When African Americans switch to a lower-fat, higher-carb diet, more of them end up with dangerously high levels of Lp(a)—a blood fat that raises heart disease risk—even though their other bad cholesterol goes down.

When African Americans eat less saturated fat (like butter and fatty meat) and more carbs (like fruits and whole grains), their bad cholesterol (LDL) goes down, but another dangerous blood fat called Lp(a) goes up—so one risk goes down while another goes up.

African Americans’ Lp(a) levels rise more than other people’s when they cut saturated fat—meaning their bodies react differently to the same diet change.

When African Americans cut saturated fat and eat more carbs, their good cholesterol (HDL) and its main protein (apoA-1) also go down—so while bad cholesterol drops, some protective factors drop too.

When African Americans eat less saturated fat and more carbs, their blood triglycerides go up a little—suggesting the liver is processing sugar differently.