"Of the thousands and thousands of patients I have personally seen over the years with coronary disease, I can count the number of people who lacked a prevalence of small LDL particles on one hand. It is possible for it to happen, but it's highly unusual. The vast majority of people who have coronary disease or a risk of developing it have an excess of small LDL particles. There's only one thing that causes small LDL particles and that's carbohydrates, not dietary fat. We use a low-carb diet to eliminate the expression of small LDL, which also, by the way, reduces blood sugar levels and normalizes blood vitamin D levels."