How to Optimize Your APO-B Levels (& Help Prevent Cardiovascular Disease)


Have you heard the term APO-B? Are you unsure of what it is? Or why it’s important?

You’ve come to the right place…

I’m an ISSA-certified nutritionist (that means that I know my stuff). I recently discovered this important compound, and I’ve spent countless hours diving into the latest research on APO-B so that you don’t have to!

After reading this article, I guarantee you will: 

  • Know the ins and outs of APO-B and why it’s so important
  • How it relates to heart disease and longevity
  • How to accurately measure it
  • How to optimize it

But before we jump in, a quick disclaimer. While I’m here to provide health and wellness information based on research and professional expertise, it’s crucial to remember that I’m not a doctor. Any health concerns should always be discussed with a healthcare professional.

Understanding APO-B

What the heck is APO-B?

Good question.

Let’s break it down. APO-B, short for Apolipoprotein B, is a naturally occurring protein in the body. There are actually 2 types, but we’re going to focus on APO-B-100. It’s not just a protein. It carries fats and cholesterols (there are 4 types) through the bloodstream. (The body doesn’t trust those nutrients swimming through the blood unsupervised). 

APO-B is a key player in the body’s cholesterol transport system.

Picture APO-B as an Uber, carrying passengers – or in our analogy, fat and cholesterol particles – to various places in the body. Ubers serve an important purpose, but our APO-B Ubers have unruly passengers that have been associated with havoc and destruction. 

APO-B is closely tied to the infamous “bad” cholesterol. This is because it provides rides to lipoproteins, Very-low-density lipoproteins (VLDL), Low-density lipoproteins (LDL), and Intermediate-density lipoproteins ((IDL). These particular lipoproteins directly contribute to atherosclerosis, a condition where plaque builds up in the arteries, increasing the risk of cardiovascular diseases.

The number of APO-B Ubers providing rides in the blood determines how many bad cholesterol particles are present in the body. 

APO-B is now considered a better risk predictor for heart disease than LDL-C. One APO-B molecule is present with each atherogenic (plaque-forming) particle. 

More APO-B? More potential for plaque build-up. It’s as simple as that.

The science backs this up. A study published in the American College of Cardiology concluded that APO-B was a better gauge of cardiovascular risk than traditional cholesterol tests.

That being said, it is important to mention that not all fats and cholesterols are bad. They ARE essential for well-being. They are particularly important for hormone and cell health.

It’s when there are too many or not enough of these compounds that it becomes dangerous.    

The Impact of Optimized APO-B Levels on Cardiovascular Health

Reduced risk of cardiovascular disease

Okay, let’s start with the heavy hitter – heart health. 

The data is clear: by lowering APO-B levels, there is a reduction in the risk of heart disease and stroke. 

When APO-B is managed, there is a reduction in the number of atherogenic particles circulating in the blood, leading to less arterial plaque and a healthier cardiovascular system. 

That means less likelihood of experiencing a heart attack, stroke, or other serious cardiovascular events. It’s super important for heart health.

Better diabetes control

APO-B levels also play a significant role in managing diabetes. 

Individuals with lower APO-B levels often show better insulin and glucose control. This means that insulin receptors are more sensitive and responsive to blood glucose. 

By optimizing APO-B levels, it minimizes the risk of diabetes.

Reduced hypertension

High blood pressure can be a silent killer, often showing no symptoms until it’s too late. 

Studies have shown a correlation between optimized APO-B levels and reduced hypertension. This makes sense because plaque in the arteries narrows them forcing the body to create more pressure to effectively move the blood throughout the system. 

This means that improving APO-B levels is a two-pronged approach to improving heart health.

Improved liver health

Did you know that APO-B plays a role in liver health, too? It does so by lowering the fat and cholesterol particles in the blood that travel to the liver. The liver is responsible for filtering the blood, and too much fat and cholesterol can damage it. The liver is the “mom” of all the organs; aka it does A LOT, and it is extremely important! Lower APO-B levels can help manage fatty liver disease, which is becoming increasingly common.

The Impact of Optimized APO-B Levels on Cardiovascular Health

Significance of APO-B Levels

What’s My Target APO-B Levels

So, you’re probably wondering, “What’s my APO-B target?”

Let’s cut through the jargon:

The normal range for APO-B is less than 100 milligrams per deciliter, or mg/dL, of blood. 

If you want to be better than normal, check out the optimal numbers below:

Based on a study by Sniderman et al. published in the Journal of the American College of Cardiology in 2016, these were the findings:

  • If you’re at high risk of atherosclerotic cardiovascular disease (ASCVD) – including diabetics – aim for an APO-B level of less than 90 mg/dL.
  • Do you have established ASCVD or are considered very high risk? Try for less than 80 mg/dL
  • In the extreme risk category? Your target should be less than 70 mg/dL.

I’m a big fan of Dr. Peter Attia and in a recent podcast, he went even further stating that less than 60 mg/dL is desirable

I also want to mention that it is possible for your APO-B to be too low. In my research, I found that anything below 40 mg/dL could indicate not enough fats and cholesterols in the body. This could also be symptomatic of an underlying health issue. 

Testing For APO-B Levels

Here’s the deal:

To know your APO-B level, you’ll need a specific blood test. This isn’t your standard cholesterol check-up, where LDL cholesterol is estimated. 

No fasting is needed for the test unless it’s being done alongside others that require it.

This test is a direct measure of APO-B, a far more reliable marker for assessing your cardiovascular risk.

How to get an APO-B test? 

So, how do you get an APO-B test?

You’ve got options. 

You can order the test online from several direct-to-consumer testing companies (like this one or this one)  

Or, you can simply ask your healthcare provider. If your healthcare provider is on board, then that’s great. Some healthcare providers may not be familiar with this test or how to interpret it. Also, they might not fully grasp the benefits of measuring APO-B over LDL cholesterol. 

Here’s where it gets tricky:

There’s no universal standard for measuring APO-B across different labs. Different methods may give slightly different results for the same sample, so consistency is key. Stick to the same lab and method for repeat tests and compare your results with the reference ranges that the lab provides.

And there is one more speed bump:

Not all insurance plans cover APO-B testing. You might need to pay out-of-pocket or seek reimbursement. Convincing your insurance company or provider of the test’s value may be necessary. I agree, it isn’t fair. 

When your results return, you’ll see a number – this is the concentration of APO-B in your blood. 

As we discussed, research and guidelines suggest that the ideal APO-B level for most is below 80 mg/dL, but I think levels below 60 mg/dL are ideal, although this can vary based on individual risk factors and medical history.

Despite these hurdles, knowing your APO-B level provides invaluable insight into your cardiovascular risk. It empowers you to make informed decisions about your health, whether that’s making diet or lifestyle changes or starting medications.

How to Optimize APO-B Levels

Dietary changes

First things first. Let’s talk about your diet.

Eating a diet that is low in refined carbohydrates, added sugars, and processed foods, and high in fiber, healthy fats, and protein can help lower your APO-B level by reducing the production and secretion of lipoproteins from the liver and intestines. It also lowers the insulin response and inflammation.

Some dietary patterns that have been shown to lower APO-B levels include Mediterranean, low-carbohydrate, and ketogenic-style diets.

I just want to make a special note about low-carb and ketogenic diets. Fiber is super important for APO-B. Eat lots of vegetables. Also, focus on unsaturated fats. Try to get a majority of your fats from avocados, olive oil, nuts, and seeds. Additionally, you should limit your bacon and processed meats. 

Physical activity

Now, let’s sweat.

Physical activity can help lower your APO-B level by increasing the uptake and clearance of lipoproteins from the blood, improving insulin sensitivity and glucose metabolism, and reducing inflammation and oxidative stress. 

Here are some studies that dive deeper into the effect of exercise on APO-B – 1, 2.

  1. Frequency and intensity of exercise

The science is clear – regular, high-intensity exercise helps lower APO-B. Aim for at least 30 minutes most days.

  1. Different types of exercises:

Aerobic exercises, resistance training, and high-intensity interval training (HIIT) can all help lower APO-B. They are beneficial in different ways. Do what you enjoy, and mix it up!


Getting enough quality sleep can help lower your APO-B levels by regulating your circadian rhythm, hormonal balance, appetite, and stress response. 

Poor sleep quality or quantity can increase your APO-B level by impairing glucose tolerance, increasing cortisol and insulin levels, and stimulating lipoprotein production. Aim for at least 7 hours of uninterrupted, deep sleep per night and avoid caffeine, alcohol, nicotine, blue light exposure, and heavy meals before bedtime.

Lifestyle modifications

It’s not all about diet, exercise, and sleep though.

1. Healthy weight

Maintaining a healthy weight is key to optimizing APO-B levels. Carrying extra pounds on your body inherently increases your APO-B levels (and other disease and illness factors). Try to get and stay within your recommended weight range (in a healthy and sustainable way).

2. Stress management 

Managing your stress levels can help lower your APO-B levels by reducing the activation of the sympathetic nervous system and the release of cortisol and adrenaline. 

These hormones can increase your APO-B level by stimulating lipolysis, gluconeogenesis, lipoprotein production, and inflammation. I am a strong advocate of yoga and meditation.

3. No smoking

Lighting up does more than damage your lungs – it can also raise your APO-B level. Kicking the habit can significantly help in your quest to optimize APO-B (and improve your overall health!)

4. Limit (or ideally, eliminate) alcohol

Not a shocker here: alcohol can negatively impact APO-B levels in the wrong direction; reducing alcohol intake can lower APO-B levels. Try to limit or eliminate alcohol. 

5. Supplements

There are some supplements that have been shown to improve APO-B levels. These naturally lower insulin and inflammation. You can easily find them at health food stores or online. 

They include:

  • Berberine
  • Niacin
  • Fiber
  • Omega-3 fatty acids
  • Potential Challenges and Solutions

Now, let’s address the elephant in the room – the challenges that can arise when trying to optimize APO-B levels.

Maintaining dietary changes

Preparation is key. Meal planning, meal-prepping, and keeping healthy snacks on hand will help you make better nutrition choices. Learn to make healthier versions of your favorite meals and treats. Also remember, a slip-up doesn’t mean failure. It’s about overall progress, not perfection.

Sticking to a consistent exercise routine 

Find a sport or exercise that you enjoy. Do it with a friend and hold each other accountable. If you’re short on time, consider HIIT workouts – they’re quick and intense. Do what you can. Even walking more or taking the stairs can make a difference. Remember, every bit counts!

Maintaining lifestyle modifications

Everyone experiences stress. Seek out stress management techniques that work for you, whether that’s yoga, meditation, or a hobby that you love. 

Also, prioritize sleep. Make sure you are getting enough. 

Quit smoking and limit alcohol. If you need help, consider support groups or resources to assist you.

How to Optimize APO-B Levels

Wrapping It Up

So, there we have it – the A-to-Z guide to APO-B, your hidden ally in the fight against heart disease.

We’ve covered a lot, haven’t we? 

From understanding what APO-B is and its role in the body, to how you can effectively optimize your APO-B levels through diet, exercise, and lifestyle changes. 

We’ve also touched on the potential challenges you might face and how to overcome them.

Let’s summarize what we’ve learned:

  1. APO-B is a key player in your cardiovascular health. It’s a better predictor of heart disease than LDL-C, and keeping your APO-B levels in check is a powerful way to safeguard your heart.
  2. There are multiple ways to optimize your APO-B levels. A low-carb, whole food fiber-rich diet, regular physical activity, maintaining a healthy weight, and making certain lifestyle modifications can all contribute to lower APO-B levels.
  3. Overcoming the challenges requires a bit of creativity and perseverance. But remember, every bit of progress counts.

Take the knowledge you’ve gained here and use it as a catalyst for change. Your heart will thank you.

Remember, proactive management of APO-B levels is more than just disease prevention. It’s an investment in a healthier, more vibrant you.

Take the first step on your APO-B journey. Your future self will thank you.

Until next time, stay heart-healthy!

Nolwen Cameron

Nolwen Cameron has had a lifelong passion for exercise and nutrition. She loves to educate and coach people to help them feel and look healthy inside and outside. She is an ISSA Certified Specialist in Fitness Nutrition and NASM Certified Personal Trainer.

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