Recently, somebody asked me on Twitter: how can we lower our ApoB? Or is it all genetics? And Rob answered: good question, these experts don't tell people what to do, now they say LDL is useless. What are we supposed to do in the real world? I totally know what you mean, Rob. Just cut the mumbo jumbo, what do we actually do in the kitchen to get the results? That's what we're all about here so let's tackle this question in less than 10 minutes. How to lower your ApoB, actionable tips, let's go. If you're not entirely sure what ApoB is, don't worry, you're definitely not alone. It turns out to be a crucial metric but these nerdy terms take a while to become household names. We've made some videos covering this in detail but the short version is that ApoB is a marker

of lipoprotein particles in our bloodstream and specifically the atherogenic lipoproteins, so the particles that actually accumulate in the artery wall and cause plaque, atherosclerosis, heart disease. Over the last several years, it's become pretty clear that apob is one of the key factors for plaque, atherosclerosis, more so than the common metrics we hear about: cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, etc. So, keeping apob in the healthy range is crucial for cardiovascular health. In fact, a new study just came out in The Lancet showing apob not only poses a risk for heart disease but also diabetes and even length of life itself. According to the authors, higher apob is detrimental to lifespan and increases risk of coronary heart disease and type 2 diabetes. Different approaches to lowering apob (that's what we're covering in this video).

should have widespread beneficial effects, including preventing common diseases and even prolonging life. So, kind of a big deal. The desirable range for apob is under 90 milligrams per deciliter and even lower if you're at very high risk. There's over 80 separate studies on lifestyle changes and their effect on apob, so we're going to go over them one by one in detail right now. So grab a drink and... no, just kidding. Everybody's like back to cat videos. Lucky for us, others have already done all that work. This article went over 87 studies and boiled it all down for us, and Alan Sniderman, one of the authors, is one of the foremost lipid experts in the world. A lipidologist, it's called. Yep, that's a real thing. So we took that paper top to bottom, we crunched down the essentials, here are the factors that lower apob: weight loss. Apob was reduced in all studies that induced

weight loss of six to twelve percent body weight. That's if you have that much extra fat, of course. Don't go off chopping arms. The way it works is, when we lose weight we produce less VLDLs, which is one of those atherogenic particles in our blood, and VLDLs can turn into LDLs. So losing weight helps us make less of these particles and it also causes more LDLs to be broken down. End result is less atherogenic particles floating around, reflected in a lower ApoB level. Another big factor is unsaturated fat. That includes mono and polyunsaturated fats. Both powerfully lower ApoB. Sources of monounsaturated fats include avocado and some vegetable oils like olive oil. Polyunsaturated fats can be found in flax, chia, or walnuts, for example. Also, long-chain omega-3s like DHA and EPA are a type of polyunsaturated fat and they can be found

in fish, algae, or algae supplements. So shifting from other foods to unsaturated fats has a robust apoB-lowering effect. The strongest effect is seen when switching from sources concentrated in saturated fats to more unsaturated fats. Switching some of our carbohydrate with unsaturated fat can also help lower apoB. As explained in the article, replacing carbohydrate with monounsaturated fats, but not saturated fats, decreases plasma apoB. It's probably the increased monounsaturated fat that reduces apoB, not the drop in carbs per se, because just reducing carbs without changing the amount of fat does not reduce apoB. But with nutrition, of course, it's always a zero-sum game; you gotta remove something to put something in, right? I can already hear some of you going no we don't, we could just pile it on, duh. Bottom line, including more sources of unsaturated fat like avocados, nuts

and seeds, fish, or non-tropical vegetable oils like olive oil or canola oil, and swapping out some of the concentrated sources of saturated fat like fatty meats and butter and some tropical oils like coconut and palm is one of the main levers that will help you lower your apob. Another thing that has been shown to lower apob is soluble fiber. Foods rich in soluble fiber include apples, okra, eggplant, berries, oats, and barley. Psyllium husk, which is a really weird name, it doesn't sound like food, it sounds like a character from Game of Thrones, but it's really rich in soluble fiber. And the way it works is it reduces absorption of cholesterol in our intestine, which helps lower apob. Okay, does this really work, this psyllium thing? Well, they tested the effect of adding psyllium to a statin, and it was as effective at lowering

lipids as doubling the statin dose. Now, some of you might be thinking, if psyllium works by reducing cholesterol absorption, what if I just eat less cholesterol? Does that work? The answer is... maybe. In one study, eating 800 milligrams of cholesterol a day, which is about four large eggs, raised apob compared to a low cholesterol diet, but it was just one study and the amount of cholesterol was pretty high so I wouldn't jump to the conclusion that dietary cholesterol is a major factor to control apob. Just good information to know. In addition to those three main factors, some other foods may also play a role. They're not as established as the main three but the evidence is suggestive. Phytosterols, which you find mainly concentrated in nuts and seeds, some randomized controlled trials suggest phytosterols may have an apoB-lowering effect.

not entirely clear, and it may require a high dose. Fructose. Very high levels of purified fructose can raise VLDLs and ApoB. In two studies, people drinking fructose-sweetened beverages every day ended up with higher ApoB. Bear in mind they were getting a quarter of their calories from these drinks, so that's a lot of soda guzzling. Maybe not an unrealistic scenario, especially in the US, so good to know. Trans fats can also raise ApoB, although in the US, trans fats are not as much of an issue anymore. They've been banned from most artificial foods, but if you live somewhere where trans fats are still a reality, something to bear in mind. There are some naturally occurring trans fats in meats and dairy, but they're much, much lower amounts. Soy protein has a possible ApoB-lowering effect. There is some heterogeneity, but in most studies on people with high lipid levels,

soy protein helped lower apob, although they used isolated soy protein, so it's not entirely clear if less processed forms of soy, like tempeh or tofu, would have the same effect. And finally, they looked at overall dietary patterns, which are most effective at lowering apob. And they found that the Mediterranean diet had the most evidence behind it. Doesn't necessarily mean it's the best diet for apob, just that it's been studied more and consistently showed benefit. Not that surprising considering unsaturated fats are a big factor in Mediterranean diets with all the olive oil and other plant fats, and it has a substantial amount of soluble fiber as well. There's also some evidence for the DASH diet, vegetarian, Nordic, and paleo, although less than for Mediterranean. But really, any dietary pattern rich in unsaturated fats should be pretty bomb for apob. Now, it's important to point out, diet can help a lot, but it's not

going to be enough for everybody. Some people need an extra boost. I don't think medication should be the default approach, but for the right people, they can be life savers. Medications that help lower apob include statins, pcsk9 inhibitors, ezetimibe, and omega-3s in a higher dose than what we get from food. So, those are the main three actionable tips to get your apob spit shining. Here are some more practical ideas to incorporate into your daily life: how to grind flax seeds for maximum absorption and how to make cheese from cashews. That got me hungry.

3 actionable tips to lower ApoB!

3 actionable tips to lower ApoB!

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