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VLDL is much larger and less dense than LDL

10.1016/j.scitotenv.2015.05.102 Sci

If such aerobic metabolism is impaired, the body switches to anaerobic production which generates nominally 18 times less ATP per glucose molecule and produces more lactic acid (392)

However, it should be noted that clinical success is a subjective assessment and is dependent on individual targets set for each participant