Lipoprotein Checklist:
Very low-density lipoproteins (VLDL)
VLDL particles are the first particles to enter the blood after production in the liver. VLDL particles are formed by combining cholesterol, triglycerides, and the protein, apoprotein B. VLDL contains only 10–15% of a person's total cholesterol.
Increased VLDL usually occurs along with increased triglycerides, low HDL cholesterol, and small LDL. Contrary to conventional wisdom, increased VLDL can occur even when triglycerides are in a "favorable" range of <150 mg/dl.
VLDL adds to coronary plaque growth. Along with intermediate-density lipoprotein (IDL), VLDL can reflect the persistence of digestive particles after a meal, called a "postprandial" (after-eating) disorder. Although elevated immediately after a fat-containing meal, processed carbohydrates in the diet create this pattern long-term. A reduction in processed carbohydrates, such as wheat flour-containing products, can yield substantial drops in VLDL, along with triglycerides.
How to Decrease VLDL
* Weight loss to ideal weight or ideal BMI (25). If achieved with a reduction in processed carbohydrates, the effect will be especially significant.
* Reduction in processed carbohydrates—especially snacks and wheat-flour containing foods like breads, pasta, pretzels, chips, bagels, etc. The reduction of high- and moderate-glycemic index foods is the factor that reduces VLDL.
* Avoidance of high-fructose corn syrup—which skyrockets both triglycerides and VLDL. High-fructose corn syrup is a common sweetener in processed foods.
* Fish oil—Dramatic reductions in VLDL are seen with fish oil. In fact, at a dose of 4000–6000 mg of fish oil (providing 1200–1800 mg of EPA+DHA), complete elimination of excess VLDL results for most people. Occasionally, higher doses are required. Fish oil is the number one strategy for reduction or elimination of excess VLDL.
* Niacin (vitamin B3)—Niacin by itself reduces triglycerides up to 60–70% and can virtually eliminate excess VLDL at doses of 500–2000 mg. (Doses >500 mg per day should be prescribed and monitored by a physician.) Niacin combined with fish oil is a very potent regimen.
* Red grapefruit—Eating red grapefruit can reduce triglycerides and VLDL by around 20%. White or blonde grapefruit lacks this effect. (However, if you take a statin drug or red yeast rice, you should not add grapefruit, since it causes accumulation of these agents.)
* The fibrates (two preparations: Lopid®, or gemfibrozil, and Tricor®, or fenofibrate) are prescription agents that substantially lower VLDL and triglycerides.
* The thiazolidinediones (Actos®, or pioglitazone, and Avandia®, or rosiglitazone), usually prescribed for pre-diabetes or diabetes, can reduce VLDL by 30%. However, these agents are accompanied by weight gain.
Track Your Plaque target: Triglycerides 60 mg/dl or less; Total VLDL <10 mg/dl.LINK |
