.

Final Thoughts

The road to healthy living can be confusing. But staying abreast of new information and guidelines is important. Consider the “All LDL is Bad” myth as dead and throw it out with last weekend’s trash. You now know that not all LDL is bad. And in fact, eating healthy saturated fats can even be good for you!


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