Why ApoB matters more than LDL cholesterol

What is ApoB?

You've likely heard of LDL before. It measures how much cholesterol is carried by LDL particles in the blood.

Apolipoprotein B (ApoB) is a structural protein in several types of atherogenic (artery-clogging) lipoproteins, including LDL. An ApoB test counts LDL particles as well as other atherogenic particles.

Essentially, LDL measures the cargo, while ApoB counts the ships. You could have identical LDL cholesterol levels but very different numbers of LDL particles. Even if your cargo looks the same, more particles mean a higher risk of cardiovascular disease.

Why ApoB is a better predictor of cardiovascular disease

LDL cholesterol has been the standard metric for decades, but it doesn't capture the full picture.

ApoB is particularly useful for people with metabolic conditions where LDL particle size varies. For example, someone with many small, dense LDL particles may have a "normal" LDL-C reading while carrying a substantially elevated risk.

It's the lipoprotein particles themselves that penetrate artery walls and drive atherosclerosis, which is the buildup of plaque that leads to heart attacks and strokes. This explains why ApoB can actually be more useful and accurate than LDL.

Many experts in the field now agree that ApoB is an important addition to a typical lipid panel. In fact, a 2024 consensus statement from the National Lipid Association concluded that ApoB is a more reliable indicator of cardiovascular risk than LDL cholesterol.

Learn more about how ApoB home testing works.

Lifestyle interventions to reduce ApoB levels

Making changes to your diet, exercise routine, and daily habits can have a significant impact on your blood lipids. These habits aren't just useful for people with elevated levels; they can play a valuable role in keeping your blood lipids in the normal range.

Diet

Try eating more fibre-rich plant foods like fruits, vegetables, and whole grains. Adding unsaturated fats like olive oil, oily fish, and nuts can also help.

The efficacy of these changes can vary by individual, and factors like BMI and genetics all affect how much your diet can change your cholesterol.

Exercise

Aim for at least 150 minutes of moderate-intensity aerobic activity per week (or 75 minutes vigorous). Consistent movement improves lipid profiles broadly, including ApoB.

Weight management

If you're overweight or obese, even modest weight loss can meaningfully shift your lipid markers.

Stress reduction

Chronic stress is associated with worse cardiovascular outcomes, though the direct effect on ApoB specifically is less well-established than diet and exercise. Still, techniques like meditation or breathing exercises could help and have little downside.

Learn more about how Thriva users reduced their cholesterol levels through lifestyle changes.

Takeaway

ApoB offers a clearer look at cardiovascular risk than LDL cholesterol alone. If you want to understand your risk, it's worth knowing your number and tracking whether your interventions are actually moving it.

Our Advanced Lipid Profile includes ApoB alongside standard markers, giving you a more complete picture of where you stand.