50% of Heart Attack Victims Had “Normal” Lab Results

Is LDL really the “bad cholesterol”? Uncover the truth behind common cholesterol myths, what high LDL and cholesterol levels actually mean, and whether elevated LDL is as dangerous as you’ve been led to believe.

Your LDL is dangerously high. What do you do? Recently, my wife had her blood test and she showed me the results and her LDL was super high and she was concerned and she was wondering, do I need to go on statins? And today, I’m going to tell you what I told her and what many people are never told about LDL. LDL is not cholesterol.

LDL protein is made by your liver. It’s a normal thing and the liver is packaging this cholesterol in a way so it can actually be delivered to the cell. Why? Why does it go into the cell? Because this cholesterol is necessary to help you build hormones, testosterone, estrogen, the stress hormone called cortisol.

Cholesterol is the raw material that helps you make vitamin D, helps you make bile. The membranes in your cell are made from cholesterol. And what’s really interesting is inside this cargo is not just cholesterol little particles, but you also have 45% of all your vitamin E is in there. You have 76% of all your carotenoids, like beta-carotene for example, is in this LDL. You also have coenzyme Q10, which supports the heart and the mitochondria as a powerful antioxidant.

You also have vitamin K in here to help prevent bleeding. So, if LDL was so bad, why do you have all these key antioxidants in there? And this next point I want to bring up is over 50% of all heart attacks have normal LDL. When you get your test back and it says LDL, it’ll usually say it’s the total amount of LDL cholesterol you have, okay? And when we’re talking about the total, we’re talking about the weight per volume.

What it’s not measuring is something way more important because inside this little cargo, you have these little particles of cholesterol. And there’s two different kinds. There’s the small ones, they call them small dense, and there’s the large ones called the large buoyant. Now, let me tell you why that’s important. Because the small dense are the ones that really can be a problem and they’re small so they can penetrate the inside of the artery wall and create problems.

I am going to show you what causes more small dense versus large buoyant, but you need to know there’s two types of LDL that are not going to be seen on your regular cholesterol test. You have to get a special test for that. It’s called an advanced lipid profile test. And just you know, the high LDL that my wife had was not the small dense. She did not have the bad kind.

She had a higher amounts of the large buoyant. I’ll explain why. This is actually not a problem, but if you don’t differentiate that, people freak out and they get scared and they’re put on something called statins, which I’m also going to talk about. So, that’s some basic things you need to know. There’s one additional thing.

I’m not going to get too far into it, but I don’t know if you’ve ever heard of something called apoB. Basically, what that is it’s the number of particles. So, it’s kind of like an indirect way of measuring if you have more of the small dense because if this number is high, that means you’re going to have higher amounts of these little particles in this little cargo truck right here. Because if you had large particles, you would have less number of them because they’re larger, but you can fit a lot more small particles. So, when you have a high apoB, that tends to mean that you probably have more small dense particles of cholesterol in that LDL cargo unit.

So, is apoB a good indicator? Yeah, it’s another good indicator to kind of help you understand what’s happening inside that little cargo unit. Now, let’s get to one of the biggest studies that was ever done on the diet. It’s called the Mediterranean diet. PREDIMED.

This is the study that a lot of doctors and the news will tell you that you will reduce your cardiovascular events by 30%. So, you want to get on this diet because they proved it. They will use it to tell you that this diet proves the prevention of heart disease. And we’re talking about over 7,000 people in Spain. This was published in the New England Journal of Medicine, the biggest intervention trial ever run.

And you see this online all over the place. The Mediterranean diet reduces cardiovascular events by 30%. Well, I want to just tear that apart because it does relate to LDL indirectly. The first big question on this diet is what are they comparing this diet to? They had one group where they basically gave them free olive oil, and they gave them free nuts and dietary counseling.

Okay? So, that was one group. The other group were told to follow a low-fat diet. That’s it. That’s what they compared.

A lot of the other details and things that they did and ate were kind of filtered out. They called that adjust lifestyle factors, which basically is kind of let’s just filter those out cuz that’s like background noise. Really, they were comparing two groups. One group that consumed more olive oil and nuts, and the other one was supposed to kind of generally follow a low-fat diet. And what was interesting about that, this group here, the control group, didn’t follow a low-fat diet.

Their fat amount, if we look at all their calories, ended up to be 37% fat, okay? The Mediterranean group had 41% fat. So, that was actually more fat. That’s a 4% difference, okay? I mean, this is a landmark study that compares people who got free food and coaching against people who got advice that they didn’t follow.

Then it was retracted. In 2018, the New England Journal of Medicine pulled the study because 21% of the participants never properly were randomized. At one site, the entire group was assigned to the same diet instead of individuals. It was then republished to reanalyze the data, but it could no longer call itself a properly randomized trial. And here’s why this matters, because studies that adjust for lifestyle factors, they’re actually removing the very things that might be causing the disease.

Because the real problem is you can’t double-blind people in a diet study. Because everyone knows what they’re going to be eating. It’s going to be in front of them. So the whole setup, the system of doing randomized control studies, never was designed for diet or food because there’s too many variables. Okay, so that’s one aspect.

The next thing I’m going to talk about in this diet was this claim that it reduced cardiovascular events by 30%. Now, if someone told you that, you’re going to look at that and go, “Wow, it’s going to reduce my heart attacks by almost a third. I’m going to get on that diet, right? Makes sense. But that’s not actually what that means.

Picture two classrooms, okay? 100 people in each classroom. Classroom A over here, they don’t get the Mediterranean diet. They’re getting the low-fat recommendation. And over five years, roughly four people in this group have a cardiovascular event.

Then we go over here in the classroom B. This is the Mediterranean diet group. Over five years, roughly three people have a cardiovascular event. One fewer person out of 100. That is called absolute risk reduction.

We’re comparing four on this side to three on this side. Relative risk is just looking at the difference between the control or the sugar group to the actual group that is tested, either the diet or a drug or whatever. So, if we look at the absolute risk on this study, this 30% relative risk comes down to like a little over 1%. One out of 100 people will benefit from this diet. And we’re just talking about adding more olive oil and nuts compared to following a low-fat diet, but you’re not actually lowering your fat very much.

So, there’s a lot of issues with research in the area of nutrition and diet and foods because there’s too many variables. RCTs were generally designed for drug re