心脏病专家说，“心脏病：胆固醇并不是真正的敌人”
Heart Disease: Cholesterol Is Not the Real Enemy
二月是美国的心脏月。心脏病杀死的美国人比其他任何死因都多。
大多数医生告诉人们高胆固醇是导致心脏病的原因。但并非所有的医生都这么认为。
心脏病学家斯蒂芬·西纳特拉（Stephen Sinatra）博士是《伟大的胆固醇神话》一书的作者，他说心脏病的真正原因是炎症(Inflammation)，而不是胆固醇(Cholesterol)。
胆固醇神话:什么真正导致心脏病?
他说:“胆固醇在心脏病的犯罪现场被发现，但它不是罪犯。”
健康的胆固醇
西纳特拉曾经相信高胆固醇是心脏病的罪魁祸首，直到他亲眼看到了自己的病人，这是不正确的。他注意到他的许多心脏病人胆固醇水平低，并且发现许多胆固醇高的人没有心脏问题。
他回忆说:“我当时在给150名患有严重心脏病的人做血管造影检查。”“反过来说，我做的是一个胆固醇含量为280的人的血管造影，他们没有心脏病。”
西纳特拉是越来越多的医生中的一个，他们在大多数情况下都吹捧高胆固醇的好处。
他说:“很多时候，胆固醇是一种伪装的、高胆固醇的礼物。”
他说高密度脂蛋白胆固醇(HDL)对你有好处，甚至低密度脂蛋白胆固醇对你也有好处，只要它是蓬松的大颗粒。
他承认，小而密集的LDL颗粒是有害的。因此，他建议，不要检查所有的低密度脂蛋白胆固醇，而是把它进一步分解成颗粒大小。
他汀类药物的副作用
由于辛纳特拉博士不认为高胆固醇是导致心脏病的原因，他不认为降胆固醇的他汀类药物对大多数服用这种药物的人有帮助。相反，他认为只有极少数的人有必要服用他汀类药物。
例如，他通常只向患有冠心病的中年男性开出他汀类药物。他还说，一小部分女性需要他汀类药物，但主要是因为他汀类药物具有抗炎作用，而不是降低胆固醇的能力。
另一方面，大体上，西纳特拉认为他汀类药物的处方过于苛刻。虽然制药公司每年销售价值300亿美元的他汀类药物，但辛纳特拉说，服用这些药物的人要为他们的健康和钱包付出代价。
换句话说，对于许多他丁药物用户来说，风险大于收益。
他说:“他汀类药物的副作用被严重低估了。”
肌肉疼痛和疲劳是他从他汀类用户那里听到的两个关键抱怨。
“医生，我不能离开椅子，我的大腿很虚弱，我不能打双网球。”我遛狗，我累极了，”他回忆说。
CBN新闻医学记者Lorie Johnson分享了她对胆固醇的看法和他汀类药物的危害:
辛纳特拉说，这些症状的原因经常被误诊。
“这些是他汀类药物的副作用，”他总结道。然而，很多医生和病人认为他们正在变老。他们没有变老; 这些是他汀类药物的副作用。
他说，70岁以上的患者尤其脆弱。
“他们不记得名字。他们不记得把眼镜或钥匙放在哪儿了。他们有时会忘记自己是谁!它可以使老年痴呆症的发病提前15年。所以你必须小心使用他汀类药物。
糖是敌人
辛纳特拉说，他汀类药物最好的一点就是能够减少炎症。但是由于他汀类药物有如此多的副作用，大多数人最好还是放弃他汀类药物，通过减少他们吃的糖的量来减少炎症。
辛纳特拉研究了证据，得出结论，不是胆固醇，而是炎症(INFLAMMATION)引发心脏病。炎症是由许多东西引起的。
吃太多的糖是最重要的原因。
胆固醇是你的朋友。糖是你的敌人。它是反派角色。它是你的敌人，”他解释道。
糖会损害动脉，增加血压，使器官老化。当然，我们都知道糖是我们在咖啡中加入的白色、颗粒状的东西。但是糖有很多其他形式。
例如，高果糖玉米糖浆是一种糖。它是苏打和糖果的主要成分，在大量的其他产品中都有它的成分，很多你甚至不认为它是“甜的”食物，比如面包或意大利面酱。
许多其他的糖浆和成分以“-糖”结尾，也是糖。
除了避免含有糖分的食物外，减少炎症还包括避免吃了之后变成糖的食物。这些被称为精制碳水化合物。
健康的脂肪
西纳特拉建议用蔬菜和健康脂肪代替糖，如坚果、鳄梨、鱼和橄榄油。他还推荐饱和脂肪，如黄油、未加工肉类和椰子油。
“我喜欢椰子油，”他说。椰子油是一种饱和脂肪。因为它是饱和脂肪，所以不容易氧化。因此,保护你。”
他鼓励人们不要担心饱和脂肪会导致心脏病。虽然他们可能会提高你的胆固醇，但他相信这不会伤害你，事实上，可能会改善你的健康。
然而，辛纳特拉指出，不要把好脂肪和反式脂肪( TRANS FAT) 混为一谈，这一点非常重要。反式脂肪也被称为氢化油，对心脏极其有害。
西纳特拉说:“我把反式脂肪称为非制导导弹，它确实会在血管中引起巨大的炎症。”
反式脂肪是人造脂肪，存在于加工食品中, 如饼干、方便面、罐头等。
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参考文献：
Heart Disease; Cholesterol Is Not the Real Enemy
February is American Heart Month. Heart disease kills more Americans than any other cause of death.
Most doctors tell people high cholesterol is responsible for heart disease. But not all doctors see it that way.
Cardiologist Dr. Stephen Sinatra, author of the book, The Great Cholesterol Myth, says the real cause of heart disease is inflammation, not cholesterol.
Related
Cholesterol Myth: What Really Causes Heart Disease?
"Cholesterol is found at the scene of the crime for heart disease, but it's not the perpetrator," he contends.
Watch Dr. Stephen Sinatra's appearance on The 700 Club, Thursday, March 5. Watch Lorie Johnson talk more about the real culprit of heart disease below.
Good Cholesterol
Sinatra used to believe high cholesterol was responsible for heart disease until he saw with his own eyes, in his own patients, that was't true. He noticed many of his heart patients had low cholesterol and saw that many people with high cholesterol did not have heart problems.
"I was doing angiograms on people with 150, who had far advanced heart disease," he recalled. "And the converse, I was doing angiograms on somebody with cholesterol of 280 and they had no heart disease."
Sinatra is among a growing number of physicians who actually tout the benefits of high cholesterol in most cases.
"Cholesterol many times can be a gift in disguise, higher cholesterol," he said.
He said high HDL cholesterol is good for you and says even LDL cholesterol is good for you as long as it's the large, fluffy particles.
He admits the small, dense LDL particles are harmful. Therefore, he recommends, instead of getting your overall LDL cholesterol checked, you get it further broken down into particle size.
Statins Side Effects
Since Dr. Sinatra does not think high cholesterol is responsible for heart disease, he does not think cholesterol-lowering statin drugs are helpful to most of the people taking them. Instead, he believes only a very small percentage of people who are taking statins actually need them.
For example, he usually only prescribes statins to middle-aged men who have coronary heart disease. He also says a small number of women need statins, but mostly because they benefit from the statin's anti-inflammatory properties, not its ability to lower cholesterol.
On the other hand, by and large, Sinatra believes statins are far too over-prescribed. Although drug companies sell $30 billion worth of statins every year, Sinatra said the people who take them are paying a price with their health as well as their wallet.
In other words, for many statin users, the risks outweigh the gains.
"The side effects of statins are grossly under-reported," he said.
Muscle pain and fatigue are two of the key complaints he hears from statin users.
"'Doc, I can't get out of a chair, I have weakness in my thighs, I can't play double's tennis. I walk the dog and I'm exhausted,'" he recalled patients saying.
CBN News Medical Reporter Lorie Johnson shares her insights on cholesterol and the dangers of statin drugs below:
Sinatra said the reason for these symptoms is often misdiagnosed.
"These are statin side-effects," he concludes. "However, a lot of the doctors and patients think they're 'getting older.' They're not getting older; these are statin side effects."
Patients over 70 years old are especially vulnerable, he said.
"They can't remember names. They can't remember where they put their glasses or keys. They forget sometimes who they are! It can actually bring on the onset of Alzheimer's disease by 15 years. So you have to be cautious with statins," Sinatra advised.
Sugar Is the Villian
Sinatra says one of the best things about statins are their ability to reduce inflammation. But since statins have so many side-effects, most people are better off ditching the statin and reducing inflammation the natural way, by reducing the amount of sugar they eat.
Sinatra looked at the evidence and concluded, instead of cholesterol, it's inflammation that causes heart disease. Inflammation is caused by a number of things.
Eating too much sugar is at the top of the list.
"Cholesterol is sort of your friend. Sugar is your foe. It's the villain. It's your enemy," he explained.
Sugar damages arteries, increases blood pressure, and ages your organs. Of course, we all know that sugar is the white, granular stuff we put in our coffee. But sugar comes in many, many other forms.
For example, high fructose corn syrup is a sugar. It is the primary ingredient in soda and candy and is found in the list of ingredients in a huge number of other products, many that you probably don't even consider a "sweet," such as bread or pasta sauce.
Many other syrups and ingredients that end in "-ose" are also sugars.
In addition to avoiding foods that contain sugar, reducing inflammation also involves avoiding foods that turn into sugar once you eat them. These are called refined carbohydrates, and are grains that have been stripped of the healthiest part, leaving only the starchy portion of the grain.
Refined carbohydrates are the "white" foods, such as white bread, white bagels, white hot dog or hamburger buns, white pasta, white rice, white tortillas, and so forth.
Good Fats
Sinatra recommends replacing sugars with vegetables and healthy fats, such as nuts, avocados, fish, and olive oil. He also touts saturated fats like butter, unprocessed meat, and coconut oil.
"I love coconut oil," he says. "Coconut oil is a saturated fat. Because it's a saturated fat, it's less prone to oxidation. So it protects you."
He encourages people to put aside their fears that saturated fats cause heart disease. Although they may raise your cholesterol, he believes that will not hurt you, and in fact, will probably improve your health.
However, Sinatra points out that it's very important not to confuse good fats with trans fats. Trans fats, which are also called "hydrogenated" oils, are extremely harmful to the heart.
"I call trans fats unguided missiles that really cause enormous inflammation in the blood vessels," Sinatra said..
Trans fats are man-made fats and are found in processed foods.
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