In 2021, the European Society of Cardiology published guidelines on preventing cardiovascular diseases. The main risk factors included smoking, high blood pressure, diabetes, and high levels of atherogenic apolipoprotein B (apoB).
ApoB is the primary apolipoprotein in LDL cholesterol (low-density lipoprotein) and triglyceride-rich lipoproteins. Numerous genetic, observational, and interventional studies have demonstrated the causal role of LDL-C and other apoB-containing lipoprotein particles in the risk of developing cardiovascular diseases. Most risk factors are modifiable, and transitioning to a healthier diet based on plant products can directly reduce cardiovascular risk by positively affecting the reduction of atherogenic lipoproteins, blood pressure, and blood glucose levels.
Recently published studies indicate that vegetarian and vegan diets were associated with reduced total cholesterol (TC) by about 7%, LDL cholesterol by about 10%, and ApoB by 14%. The results regarding TC and LDL-C are consistent with those observed for apoB. It is important to note that apoB concentration is a parameter that allows for an approximate estimation of the total number of atherogenic lipoprotein particles in the blood. Since LDL is the most abundant apoB-containing lipoprotein particle in the blood, reducing cholesterol, especially LDL-C, will lower apoB levels, as demonstrated in the mentioned meta-analysis.
These are significant and innovative findings, as other apoB-containing lipoprotein particles, such as very-low-density lipoproteins, intermediate-density lipoproteins, and lipoprotein(a), also exhibit atherogenic properties. Quantifying the impact of different diets on apoB levels gives us a more direct assessment of the ability of plant-based diets to reduce atherosclerotic burden than measurements of specific lipids or lipoprotein particles.
Based on: https://doi.org/10.1093/eurheartj/ehad211