Why not buy them separatedly as that’s the cheaper option?
I think you make a very logical point. However, the series of PESA studies showed that even “normal” or “average” LDL-C levels are still enough to build atherosclerosis. I believe the current understanding is that this is more of a “glitch” in evolution, where ApoB particles play some sort of role in the immune system. Only humans seem to have this problem, and no other mammal builds coronary artery plaque under normal conditions.
And I think you’d be surprised at the incidence of genetic conditions which cause high LDL-C. You have the blatant obvious ones like HoFE or HeFE where otherwise healthy people are walking around with LDL-C > 200 mg/dl. But you have a lot of people who are seemingly super sensitive to dietary changes. Study after study shows that while dietary interventions can move the needle, the pharmaceutical options are more powerful, have better adherence (even then, adherence to lipid and BP lowering therapy is only 50-70% because people are too lazy to even take pills). Plus they have other effects, like statins lowering vascular inflammation.
I think in principle you are correct, but in practice it can never work. You would need some sort of utopia where everybody has the optimised diet and lifestyle which they stick to 100%. I would love to go with that too, but the reality is that it doesn’t happen. Hell, there’s >10% of the population who still smokes. I can’t see WFPB diets taking off unless there’s some sort of enormous cultural shift.
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Not where I live. Twice as much separately. Target Apob as low as you can get it. Mine is 68 going for 50. Attia is going for 30-40. You take cardiovascular disease off the table at these levels. i.e. no formation of plaque in arteries
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Aspirin 150mg/day lowers Lp(a) by 56% after only 4 weeks?!?!?!?
That appears to be the finding of this clinical trial I stumbled across:
56% decrease in those with baseline Lp(a) greater than 25mg/dL. 
It’s an older study (2007), but still paywalled. Maybe it’s a fluke, poorly done study with fabricated data for all I know, but if I could tolerate aspirin I’d certainly give this a 4 week before-and-after self-trial.
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Nick1
#1950
Here is more recent, updated and thorough review on this topic:
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More recent, yes, but it’s a review and basically says “we need more data”. The point about Lp(a) being elevated at the time of an acute ischemic event is interesting, so hopefully that doesn’t explain the large decrease after aspirin therapy:
“There are a few small studies that have shown a quite significant Lp(a) lowering effect of aspirin therapy [18,19] with a wide range of effect size. These studies are limited due to their small size which makes it difficult to reduce confounding from a regression to the mean effect. In some cases, initial measurements were also taken at the time of an acute ischemic event which can lead to elevation in Lp(a) from baseline due to its role as an acute phase reactant [19]. Additional high-quality clinical studies are required to further evaluate this effect.”
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