CAD Risk factor and real life example


According to the INTERHEART study report released in 2004 involving 52 countries and 30000 individuals, the single most important predictor of Myocardial Infarction (MI) is the ratio of two proteins in the blood - Apolipoprotein B ( ApoB in short ) & Apolipoprotein A-1 (ApoA-1) Myocardial Infarction is a manifestation of Coronary artery disease ( CAD) due to atherosclerotic plaque deposits in the artery .This ratio ( ApoB / ApoA-1) is a strong risk predictor of heart disease -,better than TG/HDL ratio and TC/HDL ratio . These Apolipoproteins are not checked in the standard lipid profile test and therefore the standard lipid profile test does not give much information in so far as the heart disease risk factor is concerned . Apolipoprotein A-1 is the major structural protein of HDL particle which is large and fluffy .It is responsible for reverse cholesterol transport in the blood stream - taking the cholesterol back to the liver from the cells. Apolipoprotein B are small dense cholesterol carriers which get easily oxidized causing inflammation in the artery and therefore , they are atherogenic particles

Similar study conducted in 2010 in the Biochemistry Department of Lady Hardinge Medical College ,New Delhi also corroborates with the INTERHEART study report and recommends that ApoB / ApoA-1 ratio be used for Indian population for assessing risk of MI. The study report is attached


Here comes the crux of this post.,where I do share my real life experience

I am a follower of LCHF diet since July 2013. Though my HbA1C level has considerably reduced with LCHF diet ( from 7.2% to 6.2%) my recent Lab report indicates that my LDL cholesterol is 138 mg/dL .My Diabetologist considers this level as a bit high and has prescribed me stain drug to reduce it to a ‘safe level’ since it is higher than the reference value of 100 mg/dL . However, I was not willing to take stain drug since I knew it caused more harm than good . I know that it is the small dense component of LDL particles which are really bad and not LDL cholesterol per se. Driven by the knowledge gathered from my web search on risk predictors for heart disease , I was searching for a clinical lab where I could get my Apolipoproteins A1 & B checked. Many clinical Labs did not even know what I was referring to. Some labs asked me to spell Apolipoprotein !!.Finally, I stumbled upon a biochemistry lab attached to the famous Narayana Hrudayala in Bangalore where I have got my blood sample tested for the lipoproteins A1 & B. The results are :

Apo A-1 = 162 mg/dL ( Ref. value : 104 to 202)

Apo B = 99 mg/dL (Ref .value : 66-133)

Apo A-1 / Apo B ratio is 0.61

Though there is no reference value available for the ratio, the doctor attached to this lab informed me that the relative risk of CAD in my case is low .


According to conventional lipid test results , my risk factor for MI is high and the doctor prescribes stain for me to reduce the risk. But actually , the risk predicted by the new bio-marker( Apo B/Apo A-1) is rather low . I attribute this low risk to the LCHF diet . My HDL and TG levels have improved in the last 10 months.( 68 & 63 mg /dL respectively) Even the increase in LDL cholesterol level is due to large buoyant LDL particles which are not atherogenic .Small dense atherogenic LDL particles have in fact been reduced by restrictions imposed by LCHF diet .We could find many scholarly articles ( if we really look for) on restriction of carbohydrates leading to reduction in small dense atherogenic LDL particles while increasing the large buoyant LDL particles which are good

LCHF works .


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30 Replies

  • Thyrocare lab have all these tests. Cardiac risk markers - APOLIPOPROTEIN - A1 (APO-A1),APOLIPOPROTEIN - B (APO-B), HsCRP, HOMOCYSTEINE, LIPOPROTEIN (LPA). Their reference range Male : 0.35 - 1.0 Female : 0.30 - 0.9. As you are already reading about CHD pl. visit

  • Thank you sir , for the link with wonderful articles

  • My levels are (around 7 months back):

    96 and 86 (A1, B)

    Ratio: 0.9 and within safe range.

    My HsCRP level is 0.06

    ESR 5.0

    So all good despite a fat loaded diet for more than 2.5 years now. Struggling to get HDL up.

    Lab: Thyrocare.

    Bottom Line -- LCHF is wonderful for patients but bad for the medicare industry.

    Statins as primary line of prevention drugs is useless for patients with no previous history of CVD/CHD. Besides, it increases IR, increases insulin in circulation and also blood glucose.

  • I have done these tests two months back. All are negative. Apo A-1 / Apo B ratio is 0.3

    HDL 72 LDL 67

  • Wish i could reach those levels of HDL. Mine is steady at around 37 for 3 years now. Maybe due to me being a smoker for 27 years before giving up. Nothing that is supposed to raise HDL has worked. Walking, reducing weight ( I have dropped from 82Kg to as low as 72Kg and back up at 75 now), taking CO, Flaxoil, Flaxseed etc. HDL is stuck at 37.

    My Total Cholesterol also is stable at 160 with LDL at 90. TC has been stable at 160 over last 3 years but LDL has deceased from 110 to 90

  • Why don't you try Avocado ( instead of Mangoes !!). No harm in trying

  • I have been trying to find it since long knowing that it has fat content. Couldn't find in both Reliance Fresh and Bestprice (Bhart i-Walmart) :(

  • If it is available in places like Bangalore, Hosur, Chennai etc.I am sure it will be available in Mumbai too .You have to look for it .May be you can try in any of the online stores .I also had the same issue of locating a supplier initially. Finally, I found out in a veg cum fruit market very close to my house in Chennai .I disliked the taste of Avocado initially .Now that it has become a part of my daily must-include- diet , I love the taste like any thing. Locally Avocado is known as butter fruit ..

  • Reliance Fresh does have avocados; or, may be, few outlets; write to RelFr.and inquire which of their outlets keep avocados; God bless us all with good health,

  • As you already know it is repair process (damage caused by smoking or something else) , you can't control LDL and HDL by dietary changes. Body is in need of cholesterol so for that more LDL transport. And as it is being utilized, there is less work for HDL. As your LDL has lowered over the period means there is less requirement. (Conclusion from Dr. Malcolm Kendrick's book "The Great Cholesterol Con").

  • I have ordered CoQ10 supplement and that should arrive in 2 days by courier. Next will be ordering fish oil supplement too. Let's see how these work. I am permanently on Alpha Lipoic Acid since long and would take a call on CoQ10 and Fish Oil supplement after taking LIPID panel tests maybe six months down the line

    Been over 3.5 years since I dropped smoking after being on it for 27 years.

  • I take CoQ10 as well as Salmon Omega-3 of AMWAY. also garlic caps. helps; but most important LCHF diet; kudos to MedFree and other contributors who inspired us all with LCHF;

  • Have seen them. Good articles. But I personally find more interesting.

  • Yes spacedoc is dedicated to unearthing the great Cholesterol scam on which the STATIN Drug industry relies :)

  • HsCRP level is 9.7//. APO -A1=115 //APO-B=99 AND APO-B /APO-A1 RATIO 0.9. How to lower reactive protein level. This is the readings of my wife. She is non diabetic.

  • Does she have arthiritis/gout too? HsCRP can be elevated for a huge number of reasons. It is a sign of inflammation in body.

  • what's full form for HsCRP????????????????????? I can't immediately recollect; thnx in advance

  • High sensitivity c-reactive protein. It is protein released by liver. It is measured to assess level of inflammation.

  • Thanks for the reply. No arthritis / gout. from where to start the diagnosis?

  • What is BS & regular lipid profile? As CRP can not predict specific decease, it is one of the markers of the CHD.

  • will go in detail. thanks

  • Hey, can any one read my report on apo a1 and B and let me know if I am in low risk or high risk. I am male 45 years old.


    APOLIPOPROTEIN A1 Reading = 1.69 Range = 0.89 - 1.86 g/L


    APOLIPOPROTEIN - B Reading = 1.28 Range = 0.53 - 1.73 g/L

    Cheers and Thanks

  • Your ratio of Apo-B/ Apo-A1 is 0.76. The range is Male : 0.35 - 1.0

    Female : 0.30 - 0.9. What are your HDL and TG levels ?

  • My HDl is 49 and TG is 193...TC is 230...DLDLC is 160...col/HDL ratio is 4.7...LDL/HDL ratio is 3.3....VLDL is 38.6 :(


  • Here TG/HDL ratio is more critical. In your case it is 3.94. Best is below 2. Triglycerides are also high. Your diet seems to be of high carb .

  • TG shows you must be living the life with so called healthy diet (it is unhealthy in reality) -- HIGH CARB LOW FAT Nonsense. Switching to LCHF diet will result in TG falling like a ROCK and VLDL will reduce accordingly (TG/5 == VLDL)

    CARBS KILL, FAT is innocent.

  • Shrisamrath and Medfree, both of you are correct in your judgement. I have read a lot about the LCHF diet and have also tried to look for vegetarian LCHF recipes here and on other websites, but could not find them. My issue is my family is vegetarian and we do not cook meat at home, only eggs. hence it is very difficult to get a good high fat diet every day. could you guys please suggest any recipe book or a web link for veg LCHF diet. I would like to go ahead and start getting my system right. one more question, how much time would LCHF diet take to bring the bad values to good values?


  • You have advantage that you can eat eggs. I don't. But still manage. Search on this forum. There is lot of has been posted about recipes. You need to modify your food according to what your meter reads. Eat to your meter is the best strategy.

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