Since becoming more of an educated health consumer re. lipid testing, I find myself squarely in the middle of mainstream and alternative advice. IMHO (I could be 100% wrong) I think it's a mistake to think LDL-P doesn't matter and we should just focus on particle size. I also think it's a mistake to suggest the opposite; that small particle size, low HDL/high TGs are OK as long as LDL-C/P is low. At this point, I'm terrified enough to heed everyone's advice I want low LDL-P/apoB, low unoxidized LDL, low Lp(a), Pattern A: large and fluffy particles, with high HDL-C/P and low TGs. That being said, I think low glucose and insulin markers trump EVERYTHING followed closely by low inflammation markers.
Well said. I agree.
The idea that Lp(a) is tied to LDL-C/LDL-P/apoB (any or all) is interesting. My LDL-C has been crazy high (130-150) since eating high MUFA, but my LDL-P and apoB have been relatively decent. I tend to show discordancy in the opposite direction of most. That may fit in with your theory somehow... My understanding, however, is that Lp(a) is largely genetic. That makes me wonder is oxLDL may be the same?
The idea is that the percentage of apoB particles with oxidized phospholipids is highly correlated with Lp(a) rather than the raw oxLDL count. Thus, the logic would be that if it is hard to lower Lp(a), the critical part to lowering oxLDL would be to lower overall LDL particles. I have had only transient success with lowering Lp(a), and it is back to where it was around 150 nmol as I am playing around with other dietary stuff. Of course, there is also making sure we aren't taking in easily oxidized or pre-oxidized PUFA's and getting plenty of lipid antioxidants like green tea, olives/EVOO and other protective plants.