Almost every blood test your doctor runs includes a lipid panel. That panel includes the “good” versus “bad” cholesterol ratio.

The ratio tells them if bad cholesterol (LDL) is too high. The reason is that high LDL is linked to heart disease. The cause of high LDL, they say, is saturated fat in the diet.

But not all MDs and researchers agree. In fact, numerous studies demonstrate that people who eat higher amounts of saturated fat do not have a higher risk of heart disease!

In other words there may be no link between planned fat intake and heart disease. At the same time, other research definitely shows a link. How can we explain this difference in results?

One possible explanation is that the studies linking the two did not account for the intake of other types of foods. For example, many studies did not look at sugar intake, refined carb intake or trans-fat intake. These were earlier studies that made the fat-heart disease link. The later studies that did correct for these foods showed no link.

Interesting, is not it? It shows that these other types of foods may contribute to heart disease. And they might be a larger factor than eating planned fat.

However there is also another factor that normal lipid panel tests do not show. That is the size and density of LDL particles. There are two main types of LDL. The two types of LDL are called pattern A and pattern B.

Pattern A LDL are large, fluffly particles. Pattern B are small, dense LDL particles. How each of these affect blood vessels and heart health is very different.

Pattern B LDL (small and weak) is the dangerous one. These small, dense particles can easily lodge between the cells lining blood vessels. Once there they oxidize (become rancid). They also cause inflammation. Over time they create artery clogging plaque.

By contrast, pattern A LDL (big and fluffy) does not lodge between cells. Some people speculate that this is the beneficial form of LDL because of this. In fact, LDL in its good form is essential for building muscle. It is also associated with low triglycerides.

So it turns out that both sets of researchers are right. LDL is linked to heart disease. But it is the pattern B LDL that is a problem. Pattern A LDL supports strong muscles and better health.

So how do you increase pattern A LDL? There are no definitive studies about this. But from what we do know, it seems that there are two important considerations.

First, reduce or eliminate foods that raise triglycerides. Two of the largest causes are sugar and refined carbs. Eat whole food forms of carbs like vegetables and whole grains.

Second, make sure to exercise. There is a positive link between exercise and healthy cholesterol.

Of course we can not say yet that these two steps will prevent heart disease. However based on what we know, they will support unhealthy LDL patterns.