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Page 1: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

認識三高疾病系列 – 高血脂高血壓高血脂高血糖

14 99% 的人都不知道關於膽固醇的事實

Page 2: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

99% 的人都不知道關於膽固醇的事實

CHOLESTEROL

Page 3: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

摘要 1

將膽固醇簡單的區分成為“好” (HDL) 或“壞” (LDL) 的觀點,導致心臟疾病的持續流行。

Page 4: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

摘要 2

並非所有的低密度脂蛋白膽固醇都是一樣的。只有小而密 LDL 顆粒與心臟疾病有關,而大的、具有浮力的 LDL 是良性或是可以預防心臟疾病。

Page 5: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

摘要 3

美國心臟協會數十年的建議– 用碳水化合物取代飽和脂肪,會減少 HDL 和增加小而密 LDL ,這兩者都與心臟疾病的風險增加有關。

Page 6: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

摘要 4

飲食中的膽固醇對血液中總體 LDL 膽固醇水平的影響可以忽略。然而,每天吃雞蛋會減少小而密 LDL ,從而減少心臟疾病的風險。

Page 7: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

摘要 5

降低小而密 LDL 和保護自己免受心臟疾病的最好方法就是少吃碳水化合物 ( 而不是脂肪和膽固醇 ) ,運動和減肥。

Page 8: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

安那托爾 · 佛朗士 (Anatole France) 是作家賈克 · 安那托爾 · 法蘭索瓦 · 蒂博 (Jacques Anatole François Thibault) 的筆名。法朗士是法國小說家, 1921 年諾貝爾文學獎獲得者。

Anatole France(1844 年 4 月 16 日- 1924 年 10 月 12 日 )

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If a million people say a foolish thing, it is still a foolish thing. 

~ Anatole France

即使一百萬個人重複地說一件傻事,它仍舊是一件傻事情。

Page 10: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

並非所有的膽固醇都是一樣的

Page 11: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

一種叫高密度脂蛋白(High Density Lipoprotein, HDL) 膽固醇,

HDL 被認為是好的,越低越好。

如果對膽固醇稍為有點認識,應該聽過膽固醇有好壞之分。

Page 12: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

如果對膽固醇稍為有點認識,應該聽過膽固醇有好壞之分。

一種叫低密度脂蛋白(Low Density Lipoprotein, LDL) 膽固醇,

LDL 被認為是壞的,越高越好。

Page 13: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

事實上,沒這麼簡單。

Page 14: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

把 HDL 膽固醇當做“好”膽固醇和LDL 膽固醇當作“壞”膽固醇的過度簡化的觀點,不僅是不完整的看法,這也直接促成了心臟疾病持續的流行全球。

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但是,在我們討論為什麼之前,我們首先要解決另一個常見的誤解。

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LDL 和 HDL 並不是膽固醇。雖然我們稱它們為膽固醇,但其實它們不是。LDL( 低密度脂蛋白 ) 和 HDL( 高密度脂蛋白 ) 是運輸膽固醇通過血液的蛋白質。

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膽固醇,與所有的脂肪一樣,不溶解於水中 ( 或血液 ) ,所以它必須藉由這些脂蛋白的運輸來通過血液。LDL 和 HDL 是指運輸膽固醇的不同類型脂蛋白。

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除了膽固醇,脂蛋白攜帶三種脂肪分子( 多不飽和、單不飽和的、飽和的 - 也稱為甘油三酯 ) 。

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膽固醇是一種蠟質脂肪粒,幾乎在身體的每一個細胞都會合成,顯示其生理功能的重要性。

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打個比喻:我們 ( 膽固醇 ) 不會游泳 ( 在血液自由流動 ) ,所以只能靠坐船 ( 脂蛋白 )到不同的地方。

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一種叫高密度脂蛋白顆粒HDL-P(HDL-Particles) 。

HDL-C(HDL-Cholesterol) 就是坐在 HDL-P 船上的膽固醇,也就是我們經常說的好膽固醇。

我們坐的船 ( 脂蛋白 ) 被分為兩大類:

Page 22: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

我們坐的船 ( 脂蛋白 ) 被分為兩大類:

一種叫低密度脂蛋白顆粒LDL-P(LDL-Particles) 。

LDL-C(LDL-Cholesterol) 就是坐在 LDL-P 船上的膽固醇,也就是我們經常說的好膽固醇。

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平常我們量測的好膽固醇和壞膽固醇,就是 HDL-C 和 LDL-C 。

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血液中其實不存在膽固醇水平,因為在血液中不含膽固醇。

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當我們談到所謂的“膽固醇水平”,其實真正被測量的是各種脂蛋白 ( 如 LDL 和 HDL) 的水平。

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簡單來說:膽固醇就像乘客,要坐船到不同地方。

LDL-P 和 HDL-P 就是船,LDL-C 和 HDL-C 就是乘客 。

我們最普遍驗血寫的 HDL 或 高密度脂蛋白,其實就是 HDL-C 。 我們最普遍驗血寫的 LDL 或 低密度脂蛋白,其實就是 LDL-C 。

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之所以說 LDL-C 是不好的膽固醇,是因為我們經常在被堵塞的心血管裡找到被氧化的 LDL-P ,科學家自然認定是 LDL-C 導致心臟病了。

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我們平常驗血報告的 LDL 數字就是 LDL-C ,也就是被 LDL-P 載著的膽固醇量。 我們想像一下,一條公路塞車,是因為這條公路上的總乘客太多,還是公路上的車太多? 想想看,一輛載著十個乘客的巴士,和十輛載著一個人的車,你就想像得到了,當然是後者。

可惜的是,我們驗血得到的數字,是乘客總數 (LDL-C) ,而不是車子總數 (LDL-P) 。 要真正看心血管疾病風險,

LDL-P 數字要比 LDL-C 有用得多。

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更重要的是把所有的低密度脂蛋白膽固醇視為“壞”的想法是不正確的。

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為了使攜帶膽固醇的脂蛋白能夠引起疾病,他們必須先損傷動脈的壁。顆粒越小的 LDL ,越有可能這樣做。

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Low-Density Lipoprotein Subclass Patterns and Risk of Myocardial InfarctionMelissa A. Austin, PhD; Jan L. Breslow, MD; Charles H. Hennekens, MD; Julie E. Buring, DSc; Walter C. Willett, MD; Ronald M. Krauss, MDJAMA. 1988;260(13):1917-1921. doi:10.1001/jama.1988.03410130125037.

刊登於 1988 年 10月《美國醫學會雜誌》由加州大學柏克萊分校主導的一篇論文表示:小而密 (small, dense)LDL比正常的 LDL高出三倍更容易引起心肌梗塞 。

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另一方面,體積較大的 LDL較具浮力 (buoyant) 和容易通過循環系統移動而不致損壞動脈。

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這種小而密 LDL 的另一個問題是,它們對氧化更敏感。

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被氧化的 LDL 或 oxLDL ,是當 LDL 顆粒中的脂肪與氧作用氧化並分解而形成。

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Tribble DL, Holl LG, Wood PD, Krauss RM. Variations in oxidative susceptibility among six low density lipoprotein subfractions of differing density and particle size. Atherosclerosis. 1992;93:189-99.

發表於 1992 年 4月《動脈粥樣硬化》雜誌,由史丹佛大學醫學院所進行的一項研究表示: 在試管中較小的和更緻密的 LDL 接觸到氧化劑時會更迅速的氧化。

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為什麼這件事情這麼重要?oxLDL比正常的 LDL對於心臟疾病是大得多的危險因素。

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Circulation. 2005 Aug 2;112(5):651-7. Epub 2005 Jul 25.Plasma oxidized low-density lipoprotein, a strong predictor for acute coronary heart disease events in apparently healthy, middle-aged men from the general population.Meisinger C, Baumert J, Khuseyinova N, Loewel H, Koenig W.

刊登於 2005 年 8月《循環雜誌》由德國國立環境與健康研究中心所進行的一項研究表示 具有高水平 oxLDL 的參與者心臟病發作的的風險比低水平 oxLDL 的參與者高出四倍以上 (4.25倍 ) 。

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所以“好”與“壞”膽固醇的概念是誤導和不完全清楚。不是所有的 LDL 膽固醇是相同的。較大且具浮力的 LDL 是良性或預防心臟疾病,而小而密的 LDL 是顯著的危險因素。

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如果有一個真正的“壞”膽固醇,應該是這個小而密的 LDL 。但稱呼所有 LDL 為“壞”是一個危險的錯誤。

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低脂肪、高碳水化合物的飲食會提高“壞”膽固醇和降低“好”膽固醇

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LDL-P 大致上又能被分為兩大類。

一種叫 A 型 LDL-P (Pattern A) 。

它們比較難有機會被困在血管內壁被氧化,基本上可以說是安全,不會引起血管硬化。

A 型 LDL-P 就是所說的巴士,它們的體積較大,能載比較多的膽固醇。

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LDL-P 大致上又能被分為兩大類。

一種叫 B 型 LDL-P (Pattern B) 。

也更容易的被困在血管壁裡繼而被氧化,繼而導致心臟病。

而 B 型 LDL-P 由於體積較小,能運載的膽固醇量也比較少。

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模式 A 是當小而密 LDL較低,大且具浮力的 LDL較高, HDL較高。

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模式 B 是當小而密的 LDL較高,HDL較低,甘油三酯較高。

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模式 B強烈與心臟疾病的風險增加有關,而模式 A 沒有。

Page 46: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

導致我們血液中的飽和脂肪或膽固醇增加的並不是小而密 LDL 。而是碳水化合物。

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FASEB J. 1994 Jan;8(1):121-6.Low-density lipoprotein subclass patterns and lipoprotein response to a reduced-fat diet in men.Dreon DM, Fernstrom HA, Miller B, Krauss RM.

刊登於 1994 年 1月《美國實驗生物學協會聯盟期刊》由加州大學柏克萊分校進行的一項研究表示:減少飽和脂肪並增加碳水化合物的攝入量會將模式 A轉移到模式 B - 並在過程顯著增加心臟疾病的風險。

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諷刺的是,這正是美國心臟協會及其他類似組織已經推薦了幾十年。

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Dr. Ronald Krauss Adjunct Professor in the Department of

Nutritional Sciences at UC Berkeley

羅納德 · 克勞斯博士的研究結果表明,攝入最多飽和脂肪的參與者具有最大的 LDL ,反之亦然。

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J Lipid Res. 1991 Mar;32(3):383-94.Altered particle size distribution of apolipoprotein A-I-containing lipoproteins in subjects with coronary artery disease.Cheung MC, Brown BG, Wolf AC, Albers JJ.

刊登於 1991 年 3月《類脂研究雜誌》的一篇論文,華盛頓大學醫學院對 HDL 飲食干預的效果進行研究。研究發現,最大的 HDL 顆粒, HDL2b ,提供針對心臟疾病的最大保護作用。

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HDL利用膠體過濾法 (gel fractionation)依據其尺寸大小分為:

HDL3( 小 )亞組:細分 A 、 B 、 C(A 是最大 )

HDL2( 大 )亞組:細分 A 、 B(B比 A 大 )

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Page 53: Three-Hypers Series:Hyperlipidemia – 14 The most important thing you probably don't know about cholesterol

發表於 1993 年 2月《美國臨床營養學雜誌》的一篇論文,密西根州韋恩州立大學的研究人員對長期低脂肪飲食與血漿中脂蛋白進行研究。

Am J Clin Nutr. 1993 Feb;57(2):146-53.Dietary and anthropometric determinants of plasma lipoproteins during a long-term low-fat diet in healthy women.Kasim SE, Martino S, Kim PN, Khilnani S, Boomer A, Depper J, Reading BA, Heilbrun LK.

一年後,低脂肪飲食的參與者顯示膽固醇減少:TC 7% 、 13%的 LDL 、和 8%的 HDL 。

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密西根州韋恩州立大學的研究人員還發現:載脂蛋白 A-I很早就下降。而載脂蛋白 B 沒有改變。

血漿中的甘油三酯與體重相關。身體脂肪百分比和 W: H 與 TC 和 LDL-C呈正相關性。在 HDL-C 和 / 或 HDL2-C 和 LPL 的變化與膳食脂肪的變化直接成正比而與膳食中碳水化合物的變化成反比。TC 或 LDL-C 的變化與重量和 W : H 的變化相關,但與營養攝入的變化不相關。

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Am J Clin Nutr. 1999 Dec;70(6):992-1000.HDL-subpopulation patterns in response to reductions in dietary total and saturated fat intakes in healthy subjects.Berglund L, Oliver EH, Fontanez N, Holleran S, Matthews K, Roheim PS, Ginsberg HN, Ramakrishnan R, Lefevre M.

發表於 1999 年 12月《美國臨床營養學雜誌》的一篇論文,哥倫比亞大學的研究人員對健康受試者減少膳食中總體和飽和脂肪攝入量反應於 HDL-亞群的模式進行研究。

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研究人員的結論發現:減少膳食中總體和飽和脂肪的攝入,降低了大 (HDL2 和 HDL2b) 和小而密 HDL 的亞組,儘管降低的 HDL2 和 HDL2b 是最為明顯。

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膳食性膽固醇可以降低小型 LDL

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根據美國的研究顯示:

約有 1/4 的人對飲食中的膽固醇攝取會有血膽固醇上升的反應,稱為高反應者 (hyper-responder) 。

有 3/4 的人即使攝取較高量膽固醇,其血膽固醇亦無太大的波動,稱為低反應者 (hypo-responder) 。 主要因為體內大部份的膽固醇是由肝臟製造,由飲食的影響程面較低。

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飲食中的膽固醇的量僅微弱地與血液中的膽固醇水平相關。

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Curr Opin Clin Nutr Metab Care. 2006 Jan;9(1):8-12.Dietary cholesterol provided by eggs and plasma lipoproteins in healthy populations.Fernandez ML.

刊登於 2006 年 1月《目前在臨床營養和代謝護理的意見》期刊的一篇論文,康乃狄克大學的研究人員對健康人群中由雞蛋提供的膳食膽固醇和血漿中脂蛋白進行研究。 對於 70%的人口,食用雞蛋對血液中膽固醇水平沒有明顯影響。另外的 30%人口 ( 稱為“高反應者 hyperresponders”) ,食用雞蛋會增加 LDL 和 HDL 膽固醇的循環。

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吃蛋黃對一部分人來說,是會直接影響膽固醇數字的。這部分人稱為 hyper-responder 。據說是 30% 的人會這樣。其他的 70% 的是 hypo-responder ,就是吃雞蛋對膽固醇沒影響。

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對有影響的 hyper-responder ,雞蛋的作用是同時升 HDL 和 LDL ,所以也難說最後的綜合結果是好還是壞?

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研究人員的結論發現:心臟疾病和雞蛋攝取間缺乏連接可能部分基於以下事實,對於那些攝取雞蛋後會呈現血漿的膽固醇增加的人

( 高反應者 hyperresponders) ,飲食中的膽固醇增加了 LDL 和 HDL 膽固醇的濃度 。

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研究人員的結論發現:同樣重要的是要注意,當使用高含量的膳食膽固醇,70%的人口 (hyporesponders) 的血漿膽固醇濃度呈現了輕度增加或沒有改變。

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研究人員的結論發現:食用雞蛋已被證明可以促進大 LDL 的形成,除了從 LDL模式 B轉移到模式 A ,這是較不易形成動脈粥樣硬化。

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研究人員的結論發現:雞蛋也是保護眼睛的抗氧化劑的良好來源 ;因此,食用雞蛋可以增加血漿中葉黃素 (lutein) 和玉米黃素 (zeaxanthin) 的濃度,對那些易患視網膜黃斑區退化和白內障的人特別有益處。

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為什麼是這樣?

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因為膽固醇是一個重要的物質,它的生產是由身體緊密的調節。當你吃多了膽固醇,體內就會產生較少膽固醇,反之亦然。

這就是為什麼你吃入膽固醇的量不大會 - 如果有的話 –影響你血液中的膽固醇水平。

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食用膽固醇不僅是無害的,而且它是有益的 !

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事實上,要降低小而密 LDL 的最佳途徑之一,是天天吃雞蛋!

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刊登於 2004 年 6月《新陳代謝》期刊的一篇論文,康乃狄克大學的研究人員發現,每天吃三個全蛋,連續 12週受試者的小而密 LDL 水平平均降低 18%。

Metabolism. 2004 Jun;53(6):823-30.High intake of cholesterol results in less atherogenic low-density lipoprotein particles in men and women independent of response classification.Herron KL, Lofgren IE, Sharman M, Volek JS, Fernandez ML.

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如果現在你感到困惑,我當然不怪你。

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讓我們回顧一下超過 50 年來我們已經被告知了的信息:

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1. 食用飽和脂肪和膽固醇的飲食會提高血液中的“壞”膽固醇和增加心臟疾病的風險。

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2. 減少攝入飽和脂肪和膽固醇能保護我們免受心臟疾病。

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現在,讓我們來看看在過去十年中那些刊登在主要的同行評審期刊可信的科學研究告訴我們:

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1. 食用飽和脂肪和膽固醇會減少與心臟疾病相關的膽固醇的類型。

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2. 用碳水化合物來取代飽和脂肪和膽固醇會降低“好” (HDL) 膽固醇,提高甘油三酯水平,並增加我們的心臟疾病的風險。

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換句話說,在過去的半個世紀中,醫學“權威”給我們如何預防心臟疾病的建議,實際上是導致它的原因。

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如何降低小型 LDL

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吃少碳水化合物也許是最好的開始地方。

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減少碳水化合物有幾個心臟保護作用。

減少小而密 LDL 的水平、降低甘油三酯水平、並增加 HDL 水平。

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運動和減肥也可以減少小而密 LDL 。事實上,減肥已被證明可以扭轉模式 B 。

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前面有提到,每天吃三個雞蛋,可以降低我們的小 LDL 幾乎 20%。

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有趣的是,酒精也被證明可以降低小 LDL 20%。

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刊登於 2007 年 7月《臨床內分泌與代謝期刊》的一篇論文,哈佛醫學院附屬貝斯以色列女執事醫療中心的研究人員對老年人飲酒與其脂蛋白子群的關係進行研究。

J Clin Endocrinol Metab. 2007 Jul;92(7):2559-66. Epub 2007 Apr 17.Alcohol consumption and lipoprotein subclasses in older adults.Mukamal KJ, Mackey RH, Kuller LH, Tracy RP, Kronmal RA, Mittleman MA, Siscovick DS.

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研究資料來自《新血管健康研究》(the Cardiovascular Health Study)包括 1,850 名年齡大於 65歲,之前沒有新血管病史的參與者。

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研究結果顯示:酒精攝入量與總體低密度脂蛋白 (LDL) 顆粒呈現一個 U形的方式相關聯。

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研究結果顯示:每週飲用一杯以上酒精飲料的受試者有大型 LDL 顆粒的數量最多。

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研究結果顯示:每週飲用 7-13杯酒精飲料的受試者有小型 LDL 顆粒的數量最低。

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研究結果顯示:酒精攝入量與大型和中型的 HDL 顆粒呈強正相關,但與小型 HDL 顆粒濃度成反比關係。

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研究結果顯示:酒精攝入量與小型和中型極低密度脂蛋白 (VLDL) 顆粒濃度成反比關係。

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研究結果顯示:三種脂蛋白的平均粒徑與酒精攝入量都呈正相關。

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研究的結論:對於沒有臨床心血管疾病病史的老年人,飲用酒精會降低總體 LDL 顆粒、較低水平的小型 LDL 、 HDL 和 LVDL 顆粒;較高水平的大型 LDL 和中型和大型 HDL 顆粒。

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換句話說,如果你想降低心臟疾病的風險,做美國心臟協會 ( 也可能是你的醫生 )告訴你相反的事。

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吃黃油、吃雞蛋、吃傳統的動物脂肪。減少碳水化合物、植物油和加工食品攝入量,並保持運動和健康的體重範圍。

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如何量測小型 LDL 的水平

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一般我們的血液化驗報告都只寫了一個 LDL-C 數,並沒有告訴你有多少 LDL-P ,更沒有說明有多少屬於 A 型、有多少屬於 B 型。 所以,看到的血液報告裡的 LDL 數字其實沒什麼意義。

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首先請記住,定期的膽固醇測試不會告訴你關於小型 LDL 水平任何信息。標準的測試只是測量你的總膽固醇、低密度脂蛋白和高密度脂蛋白。但對於危險的小型 LDL 和良性或具保護性的大型 LDL 並不做出區別。

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最快、最便宜 (儘管是間接 ) 的方法是在飯前 60 分鐘和飯後 60 分鐘 ( 被稱為“餐後”血糖測試 )測試你的血糖。

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餐後血糖測試可以是對小型 LDL 的粗略指標的原因在於,觸發血糖上升同樣的食物也會增加小型 LDL 。這種食物也就是碳水化合物。

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如果你的餐後血糖高於 120毫克 / 分升,這可能是一個暗示表明高於所希望的小型 LDL 的水平。這個測試不是小型 LDL 完美的近似值,但它是最便宜和最簡單的方法。

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如果你想獲得更具體的數據,我推薦兩個測試,使用略為不同的方法來測量小型 LDL:

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1. LDL-S3 GGE (Gradient Gel Electrophoresis) Test. 梯度凝膠電泳測試

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將血液中的蛋白分布在凝膠調色板上。當分子從一端移動到另一端時,凝膠逐漸變密。大型 LDL移動速度較慢而小而緻密 LDL 顆粒移動較快。染色凝膠後,科學家們就可以確定你的 LDL 膽固醇顆粒的平均尺寸。

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2.The VAP (vertical auto profile) Test. 自動化垂直概況分析測試

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血液樣品被混合溶劑中,通過密度來分離脂蛋白。小而緻密顆粒會下沉,大而蓬鬆的顆粒會留在頂部。然後將液體染色進行分析,可以顯示出 22 種不同的脂蛋白亞組。

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VAP 血脂測試是由Atherotech Diagnostics公司研發。

VAP能鑒定總膽固醇 (TC) 、高密度脂蛋白 (HDL) 、低密度脂蛋白 (LDL) 、和甘油三酯 (TG) 。

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VAP 可報告 22 種血液膽固醇成分,包括對非空腹直接 LDL及脂蛋白所有子類的準確測量。

VAP test 只會告訴你 LDL - p 是 A 型還是 B 型,它並不能告訴你 ox LDL 有多高。

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如果你有 60%的小 LDL 顆粒,而且你的總 LDL 為 150毫克 / 分升,那麼你有 90毫克 / 分升小 LDL(150 的 60% ) 。

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我們的目標是維持不超過 30%的小 LDL 顆粒。在我們的現實生活經驗,這已被證明是有效且實用的水平目標。

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沒有這些測試怎麼辦?

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其實你還是可以從血液報告裡猜測出你身體裡的 LDL-P 到底主要是 A 型還是 B 型的。

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一般來說,如果你的 HDL-C 偏低、三酸甘油酯 (Triglyceride)偏高 ( 高於 100 mg/dl) 、血糖偏高,你很有可能有很多 Pattern B 的 LDL-P 。

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事實上,更好評估心臟病風險的方法是看看你的 三酸甘油酯 :HDL-C 比例。將單位先轉換成美國單位 mg/dl 。如果比例是高於 4 ,你要留意一下你的飲食習慣了,因為這反映了你的心臟病和糖尿病等風險都很高。

如果你的比例是低於 2 ,你身體裡的 LDL-P 應該主要是 Pattern A ,風險亦比較低。

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William R. Davis American cardiologist

預防心臟病醫生

“ 三酸甘油酯在 150 mg/dl 水平是不正常的。把目標設在 50 mg/dl 比較合理。而 HDL ,除非達到 50 mg/dl 或以上,否則我不會滿意的。”

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我的數字很不理想!怎麼辦?

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其實,要把三酸甘油酯 :HDL-C 比例降低,基本上就是要減低三酸甘油酯和提高 HDL-C 。

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其實只要你把日常的碳水化合物的攝取量減低,三酸甘油酯數字就可以在短時間內有很明顯的改善,而 HDL-C 也會隨之慢慢增加。

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另外,多吃一些好的飽和脂肪 ( 如椰子油 ) 和多做運動也能增加身體的 HDL 。

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唐納德 · 米勒 心臟外科醫生 Dr. Donald W. Miller, Jr.  professor of surgery, cardiothoracic division, Univ. Washington

“ 我們必須明白我們經常掛在口邊的 ‘ HDL 是好的’ 和 ‘ LDL 是不好的’ 是不對的。”

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唐納德 · 米勒 心臟外科醫生 Dr. Donald W. Miller, Jr.  professor of surgery, cardiothoracic division, Univ. Washington

“ 膽固醇負責太多重要的工作了。如果你有大量的膽固醇,你應該感到慶幸。”

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唐納德 · 米勒 心臟外科醫生 Dr. Donald W. Miller, Jr.  professor of surgery, cardiothoracic division, Univ. Washington

“ 事實上,你的 LDL 數字高可能並不是一件壞事。’ LDL 是不好’的概念是完全沒有科學事實基礎的。它只是被利用來嚇唬人和出售降膽固醇藥物的受害者。”

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LDL-P 其實在我們身體扮演很重要的角色。它把很重要的膽固醇運到身體不同地方進行不同的工作。

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LDL 對我們腦部健康尤其重要。如果我們 LDL-C 太低,我們會更易患上憂鬱症。

如果你的 LDL-C 低於 100mg/dl ,你會更容易有自殺傾向。

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假若你發現你的 LDL-C 異常地高,你不應該想辦法用藥物降低它,這是無意義的。

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你應該更要關心是什麼原因導致你的 LDL-C 突然增多?

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是否身體出現什麼毛病,讓肝臟不停制造和委派 LDL-C 去搶救?找到問題源頭才是最重要的。

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Back-ups

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