ApoB

NOT MEDICAL ADVICE (consult your doctor): How did I go about coming up with the recommendations below? I asked Chat GPT the following prompt: “Through diet and lifestyle alone, what are the best known ways to lower one’s ApoB?” It gave me the following framework. I then went to go see if I could validate these from trusted sources (Chat GPT is usually pretty good but you never know where it is pulling from and it can make mistakes and has even been known to “hallucinate” answers in attempts to try and be helpful). Given my methodology, this is OBVIOUSLY not medical advice for anyone else. Check with your healthcare provider, track your own bloodwork, etc.

Lowering Apolipoprotein B (ApoB) through diet and lifestyle is one of the most effective ways to reduce cardiovascular risk. ApoB is a marker of atherogenic lipoproteins (LDL, VLDL, remnants, and Lp(a)), and lowering it is more predictive of heart disease reduction than just lowering LDL-C.

Dietary Strategies to Lower ApoB

Focus on whole, unprocessed foods. Diets like the Mediterranean diet, which emphasize fruits, vegetables, whole grains, legumes, nuts, and fish, have been shown to lower ApoB.

1. Reduce Saturated Fat Intake:

Sources: Fatty cuts of beef, lamb, pork, butter, cheese, coconut oil, palm oil.

Why? Saturated fat increases LDL and ApoB by reducing LDL receptor activity, making LDL particles linger longer in circulation.

2. Increase Monounsaturated & Polyunsaturated Fats

Sources: Olive oil, avocados, nuts (especially almonds & walnuts), seeds, fatty fish (salmon, sardines).

Why? These fats help lower LDL and ApoB by enhancing LDL receptor activity and reducing small, dense LDL particles.

3. Prioritize Soluble Fiber

Sources: Oats, barley, beans, lentils, flaxseeds, chia seeds, apples, citrus fruits, psyllium husk.

Why? Soluble fiber binds bile acids in the gut, leading the liver to pull more cholesterol from the blood to make new bile, thereby reducing ApoB.

4. Reduce Refined Carbohydrates & Sugar

Sources: White bread, pastries, sodas, sugary cereals, processed snacks.

Why? Excess sugar and refined carbs increase hepatic lipogenesis, leading to more VLDL production, which raises ApoB.

5. Eat More Omega-3s (EPA & DHA)

Sources: Fatty fish (salmon, mackerel, sardines), fish oil supplements, algae-based omega-3s.

Why? Omega-3s help lower VLDL production in the liver, indirectly reducing ApoB.

6. Limit Processed & Fried Foods (Trans Fats & Seed Oils in Excess)

Sources: Packaged snacks, fried fast food, baked goods with hydrogenated oils.

Why? Industrial trans fats increase ApoB, LDL, and inflammation significantly.

Lifestyle Strategies to Lower ApoB

1. Regular Aerobic Exercise

Moderate to high-intensity cardio (cycling, running, swimming) can improve LDL clearance, lower VLDL production, and reduce ApoB.

2. Strength Training

Resistance exercise improves insulin sensitivity and helps reduce small, dense LDL particles (which are ApoB-rich).

3. Maintain a Healthy Body Fat Percentage

Reducing visceral fat lowers hepatic VLDL production, which in turn reduces ApoB levels.

4. Optimize Sleep & Manage Stress

Chronic stress and poor sleep increase cortisol, which can increase hepatic lipid production and ApoB levels.

5. Avoid Excess Alcohol

Alcohol increases hepatic triglyceride synthesis, leading to higher VLDL and ApoB.

6. Time-Restricted Eating (Intermittent Fasting)

May help reduce hepatic fat accumulation and improve lipid metabolism.

How Much Can Diet & Lifestyle Reduce ApoB?

Dietary changes alone can lower ApoB by 10-30%, depending on individual response.

Adding exercise & weight loss can further reduce ApoB, sometimes by 30-40%.

If ApoB remains elevated despite lifestyle changes, medications (statins, PCSK9 inhibitors, ezetimibe, or bempedoic acid) may be needed.

Pharmacology

Statins
PCSK9 Inhibitors

Supplements to consider:

Berberine
Omega-3