One of the most important, and often misunderstood topics we discuss with patients at Vitality is cholesterol. You’ve probably heard that “high cholesterol” causes heart disease. But is that the full picture?
There is a lot to unpack when discussing the complex world of lipids (fats in your blood) and how they relate to cardiovascular disease (CVD). Especially with the groundbreaking research from leading lipidologist Dr. Tom Dayspring, someone whose work has reshaped how we think about cholesterol, particle size, and true cardiovascular risk.
What Are Lipids and Why Do They Matter?
Lipids include cholesterol and triglycerides, fatty substances that travel through your bloodstream. While essential for hormone production, brain health, and cell membranes, certain patterns of lipid imbalance can significantly increase your risk for heart attacks and strokes.
Most patients are familiar with these terms from their blood work:
Total Cholesterol
LDL ("bad" cholesterol)
HDL ("good" cholesterol)
Triglycerides
However, Dr. Tom Dayspring and other experts have made it clear: it’s not just about your LDL number—it’s about what’s inside that LDL.
New Key Players: ApoB and Lipoprotein Particles
Each LDL particle carries cholesterol through the blood. The problem isn’t the cholesterol itself—it’s the number of particles (especially small, dense LDL particles) that matters most. These particles can damage blood vessel walls, trigger inflammation, and initiate plaque buildup.
This is where Apolipoprotein B (ApoB) comes in. Every atherogenic (plaque-forming) particle contains one molecule of ApoB, so ApoB testing gives a more accurate count of the harmful particles than standard LDL cholesterol tests.
Dr. Dayspring puts it simply: “If there’s one test you do to assess cardiovascular risk, it’s ApoB.”
High ApoB = more particles = higher risk of cardiovascular events, even if your LDL cholesterol appears “normal.”
Triglycerides and Insulin Resistance
Another critical piece of the puzzle is your triglyceride level, especially in the context of metabolic health. Elevated triglycerides often point to insulin resistance, which can increase your risk for type 2 diabetes and cardiovascular disease.
At Vitality, we dig deeper. A normal basic lipid panel doesn’t always mean low risk—especially if there are underlying issues with insulin, inflammation, or endothelial (blood vessel) function.
Advanced Lipid Testing: Beyond the Basics
At Vitality, we use advanced lipid panels to go far beyond the standard cholesterol test. These include:
ApoB: a marker of atherogenic particle count
LDL-P: total number of LDL particles
Lp(a): a genetic lipoprotein that significantly increases heart disease risk
Our goal is to reduce the number of harmful particles in your bloodstream—not just lower your LDL cholesterol with medication. We evaluate root causes such as:
Poor metabolic health
Chronic inflammation
Poor gut health
Hormonal imbalances
Sleep disruption
Genetics (like Lp(a) levels)
Depending on your risk profile, we may use a combination of lifestyle interventions, targeted supplementation, and if necessary, prescription medications like statins or PCSK9 inhibitors—always personalized to you.
What You Can Do Right Now
Here are a few powerful steps you can take to support optimal lipid health:
Get advanced lipid testing, including ApoB
Focus on real, unprocessed foods—especially healthy fats like olive oil, nuts, avocado, and wild fish
Exercise regularly, particularly strength training and Zone 2 cardio
Prioritize sleep and stress management
Address insulin resistance
Cholesterol is not the enemy. But elevated ApoB and dysfunctional lipid particles are major risk factors for heart disease. At Vitality, we take a comprehensive, science-backed approach to help you understand your personal risk—and reverse it.
If you're ready to go beyond the basics and truly optimize your cardiovascular health, we’re here to guide you with the latest research, personalized care, and a clear path forward.
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