Why ApoB Deserves an ASBO!
We’ve talked about why ApoB is the marker that matters most and why simply knowing your “good” and “bad” cholesterol numbers doesn’t tell you the full story.
Now lets look a at ApoB a bit more forensically and delve into how it actually behaves inside your arteries and why that behaviour is what really drives Atherosclerosis!
“Whoa, whoa, whoa Ben… hang on a second... what's this 'Atherosclerosis' you speak of?"
"Good question!"
Atherosclerosis is the slow, silent build-up of fatty plaques inside your arteries. Over time, these plaques narrow the vessel, make it stiffer, and restrict blood flow, raising the risk of heart attack and stroke.
And, as you’re about to see, ApoB is right at the centre of how that process starts.
Welcome to Artery Avenue...
Picture a busy street lined with houses. The street is your blood vessel, with houses representing the arterial wall. Each house has a neat white picket fence outside it — that’s the endothelium — a delicate single-cell layer that guards the inside of your arteries and veins.
Now, this street has a lot going on...
Cars (red blood cells, immune cells, nutrients) are constantly speeding by, along with those tiny delivery vans carrying cholesterol you may remember from my previous email — the lipoproteins.
Now, as you may remember, it’s normal for some of these vans (lipoproteins) to pull up to the curb, drop off their cargo, and leave again... that’s what HDL does.
Think of them like a friendly neighbour popping in for a chat and heading home again afterwards.
However...
LDL particles, the ones that are tagged with ApoB, behave quite differently.
They’re more likely to squeeze through the fence (endothelium) and wander up onto the porch (the sub-endothelial space).
And here is where it starts to get dicey:
Once they’re on the porch… they don’t always leave.
If this unwanted guest (LDL/ApoB) loiters long enough, it’s attacked by tiny unstable molecules (ROS), which chemically “scuff up” the particle and make it harmful. That particle now becomes toxic.
It’s now going to earn its 'ASBO' status and behaves like a drunk guest who refuses to leave, and it gets worse....
Starts inviting its mates over too!!
More ApoB-tagged particles arrive, and the situation escalates.
Here’s why ApoB number matters
The more particles you have circulating, the higher the chances that some will slip through the fence, get stuck, and trigger this chain reaction.
Call the police!!
The police — your immune system in this analogy — now recognises there’s a problem. It rallies immune cells called monocytes, which transform into Pac-Man (macrophages) and start gobbling up the now toxic LDL to try and clear the mess.
But there’s yet another catch...
If they eat too much, they swell up and explode forming a foam cell which, under a microscope, look like the fatty streak.
These fatty streaks are the first sign of atherosclerosis.
Over time, they grow into plaques that harden and narrow the artery, restricting blood flow.
And that..my friends is how a long-term cardiovascular problem begins
Not from cholesterol itself, but from the behaviour of ApoB-carrying particles inside the arterial wall.
CASE CLOSED: ApoB deserves an ASBO.
Cardiovascular risk rises with the number of particles on the road... not just how much cholesterol they’re carrying.
More “delivery vans” means more chances to slip past the fence, get stuck, and spark trouble inside the artery wall.
About the Author
Ben Cooper is a Registered Nutritional Therapist, Functional Medicine Practitioner, and founder of Cooper Coaching and ReCooper8 — online programmes dedicated to gut health, hormonal balance, and cardiovascular wellness.
With over 15 years in the health industry, Ben helps clients understand and optimise their biomarkers, from ApoB to insulin sensitivity, using a science-based, holistic approach to long-term health.