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2 Ways to Lower ApoB

In a recent interview with Dr. Gil Carvalho, I asked about his stance on ApoB, which is a protein that is attached to the heart disease causing lipoproteins found in our blood stream (when too abundant). In it, he mentioned a few ways to improve one’s lipoprotein burden that I found interesting and thought I would highlight for you.

1. The P/S Ratio

The P/S ratio stands for the polyunsaturated/saturated fat ratio. Essentially, the higher P/S ratio, the evidence seems to track with lower ApoB levels [1][2]. This can be achieved through two methods - one, reducing overall saturated fat intake, and two, increasing polyunsaturated fat intake. I will note that not all saturated fat is created equal, nor is all polyunsaturated fat, but if a person were to take these rules, in general, it would lead to an increase in the P/S ratio and lower ApoB. For reference, the standard American diet has a P/S ratio of around 0.6 and it’s typically thought that 1.0 or higher is a good target.

2. Caloric Restriction + Exercise

This one was especially interesting, because I was introduced to a study [3] wherein the researchers did something unique. Apparently, they had people lose body fat through simple caloric restriction, but then put them on an exercise plan (nothing too special there…). What was unique is that they let the participants then stop their caloric restriction and only exercise (thereby maintaining their weight) and they still experienced a robust drop in ApoB levels. So, the take away being that fat loss drops ApoB, exercise drops ApoB, the combination drops ApoB further, but exercise after a fat loss phase (and no longer losing body fat) can preserve a healthful drop in ApoB.


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[1] Drouin-Chartier JP, Tremblay AJ, Lépine MC, Lemelin V, Lamarche B, Couture P. Substitution of dietary ω-6 polyunsaturated fatty acids for saturated fatty acids decreases LDL apolipoprotein B-100 production rate in men with dyslipidemia associated with insulin resistance: a randomized controlled trial. Am J Clin Nutr. 2018;107(1):26-34. doi:10.1093/ajcn/nqx013

[2] Blaton V, De Buyzere M, Declercq B, et al. Effect of polyunsaturated isocaloric fat diets on plasma lipids, apolipoproteins and fatty acids. Atherosclerosis. 1984;53(1):9-20. doi:10.1016/0021-9150(84)90100-x

[3] Beals JW, Kayser BD, Smith GI, et al. Dietary weight loss-induced improvements in metabolic function are enhanced by exercise in people with obesity and prediabetes. Nat Metab. 2023;5(7):1221-1235. doi:10.1038/s42255-023-00829-4

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