Diet taboos for high cholesterol

The core of dietary taboos related to high cholesterol is not to completely ban high-cholesterol foods, but to prioritize and strictly avoid trans fats, control excessive intake of added sugars and refined carbohydrates, and reasonably limit the intake of high-saturated fat foods based on one's own blood lipid risk level. In the past, the well-known requirement of "daily dietary cholesterol not exceeding 300mg" has been canceled in the dietary guidelines of many countries after 2015. There is no need to worry too much about a bite of egg yolk or a piece of pork liver.

A while ago, my physical examination showed that my total cholesterol was 6.8. When I got home, I immediately replaced all the eggs in the refrigerator with a "healthy diet" of eating only egg whites. I didn't even touch my favorite braised pork sausage. As a result, my blood lipids did not drop much after three months of follow-up tests. Instead, I felt dizzy and weak all day long due to lack of B vitamins. In fact, this "one-size-fits-all ban on high-cholesterol foods" approach is no longer applicable to current nutritional research conclusions.

Let me first clarify this controversial point: 70% of the cholesterol in our body is synthesized by the liver itself, and only 30% is consumed from food. Most people have the ability to automatically regulate dietary cholesterol. If they eat too much, the body will reduce its synthesis, so people with high cholesterol do not need to completely avoid foods such as egg yolks and animal offal. Of course, this does not mean that it is completely ignored. Traditional cardiology doctors will still recommend appropriate control of the intake of single high-cholesterol foods for extremely high-risk groups with coronary heart disease and carotid plaques. This difference is essentially a different plan for people with different risk levels, and there is no absolute right or wrong.

What you really need to avoid 100% is trans fat. This is the "bad cholesterol killer" that has been hammered by academic circles around the world. It not only increases low-density lipoprotein (also known as bad cholesterol LDL), but also reduces high-density lipoprotein (good cholesterol HDL) that can clean blood vessels. Both ways damage blood vessels. Don’t think that trans fat is far away from you. The bubble milk tea made with non-dairy cream in the milk tea shop downstairs, the shortened egg tarts freshly baked in the bakery, the fried dough sticks that have been repeatedly fried for three days at the breakfast stall, and the cookies in the supermarket with “margarine”, “hydrogenated vegetable oil” and “shortening” on the ingredient list are all the hardest hit areas. I once treated a little girl who works in design. Her blood lipids were high and could not be lowered for half a year. When I asked her, I found out that she would order a cup of instant coffee and two butter cookies for afternoon tea every afternoon. I stopped doing this for two months and then checked again. The bad cholesterol was directly reduced by 1.2mmol/L, which is more effective than taking medicine.

A more invisible pitfall than trans fat is actually added sugar and refined carbohydrates that many people don’t care about at all. Many people think that if I eat white rice and steamed buns every day without touching a bite of fatty meat and egg yolks, there must be nothing wrong with me. However, they don’t know that after excess sugar enters the body, it will be directly converted into triglycerides, and it will also induce the production of small and dense bad cholesterol. This kind of cholesterol particles are smaller and more likely to penetrate into the blood vessel walls to form plaques, which is much more harmful than ordinary bad cholesterol. Last time, an older brother came to me and asked me how he still had high cholesterol despite being a vegetarian every day. When asked, he drank two large bowls of rice treasure porridge with added sugar every morning, and a bottle of lactobacillus drink at noon to relieve fatigue. The total amount of sugar in these two alone was almost 50 grams, which already exceeded the daily limit of 25 grams recommended by the WHO.

As for the saturated fat that everyone is struggling with, there is no need to talk about it. The current consensus in mainstream academic circles is that if the energy supply ratio of saturated fat does not exceed 10% of the total daily calories, there will be no problem. For people with high blood lipids, it will be fine if it is within 7%. If you drink a glass of whole milk every day and occasionally eat two pieces of lean braised pork, there will be no problem at all. Of course, there are different opinions. For example, supporters of the ketogenic diet believe that saturated fat has no negative impact on blood lipids. However, there is currently not enough large-scale research to support this conclusion. Friends who already have dyslipidemia do not need to use themselves as guinea pigs to test. It is definitely not acceptable to eat butter hot pot and fat lamb rolls open.

Talking about how to eat high-cholesterol foods that everyone is most concerned about, my advice to my friends has always been: it is perfectly fine for ordinary people with high cholesterol to eat one whole egg a day. If you are really worried, it is okay to eat one every other day.； Animal offal such as pork liver and kidneys should be eaten 1-2 times a month. One or two each time is enough to satisfy the craving. Complete taboos may lead to a lack of nutrients such as vitamin A and heme iron, which is not worth the gain. If you belong to the small group of people who are sensitive to dietary cholesterol and your blood lipids do rise significantly after eating, then just eat less and don't feel guilty.

I have come into contact with so many people with dyslipidemia, and I found that the easiest ones are two extremes: either they dare not eat anything, and they eat boiled vegetables every day until they are malnourished, which in turn lowers their good cholesterol.； Either you don't care about anything and keep eating highly processed snacks, only to regret it when you end up with plaque. In fact, there is really no need to turn diet into a math problem and focus on calculating the cholesterol content of a certain food. Eat more high-quality ingredients such as whole grains, dark green vegetables, and deep-sea fish, and avoid those highly processed foods with a long list of incomprehensible ingredients. Occasionally, when friends get together, they want to eat egg yolk crisps or braised sausages. One or two bites will not cause any problems, but worrying all day long will be bad for blood lipids.