https://www.youtube.com/watch?v=fuj6nxCDBZ0

This is a good video, by Ivor Cummins, on the issue of cholesterol and heart disease. He makes a fairly good argument that hyperinsulinism/insulin resistance is a stronger predictor of heart disease than cholesterol. But there also seems to be as good evidence for ApoB or ldl particle count as there is for insulin as a predictor of heart disease, as he points out.

http://www.lipidsonline.org/slides/...lar+study&dpg=3

This is a slide from the Quebec study that Cummins uses, showing risk of heart disease, with insulin levels vs. ApoB particle count. This seems clear--if you have to choose between a nice low particle count and low insulin, you should choose low insulin. At the lowest insulin levels, the difference between high and low particle count was non-significant--very low risk in either case. The other thing that's clear is--if you can't get your insulin down, it probably becomes that much more important to get your ApoB number into the desirable range. Even when somebody gets their blood sugar in order on a low carb diet--there's still the question of how much insulin it took their body to do so. Insulin low enough to to make particle count an insignificant risk factor might not be an option everybody has. I think more aggressive approaches, throwing some fasting into the mix, might help to get insulin low enough.

High particle count plus high insulin gave a risk of heart disease eleven times that with a low particle count and low insulin. A low particle count with high insulin associated with triple the risk.