Cholesterol: Debunking Myths for Diabetics

Cholesterol issues

Hello Dr.
Hsiao: I have diabetes, and my total cholesterol, LDL cholesterol, and triglycerides are all elevated.
Both my doctor and diabetes health literature suggest that I should not consume too many high-cholesterol foods.
However, I came across an article online that claims there is no direct correlation between the consumption of high-cholesterol foods and the cholesterol levels in the body.
Is this article correct? Thank you.
Here is the link to the article: https://tw.news.yahoo.com/%E6%AF%8F%E5%A4%A9%E5%90%833%E9%A1%86%E8%9B%8B-%E7%AB%9F%E5%8F%AF%E9%99%8D%E5%A3%9E%E8%86%9C%E5%9B%BA%E9%86%87-%E4%BD%A0-%E5%AE%9A%E8%A6%81%E7%9F%A5%E9%81%93%E7%9A%84%E3%80%8C%E5%9C%A8%E5%9C%A8%E5%9C%A8%E3%80%8D%E8%88%87%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8%88%88%E8

tom, 40~49 year old female. Ask Date: 2016/03/01

Dr. Xiao Yongxun reply Internal Medicine

1.
Essentially, there are many articles online with a diverse theoretical foundation; although they have their sources and basis, I prefer not to comment on them personally.

2.
According to current research reports, the sources of cholesterol indeed include dietary intake and endogenous production.
Cholesterol is also an important raw material for the synthesis of adrenal corticosteroids, sex hormones, and other endocrine substances in the body.
Based on the theories widely accepted by most physicians in the medical field today, elevated total cholesterol (T-cholesterol) and low-density lipoprotein cholesterol (LDL) levels, along with low high-density lipoprotein cholesterol (HDL) levels, are still considered significant risk factors for cardiovascular diseases, strokes, and peripheral artery diseases.
Clinically, the use of various cholesterol-lowering medications (such as statins and niacin) has been shown to reduce the risk of these diseases.
3.
As for what kind of diet can lead to hypercholesterolemia, the answer has indeed changed or been fine-tuned with the emergence of various research studies and repeated validations.
Many foods that were previously thought to cause hypercholesterolemia interestingly contain factors that can also lower cholesterol, including eggs.
In light of this controversy, in addition to continuing research, both physicians and patients need to consider how to address the situation until the true causes are identified.
4.
Regarding your mention of "having diabetes, with elevated total cholesterol, bad cholesterol, and triglycerides," I believe that excessive consumption of high fructose corn syrup, trans fats (including margarine, creamers, partially hydrogenated oils, and ghee), high-calorie diets, and foods or beverages with artificial additives should be avoided as much as possible.
In other words, these can be consumed, but not beyond the body's metabolic capacity.
Trans fats have been recognized as one of the causes of increased total cholesterol and LDL cholesterol levels, and thus are currently banned in countries like the United States, Taiwan, and Europe.
As for high fructose corn syrup, which is widely used in various foods and beverages, many reports have highlighted its hidden risks; however, there are still some controversies that need clarification.
Artificial additives have always been questioned, with many substances once considered safe now deemed harmful; therefore, it is recommended to consume "natural foods" as much as possible and avoid "processed foods."
5.
Specifically regarding eggs, it is still recommended for adults to limit their intake to no more than 2-3 eggs per week.
Factors to consider include not only cholesterol but also antibiotics or other substances added during the farming process.
6.
In summary, regarding your question, I personally suggest that all types of food should be consumed to ensure adequate and balanced nutrition; however, it is important to avoid excessive intake that could lead to hyperglycemia and hyperlipidemia.
Additionally, regular exercise, timely medication adherence, sufficient sleep, and managing stress levels are also very important.

Reply Date: 2016/03/01

More Info

Understanding cholesterol, particularly in the context of diabetes, is crucial for managing overall health. The relationship between dietary cholesterol intake and blood cholesterol levels has been a topic of debate for many years. Traditionally, health guidelines have recommended limiting dietary cholesterol, especially for individuals with diabetes or those at risk of cardiovascular diseases. However, recent research has begun to challenge some of these long-held beliefs.

Firstly, it is essential to understand that cholesterol in the body comes from two primary sources: the liver produces cholesterol, and we also obtain it from our diet. The liver is responsible for the majority of the cholesterol in our bodies, and it regulates cholesterol levels based on our dietary intake. When we consume high-cholesterol foods, the liver may compensate by producing less cholesterol. This is where the confusion often arises. Some studies suggest that for most people, dietary cholesterol has a minimal impact on blood cholesterol levels. However, this does not apply universally, especially for individuals with diabetes or metabolic syndrome.

For diabetics, the concern is not just about cholesterol levels but also about the overall lipid profile, which includes low-density lipoprotein (LDL, often referred to as "bad" cholesterol), high-density lipoprotein (HDL, or "good" cholesterol), and triglycerides. Research indicates that individuals with diabetes are at a higher risk for cardiovascular diseases, and managing cholesterol levels becomes even more critical. Elevated LDL and triglycerides can lead to atherosclerosis, increasing the risk of heart attacks and strokes.

The article you referenced suggests that consuming high-cholesterol foods does not directly correlate with increased cholesterol levels in the body. While this may hold true for some individuals, it is essential to consider that people with diabetes often have altered lipid metabolism. For them, dietary cholesterol can indeed influence blood cholesterol levels more significantly than in the general population. Therefore, it is prudent for diabetics to monitor their cholesterol intake closely.

Moreover, the type of fats consumed is equally important. Saturated and trans fats can raise LDL cholesterol levels more than dietary cholesterol itself. Foods high in saturated fats, such as fatty cuts of meat, full-fat dairy products, and certain oils, should be limited. Instead, focusing on healthy fats, such as those found in avocados, nuts, seeds, and olive oil, can help improve cholesterol levels and overall heart health.

In summary, while there is some evidence suggesting that dietary cholesterol may not significantly impact cholesterol levels for everyone, individuals with diabetes should approach this topic with caution. It is advisable to maintain a balanced diet rich in whole grains, fruits, vegetables, and healthy fats while limiting saturated and trans fats. Regular check-ups with healthcare providers to monitor cholesterol levels and adjust dietary habits accordingly are essential for managing diabetes effectively.

If you have further concerns about your cholesterol levels and dietary choices, it would be beneficial to discuss them with your healthcare provider or a registered dietitian who can provide personalized advice based on your health status and dietary needs.

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