Heart Health
LDL Cholesterol
What This Marker Tells Us
Measures "bad" cholesterol that can deposit in arteries causing atherosclerotic plaques; elevated LDL is the primary modifiable risk factor for heart disease and stroke.
Why It Matters
LDL particles transport cholesterol from liver to tissues but can deposit in arterial walls, particularly when oxidized or when present in excess. LDL is directly causal in atherosclerosis; decades of research prove lowering LDL reduces cardiovascular events. However, standard LDL-C measurement has limitations: it doesn't distinguish between large fluffy LDL (less harmful) and small dense LDL (very atherogenic), and it's often calculated rather than directly measured. Optimal LDL depends on individual risk: low-risk people target below 100 mg/dL, moderate-risk below 70 mg/dL, high-risk below 55 mg/dL. Very high LDL (above 190 mg/dL) may indicate familial hypercholesterolemia requiring aggressive treatment. LDL particle number (LDL-P or apoB) provides better cardiovascular risk assessment than LDL-C alone.
How to Interpret Your Trends
Traditional guidelines suggest LDL below 100 mg/dL for most people, below 70 mg/dL for those with cardiovascular disease or diabetes, and below 55 mg/dL for very high-risk individuals. However, optimal LDL is increasingly debated—some evidence suggests lower is better without a clear lower threshold. LDL of 100-129 mg/dL is "near optimal," 130-159 mg/dL is "borderline high," 160-189 mg/dL is "high," and above 190 mg/dL is "very high." Rising LDL trends indicate increasing cardiovascular risk requiring intervention. Falling LDL trends reflect improving cardiovascular risk profile.
What Influences This Marker
LDL increases with dietary saturated fat (moderate effect), trans fats (strong effect), obesity, sedentary lifestyle, smoking, hypothyroidism, kidney disease, familial hypercholesterolemia, and aging. LDL decreases with statin medications (most effective), soluble fiber (oats, psyllium, beans), plant sterols/stanols, weight loss, exercise, plant-based diets, soy protein, and nuts. Genetics strongly influence LDL; some people require medication to achieve target LDL despite optimal lifestyle. Saturated fat's effect on LDL varies individually based on genetics.
How Your Team Uses It
Your coach implements evidence-based dietary patterns reducing LDL: increasing soluble fiber through oats, legumes, and psyllium; incorporating plant sterols from fortified foods; emphasizing monounsaturated fats (olive oil, avocados, nuts); reducing saturated fat from animal sources; eliminating trans fats completely.
Related Signals We Also Review
Total cholesterol, HDL, triglycerides, LDL particle number (apoB or LDL-P when available), non-HDL cholesterol, hs-CRP, family history, and other cardiovascular risk factors for comprehensive risk assessment.