Life Extension Magazine®
Man holding chest before taking blood test

Why Blood Tests are not Saving More Lives

Achieving healthy apolipoprotein B levels can decrease coronary artery disease risk. Conventional blood tests usually do not test for apolipoprotein B.

By William Faloon.

William Faloon
William Faloon

Back in the 1950s, a scientist uncovered the link between LDL cholesterol and atherosclerosis.1,2

Critics argued that heart attacks occurred in some people who did not have excess LDL.

What was not known in early years is that there are different types of LDL particles.

If your LDL surface contains high levels of a protein called apolipoprotein B, it is more likely to damage arterial walls and set the stage for atherosclerosis.

In some populations, those who maintain low lifetime apolipoprotein B levels have an approximately 90% decreased risk of coronary artery disease.3

What impresses us is evidence showing regression of arterial plaque when apolipoprotein B blood levels are reduced.4

Despite intensive educational efforts, apolipoprotein B blood tests are not routinely incorporated into primary care medicine. The tragic result is a failure to prevent heart attacks, strokes, and other occlusive arterial diseases.

For Life Extension® readers, this problem was resolved when apolipoprotein B was added to comprehensive blood tests they undergo each year.

We know today that atherosclerosis is a result of a myriad of risk factors. These include elevated glucose, insulin, homocysteine, triglycerides, and inflammation,5,6 along with hormone imbalances.

This article reveals how coronary artery stenting, bypass surgery, and sudden death can be reduced via inclusion of apolipoprotein B in annual blood test panels.

Heart attack incidence peaked in the year 1968, accounting for 37% of all deaths in the United States.7,8

The epidemic was alarming, as it often targeted otherwise healthy people at the peak of their careers.

Advances in prevention and treatment led to marked reductions in sudden death and improved survival in those stricken.

While heart disease remains the leading killer, it was responsible for 25% of American deaths in 2019 compared to 37% in 1968.9,10

As blood testing evolves to better detect artery-damaging factors, further declines in coronary artery disease and ischemic stroke are likely.

Role of Lipoproteins

Apolipoprotein B is linked to the initiation and propagation of atherosclerosis.11

High levels of apolipoprotein B penetrate the inner arterial wall (the endothelium) and set the stage for blockage of blood flow.12-14

Those whose blood test shows elevated cholesterol and apolipoprotein B are especially at risk.15-17

To put this in perspective, higher apolipoprotein B levels have been associated with a 60% increase in coronary heart disease when total cholesterol and HDL are in safer ranges.18

In people with higher levels of cholesterol and apolipoprotein B, along with lower HDL, there is a 160% increased incidence of coronary disease.18

Elevated apolipoprotein B is a more reliable marker for cardiovascular disease than LDL, HDL, and total cholesterol.19-22

The good news is that apolipoprotein B can be easily tested in one’s blood and reduced to safe ranges if need be.

Eat Walnuts

Healthy foods

A myriad of studies associate walnut consumption with reduced risk of coronary heart disease.23-26

A study assessed a range of cardiovascular risk markers in response to a diet containing about 1.52 ounces of walnuts daily for eight weeks compared to a typical Western diet.23

Two benefits of walnut consumption in this trial were a modest non-HDL cholesterol reduction and a more pronounced 5.5% reduction in apolipoprotein B.23

These findings led the researchers to conclude that the observation of reduced cardiovascular events in people who eat walnuts may be explained in part by reduced non-HDL cholesterol and apolipoprotein B.23

A follow-up analysis looked at previous studies that evaluated consumption of tree nuts and found reductions in apolipoprotein B in type II diabetics who consumed higher amounts of tree nuts.27

Dietary Changes for Lowering Apolipoprotein B

Those who follow a more Mediterranean style diet have a reduced incidence of cardiovascular disease and lower apolipoprotein B blood levels.29,30 Here are some additional dietary suggestions:

  • Eat far fewer saturated fats (such as butter, palm oil, coconut oil, meat fats, and milk fats); trans fats (such as margarine, vegetable shortening, and partially hydrogenated oils); and dietary cholesterol.
  • Eat far more fiber-rich foods (especially soluble fiber from beans, yams, tree nuts, oats, barley, and berries).
  • Eat vegetable proteins (such as tofu and beans) in place of meat and poultry.
  • Eat fewer added sugars and refined grains (such as white flour).
  • Eat more cold-water fish.

Avoid Sugar

An investigation looked at associations of apolipoprotein B blood levels with education, lifestyle factors, and dietary patterns.28

The intake of sucrose and foods containing added sugar (such as pastries, sweets, jam and sugar- sweetened beverages) correlated with higher apolipoprotein B levels.28

This study identified other unhealthy factors such as smoking, obesity, and low physical activity with unfavorable lipoprotein profiles.

Exercise Training

A one-year study of overweight, healthy men found a reduction in apolipoprotein B (but not LDL cholesterol) in response to exercise training.31

This led the authors of the study to postulate that exercise might makeLDL less atherogenic by reducing apolipoprotein B.

Importance of Sleep

Man exercising

A Chinese study looked at the relationship of sleep duration and apolipoprotein B blood levels using data from 7,381 subjects.32

The participants were divided into three categories according to sleep duration: less than six hours, seven to eight hours, and more than nine hours.32

The study found that short sleep duration (under 6 hours) in women was associated with 1.75-fold greater odds of elevated apolipoprotein B compared to women who got 7-8 hours of sleep per night.32

Longer sleep duration in men was associated with decreased apolipoprotein B. The study authors concluded:

“Sleep hygiene management could serve to treat and prevent cardiovascular diseases by altering unfavorable apolipoprotein profile.”32

Thyroid Hormones and Lipoproteins

People with insufficient thyroid hormones can have elevated cholesterol, LDL, triglycerides and apolipoprotein B.33-35

In some cases, people are prescribed statin drugs to lower cholesterol when the appropriate use of a thyroid hormone medication would normalize their lipid profile.

One of several studies on this topic concluded by stating:

“A reduction in lipid and lipoprotein levels after thyroid hormone replacement in our study cohort resulted in a less atherogenic profile.”36

Effects of Fish Oil

The effects of fish oil (1,800 mg of EPA and 1,200 mg of DHA a day) were studied on 10 healthy males for four weeks.37

The result was about a 30% reduction in production of apolipoprotein B and reductions in other vascular risk factors like triglycerides and VLDL.37

Note that this EPA/DHA dose of 3,000 mg a day is much higher than many fish oil studies that sometimes use less than 1,000 mg a day.

What is Apolipoprotein B?

Apolipoprotein B is found on all cholesterol particles except HDL.43

This includes LDL and VLDL (very-low-density-lipoproteins).

High levels of VLDL increase the synthesis and secretion of apolipoprotein B.44

Higher apolipoprotein B generally equates to a higher amount of glycated and oxidized LDL particles, which are initiators of arterial plaque.45,46

Acute Risk of Excess Apolipoprotein B

A review of factors that underlie acute heart attack revealed a startling finding.

Amongst those with the greatest risk were current smokers and people with elevated blood ratios of apolipoprotein B to apolipoprotein A1.38 (Apolipoprotein A1 is the major protein component of beneficial HDL.)

This comprehensive analysis identified other known causes of heart attack such as hypertension anddiabetes. It then listed protective factors including daily consumption of fruits and vegetables, exercise, and modest consumption of alcohol.38

Study participants who were non-diabetic, did not smoke, and had no lipid abnormalities, including high blood ratio of apolipoprotein B to apolipoprotein A1, showed large reductions in acute heart attack risk.38

A separate study found that the cruciferous vegetable extract I3C (indole-3-carbinol) reduced apolipoprotein B secretion from liver cells as much as 56%.39 This may be a mechanism by which plant foods like broccoli reduce cardiovascular risks.

Drugs That Lower Apolipoprotein B

Prescription drugs that lower cholesterol and LDL also reduce blood levels of apolipoprotein B.40

A potentially beneficial mechanism of statin drugs and the new PCSK-9 inhibitors (like Repatha®) is that they can lower LDL down to around 30 mg/dL. Normal target goals for LDL are below 70-100 mg/dL.41

Some people tolerate statin drugs, while others encounter unbearable side effects.42

We are intrigued by the potential of drugs like Repatha® to potentially reverse atherosclerosis by driving lipoproteins down to the levels of those seen in healthy teenagers. The problem is that even at a reduced price of $5,900 a year, Repatha is cost-prohibitive and seldom covered by insurance.

I know most readers of Life Extension® Magazine seek non-drug solutions whenever possible.

With the availability of apolipoprotein B blood tests, one can choose to utilize some of the natural interventions described so far and verify efficacy with follow-up blood tests.

Apolipoprotein B and Fasting Insulin—No Added Cost!

Those with high apolipoprotein B blood levels are at greater risk for coronary artery disease.47

In 2018 we added the apolipoprotein B to the Male and Female Blood Panels at no additional cost.

If an apolipoprotein B blood test result shows high levels, steps can be initiated to correct this.

Last year we added fasting insulin to theMale and Female Panels and kept our same low price. High fasting insulin levels may indicate that type II diabetic complications are manifesting.

High insulin levels may also interfere with one’s ability to lose weight.

Annual Lab Test Sale

Optimal blood levels

The high cost of conventional blood testing precludes many people from availing themselves of this life-saving diagnostic.

We resolved this 24 years ago by enabling our readers to order low-cost blood tests direct, and then to visit a drawing station in their area at their convenience.

Results come back in less than a week and are emailed and mailed to you.

If you have any questions, our Wellness Specialists are available to assist seven days a week at no charge.

Once a year, we discount prices of all lab tests. This serves as a reminder to have one’s annual tests performed at the year’s lowest prices.

This year’s lab test sale expires on June 1, 2020.

Many more tests were added to the popular Male and Female Panels over the past 14 years and this year’s panels include a serum magnesium test.

Magnesium is perhaps one of the most important dietary supplements. Knowing your magnesium blood level can enable individualized dosing of this mineral that costs only pennies a day.

The Lab Sale price is $224 for the Male or Female Blood Test panel that now includes magnesium. This is a fraction of the $2,000 price charged by commercial labs.

To order the new Male or Female Blood Panels (that also include apolipoprotein B), call 1-800-208-3444 (24 hours) or log on to:

For longer life,

For Longer Life

William Faloon, Co-Founder
Life Extension Foundation Buyers Club


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