Small LDL: Simple vs. complex carbohydrates 4. May 2010 William Davis (17) Joseph is a whip-smart corporate attorney, but one who accepts advice at his own pace. He likes to explore and consider each step of the advice I give him. Starting (NMR) lipoprotein panel on no treatment or diet change:LDL particle number 2620 nmol/L (which I would equate to 262 mg/dl LDL cholesterol) Small LDL 2331 nmol/L--representing 89% of LDL particle number, a severe dominance of small LDLI advised him to eliminate wheat, cornstarch, and sugars, while limiting other carbohydrate sources, as well. Joseph didn't like this idea very much, concerned that it would be impractical, given his busy schedule. He also did a lot of reading of the sort that suggested that replacing white flour with whole grains provided health advantages. So that's what he did: Replaced all sugar and refined flour products with whole grains, but did not restrict his intake of grains. Next lipoprotein panel with whole grains replacing white refined flour:LDL particle number 2451 nmol/L Small LDL 1998 nmol/L--representing 81.5% of LDL particle number. In other words, replacing white flour products with whole grain products reduced small LDL by 14%--a modest improvement, but hardly great. I explained to Joseph that any grain, complex, refined, or simple--will, just like other sugars and carbohydrates, still provoke small LDL. Given the severity of his patterns, I suggested trying again, this time with full elimination of grains. Next lipoprotein panel with elimination of whole grains:LDL particle number 1320 nmol/LSmall LDL 646 nmol/L--48.9% of total LDL particle number, but a much lower absolute number, a reduction of 67.6%. This is typical of the LDL responses I see with elimination of wheat products on the background of an overall carbohydrate restriction: Big drops in precisely measured LDL as LDL particle number (i.e., an actual count of LDL particles, not LDL cholesterol) and big drops in the number of small LDL particles. You might say that wheat elimination and limitation of carbohydrate intake can yield statin-like values . . . without the statin.