Diet, Exercise and Conquering Your Small LDLs

Melanie Thomassian Health Pro

    Most people are aware that having high LDL cholesterol isn't good for heart health. But, studies have found it isn’t only the quantity of LDL in your blood that's important, it’s also the quality


    Paul Ziajka, M.D., clinical lipidologist with the Southeast Lipid Association, states, "Small, dense particles of LDL are much more inflammatory than larger particles."


    I asked Registered dietitian, Lisa Nelson, for her thoughts on small, dense LDL, here's what she said:


    "There are five different Low Density Lipoprotein (LDL) categories ranging in size, density, and buoyancy. The smallest and densest LDL particles are the most dangerous in regards to health. Small-dense LDL is a specific risk factor that can be independently associated with heart disease.

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    Small-dense LDL can more easily penetrate artery walls due to their smaller size. The smaller the LDL particle the more likely it is to enter the artery endothelium, where it can become oxidized and lead to plaque formation. Research shows that niacin is one tool for treating small-dense LDL cholesterol, as well as making diet and lifestyle changes to promote heart health."


    You may be interested in this ecourse provided by heart health dietitian Lisa Nelson RD How to Lower Cholesterol in 8 Simple Steps."


    Worried about small, dense LDL? Here are 5 checks you should make:


    1. Check your carbs

    As Dr Davis regularly points out here at Health Central, keeping a check on your carbohydrate intake, particularly those from sugars and refined starches, is very important in terms of small LDL. 


    In its most basic form, this means avoiding sugar loaded drinks and snacks, and instead including more whole foods in your diet, such as ground flaxseed and oat bran.


    2. Check your fats 

    Having fat in your diet is very important, so the standard advice to "go low fat" isn't all that helpful. The important thing to remember is, to get fat from the right sources. 


    A high percentage of the fats in your diet, should be coming from things like olive oil, oily fish, avocados and unsalted, unroasted nuts (walnuts, almonds, hazelnuts), and less should be coming from processed meats and cookies, etc.


    3. Check your antioxidants

    You should aim to eat more antioxidant rich, brightly colored vegetables and fruit, in an effort to maintain your heart health. 


    At the very minimum eat 5 portions per day, but you really need to be eating more. Go for fresh produce whenever you possibly can, and if cooking them, do so for the least amount of time to preserve their nutritional goodness.


    4. Check your weight

    In a study, researchers found the majority of overweight men who were pattern B (mostly small LDL), switched to pattern A (mostly large LDL), after they lost an average of 19 pounds. 


    So, it certainly won't do any harm to lose a few pounds, if you are carrying some extra weight. Once again your aim should be 1 to 2 pounds per week, via exercise and a healthy diet.


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    5. Check your exercise

    Daily exercise is extremely important in terms of protecting your heart, and reducing small, dense LDL. But, it needs to be regular to maintain the benefit. 


    The standard advice is to aim for 30 minutes per day. I suggest finding an activity you really enjoy — then before you know it, you'll be working out for longer, and noticing the benefits! Cardio exercise is really important, so try to include some each week, and workout at a level where your heart rate is increased above normal. 


    6. Check your meds

    If you are already taking medication to lower your cholesterol levels, some of these drugs — such as fibrates and niacin — may also reduce the formation of small, dense LDL. 


    Speak to your doctor for further information.


    As a side note, if you smoke... stop! This is so important for overall good heart health. There's no point putting the above into action, and forgetting about this important factor.


    This is certainly far from an exhaustive list, but by including even a few of these lifestyle changes, it could help turn your cholesterol worries into a thing of the past.


    Melanie Thomassian is a registered dietitian, and author of, get more healthy eating tips on her website.


Published On: April 15, 2010