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  • Cholesterol, for decades, it's been demonized as the reason so many people have heart disease.

    膽固醇多年來都被認為是人們罹患心臟疾病的原因

  • We've been watching it and avoiding it like the plague.

    我們一直小心避免著,如同逃離瘟疫般

  • Why? Does that do any good? The answer may surprise and depress you

    為什麼? 這樣有意義嗎? 答案可能讓你很驚訝,也可能失望

  • This is Healthcare Triage.

    我們是Healthcare Triage

  • Okay, let's start with heart disease, which is still pretty much the biggest killer in the industrial world.

    好的,我們先從心臟疾病開始,畢竟這仍然是工業社會的一大殺手

  • Most of the problems come from atherosclerosis, where the walls of blood vessels

    大多數的心臟疾病從動脈硬化而來,動脈硬化就是血管壁

  • thicken and fatty plaques form. Later, clots can develop

    硬化然後血小板脹大。接著,就會產生血塊

  • or fragments of plaques can break off and clog up other vessels. If those blockages

    或是血小板破裂並堵塞其他血管。如果這種

  • occurring vessels that feed the heart

    血管堵塞發生在心臟

  • you have a heart attack.If those vessels feed the brain, you have a stroke

    就會導致心臟病發;如果這種血管堵塞發生在腦袋,就會導致中風

  • neither is good. And look, you need cholesterol. It's not poison.

    這兩個情形都不太好。聽著,你需要膽固醇,這並不是毒藥

  • Your liver makes about a thousand milligrams of it a day, cuz you need it to make

    肝臟一天大概製造一千毫克,因為你需要膽固醇

  • certain vitamins and hormones.

    來製造某些維生素和賀爾蒙

  • It's necessary to make cell walls, and it helps digest and move fat around your body.

    膽固醇對於製造細胞壁是必要的,它還能幫助消化並轉移體內的脂肪

  • It gets around in two forms. Low-density lipoprotein, or LDL cholesterol is the bad kind.

    膽固醇主要有兩種形式:低密度脂蛋白,也就是LDL cholesterol,是不好的一種形式

  • It's the one that's been implicated in causing atherosclerosis.

    這就是導致動脈硬化的原因

  • But there's also high-density lipoprotein, and that's the good cholesterol

    另種形式則是高密度脂蛋白,這是好的膽固醇

  • Now there are many things that have been linked to heart disease and atherosclerosis is just one of them.

    有許多東西和心臟疾病有關,動脈硬化只是其一

  • Plus, the right medical treatment about cholesterol to focus on is debatable

    此外,關於正確的膽固醇治療方式仍然有爭議

  • Is it the total amount? The LDL level only?

    是和膽固醇總體的量有關?低密度脂蛋白的量?

  • The ratio about the RHEL? Something else?

    高密度脂蛋白的量?其他因素?

  • All hotly contested. But what wasn't contested, at least not terribly publicly,

    這些都有很多爭議。但沒有爭議的是(至少沒有太廣為爭議)

  • was that we should avoid cholesterol in our food and that

    我們應該避免食物中的膽固醇

  • is where the dietary recommendations come in. For a long long time,

    而這就是我們的攝取建議。有很長一段時間,

  • we've been told that we should limit our intake of cholesterol to no more than

    我們被告知應該限制膽固醇攝取量

  • three hundred milligrams a day.

    一天不應該多餘300毫克

  • That's not a lot, just one egg has about 220 milligrams of cholesterol in it.

    這真的有點少,畢竟一顆蛋就有220毫克的膽固醇

  • So you know with two-egg-omelet will be a bad idea

    所以現在知道兩顆蛋的歐姆蛋不是個好主意

  • Forget the three-egg-omelet. Mattered you ate nothing else with cholesterol all day

    忘掉三顆蛋的歐姆蛋吧! 其實膽固醇根本不影響你吃了

  • Cholesterol warnings have been in effect since the 1960s, since 1994,

    關於攝取膽固醇的警告從1960年代就開始了,自從1994年

  • laws required food in the United States to report cholesterol values on nutrition labels

    法律制定在美國販售的食物需要在營養標籤上標明膽固醇的含量

  • So people could make more informed choices, and we cut out eggs

    所以人們可以被告知這些消息,進而做出選擇。所以我們不吃蛋

  • we cut out meat, we cut out shrimp.

    不吃肉、不吃蝦

  • Some of us even cut out milk, which was a good idea for other reasons. And that sucked.

    有些人甚至不喝牛奶,不過在其他層面上這是個不錯的想法。但真的爛透了

  • Today the average adult male in the United States consumes about three

    今日,美國男性平均攝取

  • hundred forty milligrams of cholesterol a day.

    340毫克的膽固醇

  • And experts complain that's not good enough.

    但專家說這不夠好

  • Plus, I ate egg white omelette. Have you tried them? Tasteless

    還有,我吃蛋白歐姆蛋。你有吃過嗎?超難吃

  • Was it necessary? To the research, turns out there have been good studies

    這些真的是必要的嗎? 在進行一番搜索後,我們發現有許多好的研究

  • on whether dietary cholesterol affect the level of cholesterol in your blood.

    關於控制膽固醇的飲食是否影響血液內的膽固醇含量

  • For instance, a 2004 study took people and randomized them to one of two groups.

    舉例來說,2004年一個研究將實驗對象隨機分兩組

  • One was given the equivalent of more than three eggs a day per 30 days,

    一組在30天內給他們超過3顆蛋

  • and the other got a placebo. Then they switched group. They measured their serum cholesterol after each intervention period.

    另外一組得到安慰劑,接著他們對調。在實驗期結束後,將他們的血清中膽固醇含量拿來研究

  • What they found and what's been found in many other studies

    他們發現,如同在其他實驗中得到的結果

  • is that about 70 percent of people are what we call hypo responders to dietary cholesterol.

    就是超過七成的實驗對象,對於控制膽固醇的飲食就是我們所說的弱反應受試者

  • This means that after consuming three eggs a day for 30 days,

    這代表,在30天每天攝取超過3顆蛋後

  • they've seen no real increase in their plasma cholesterol ratios.

    實驗對象在血漿中的膽固醇比例並沒有實質上升

  • Their cholesterol levels have almost no relationship to what they eat.

    他們膽固醇的含量幾乎和他們所吃的東西毫無關聯。

  • There have been many randomized controlled trials in this area.

    在這個實驗中還有許多不定性的因素

  • In 2013, researchers published a systematic review of all recent studies

    在2013年,研究者發表了關於所有研究的有系統整理

  • just from 2003 year after.

    從2003年開始

  • Twelve of the met criteria and seven of them control for background diet.

    有12個達到標準,7個控制著飲食

  • Most of the studies the controlled for background diet found that altering

    大多數控制飲食的研究發現

  • cholesterol consumption had no effect

    改變膽固醇攝取量

  • on the concentration of blood LDL cholesterol. A few studies could only

    對於控制低密度脂蛋白的含量毫無影響力。一些研究只能

  • detect differences in small subgroups of people

    在更精細的團體中得到不同的數據

  • with certain genes or a predisposition to problems. In other words,

    這些團體有共同的基因或是類似體質。也就是說

  • in most studies, all people didn't respond to changes in their intake of cholesterol.

    在大部分的研究中,大家對於膽固醇攝取量的改變並沒有反應

  • in just a few, a minority of patients responded to changes in their dietary cholesterol.

    只有一小部分的實驗對象有反應,在控制膽固醇的飲食中

  • Have recommendations change for the publication and any studies?

    給大眾的飲食建議、研究是否有改變呢?

  • No~ I still get lectures from people telling me that this or that has too

    不,我仍然聽到很多人對我說

  • much cholesterol in it. But all that may be about to change.

    「這膽固醇含量太高了」。不過這一切或許要改變了!

  • In December, a dietary guidelines summit committee,

    在十二月,召開了一個飲食指南會議

  • met to discuss possible changes to the next set of dietary guidelines for the United States to be released this year.

    來討論今年要提供給美國全國的飲食指南

  • After their meeting, the published report

    在這個會議之後,他們公開了會議記錄

  • You can go look at it. It said and I quote "Cholesterol is not considered a nutrient of concern for over consumption.

    大家不妨去瞧瞧。我在這引用:膽固醇不被認為是營養攝取上的問題

  • I'm sure that will come as a surprise to the vast

    我相信這對於大部份美國人還有世界上其他人來說

  • majority of Americans and people worldwide,

    將會是個大驚喜

  • who for decades have been watching the cholesterol intake religiously.

    對那些一直以來對膽固醇攝取量緊張兮兮的人

  • It's very possible that the US government might finally change their

    美國政府也很有可能終於願意

  • dietary guidelines this year to reflect this back.

    改變他們的飲食指南來反應此研究

  • But we don't yet know for sure. Now that doesn't mean the bad levels of

    但我們不是太確定拉。這不代表血液中的膽固醇含量

  • cholesterol in your blood are dangerous,

    是危險的

  • it also doesn't mean that all the people on drugs to help produce their

    也不代表使用藥物來控制膽固醇的人們

  • cholesterol level don't need them.

    不再需要服藥

  • it's now thought that it's the consumption of saturated and trans fats perhaps,

    現在認為或許是反式脂肪

  • which make more of difference and that's what we should focus on.

    才是真正的因素,才是我們該注意的地方

  • But we haven't been totally evidenced based on our fat recommendations either

    但因為我們的飲食指南,我們並沒有很確定

  • and that's the subjective of next week's Healthcare Triage.

    而那就是下周我們Healthcare Triage的主題囉!

Cholesterol, for decades, it's been demonized as the reason so many people have heart disease.

膽固醇多年來都被認為是人們罹患心臟疾病的原因

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B2 中高級 中文 美國腔 膽固醇 飲食 含量 攝取 研究 動脈

其實膽固醇沒有你想像的那麼糟! Cholesterol Isn't Quite as Bad as You've Been Told

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    少少 發佈於 2015 年 08 月 16 日
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