Restaurant owner eats a light diet, why doesn't blood lipid cholesterol drop to normal? Doctors find the reason

Yesterday a friend of mine came to me. He is the owner of a restaurant, 45 years old. He had his blood lipids checked a few years ago and found that he had high blood pressure. Since then, he has been eating a light diet, almost no meat, and rarely eats greasy food. He runs a restaurant and does not eat restaurant meals. He cooks at home, mainly boiled or steamed.

Half a year had passed, and he had lost weight, but after a blood lipid recheck, his cholesterol was still high, so he suspected that the test was wrong. He came to me just to check again to see if the test was wrong, and to ask how to lower blood lipids.

I compared the two test results:

Six months ago: triglyceride 5.4, cholesterol 7.4, low-density lipoprotein 4.8;

Now check: triglyceride 1.4, cholesterol 7.2, low-density lipoprotein 4.5;

I said: A light diet is still effective. Look, the triglycerides are now normal.

Boss Hu said: Cholesterol is still high. People say that cholesterol is the most terrible, right?

I said: Relatively speaking, cholesterol, especially low-density lipoprotein, has a greater impact on the cardiovascular system. When it increases, it will produce more vascular waste and even cause cardiovascular and cerebrovascular diseases.

But it does not mean that not eating meat or greasy food and a light diet will definitely lower cholesterol to normal levels.

1. Why does cholesterol rise?

Many people think that if we eat too much greasy food and too much meat, our blood lipids will increase. This idea is not wrong, but it is not entirely correct.

Let’s look at this picture:

That is to say, 1/4 of our LDL cholesterol is increased due to diet, and 3/4 is synthesized by the liver itself. In other words, only a small part of our cholesterol and LDL cholesterol is related to diet. The vast majority of the increase is caused by our own metabolic abnormalities, which are metabolized by the liver, not by diet.

This explains why Mr. Hu had high cholesterol and low-density lipoprotein cholesterol six months ago, but after six months of a light diet, his cholesterol and low-density lipoprotein cholesterol have not dropped significantly.

But why is triglyceride, a blood lipid, normal?

This is because triglycerides are different from cholesterol. Triglycerides are mainly caused by our unhealthy diet, such as greasy, fried, refined grains, desserts, etc. If you control your diet and eat a light diet, most triglycerides can drop, and drop significantly, and can drop to normal.

Therefore, the main reason for the increase in cholesterol and low-density lipoprotein is self-metabolism, which explains why some people do not eat meat, some are very thin, but still have high cholesterol and low-density lipoprotein.

2. What to do if your cholesterol level rises?

1. Healthy diet is the foundation

Although the effect of diet on cholesterol is relatively small, this is relative, not that diet has no effect, and 1/4 is also a very large proportion. Therefore, when cholesterol rises, you must first eat a healthy diet, but a healthy diet does not mean not eating meat, and it does not mean that it can only be boiled or steamed. A healthy diet is relative, and it is a comprehensive low-salt, low-oil, and low-sugar diet. To be more specific, eat less fatty meat, offal, etc., and limit red meat appropriately. Eat mainly poultry such as chicken, and eat more fish appropriately to promote blood lipid metabolism. There is no limit on fruits and vegetables, and coarse grains are appropriately increased, with an appropriate amount of nuts and dairy products. This kind of diet is healthy and conducive to controlling blood lipids, not not eating meat.

At the same time, you must insist on proper exercise, aerobic exercise 3-5 times a week, more than 30 minutes each time, such as running, swimming, cycling, etc., which is beneficial to blood lipid metabolism.

2. Sometimes you have to take drugs to lower blood lipids

But even so, some cholesterol is not normal, which is what we said above, because of its own metabolism. At this time, you may need to take lipid-lowering drugs to control blood lipids, and statins are the first choice for lowering cholesterol and low-density lipoprotein cholesterol.

1) Simple hypertension or other high-risk factors, the ideal level of low-density lipoprotein is less than 3.4.

2) Diabetes; hypertension + (male ≥45 years old or female ≥55 years old)/smoking or + smoking/family history of premature ischemic cardiovascular disease; chronic kidney disease stage III or IV; low-density lipoprotein ≥4.9;

The ideal LDL level for these four groups of people is less than 2.6.

3) Patients with clear history of ischemic cardiovascular and cerebrovascular diseases, such as coronary heart disease, angina pectoris, myocardial infarction, cerebral infarction, heart stents, heart bypass surgery, etc.; hypertension + diabetes; diabetes + age (male ≥ 45 years old or female ≥ 55 years old) or + smoking or + family history of premature ischemic cardiovascular disease, and low-density lipoprotein ≥ 3.4;

The ideal LDL level for these three groups of people is <1.8, or a decrease of ≥50% from the baseline level.

In short, a healthy diet is the basis for preventing and controlling hyperlipidemia, but for hypercholesterolemia, even with a healthy diet, some people's blood lipids cannot return to normal and may need lipid-lowering drugs.