2022台灣血脂治療指引(英文版)下面中文使用google自動翻譯
非藥物療法
飲食
多項觀察性和隨機臨床研究表明，健康的飲食模式與較低的動脈粥樣硬化性心血管疾病 (ASCVD) 風險相關，例如地中海飲食、DASH（膳食療法控制高血壓）飲食、台灣健康飲食 (TEA) 和台灣素食。
台灣飲食模式研究也指出，油炸食品、甜食和含糖飲料、高脂肪和高糖糕點、肥肉和動物內臟是心血管代謝疾病的危險食物。
基於這些研究，一種有益心臟健康的飲食模式包括：
富含植物性食物，例如全穀物、蔬菜、新鮮水果、堅果和種子、茶以及富含不飽和脂肪酸的非熱帶植物油（例如大豆油、葵花籽油、橄欖油）；
富含ω-3脂肪酸的食物（例如魚類、大豆、豆類）；
低反式脂肪、油炸食品、肥肉、加工肉類或魚類製品（例如香腸、培根、火腿和熱狗）以及添加糖/精製糖的攝取量應較低。
統合分析表明，低碳水化合物飲食可能有助於減輕體重並改善高密度脂蛋白膽固醇 (HDL-C) 和三酸甘油酯 (TG) 水平。 然而，低密度脂蛋白膽固醇 (LDL-C) 和總膽固醇 (TC) 升高的潛在後果是一個主要問題。
在過去幾十年，雞蛋攝取量與動脈粥狀硬化性心血管疾病 (ASCVD) 發生之間的關聯性已得到證實，但仍存在爭議。雞蛋不僅飽和脂肪酸含量低，而且富含蛋白質和各種微量營養素，這些營養素已被證明可以促進大分子 LDL-C 的形成，而大分子 LDL-C 的致動脈粥樣硬化作用較弱。 由於可能仍存在中等的劑量反應關係，因此應根據個人的 LDL-C 目標值和營養狀況來調整雞蛋的攝取量。
此外，乳製品攝取的影響也存在爭議，因為先前的研究發現飽和脂肪酸含量會增加低密度脂蛋白膽固醇（LDL-C）水平。 近期的一些統合分析顯示，乳製品攝取對心血管結局的影響可能是正面的，也可能是中性的，而一項台灣的前瞻性研究則顯示乳製品具有保護作用。乳製品，包括發酵乳製品以及最好是脫脂或低脂乳製品，可以作為健康飲食的一部分適量食用。
Non-pharmacological therapy
Non-pharmacological therapy
Diet
Several observational and randomized clinical studies have demonstrated association between a lower risk of ASCVD and healthy dietary patterns, such as Mediterranean diet, DASH (Dietary Approaches to Stop Hypertension) diet, healthy Taiwanese eating approach (TEA), and Taiwanese vegetarian diet. Taiwanese dietary pattern studies also identified fried foods, sweets and sweetened beverages, high fat and sugar-containing pastry, fatty and organ meats as risky foods for cardiometabolic diseases.47,49 Based on these studies, a cardioprotective dietary pattern includes: rich plant-based foods including whole grains, vegetables, fresh fruits, nuts and seeds, tea, and unsaturated fatty acid-rich non-tropical plant oils (e.g., soybean oil, sunflower oil, olive oil); sources of omega-3 fatty acids (e.g., fish, nuts, legumes); good protein foods (low degree processed soy product, fish, egg, and lean animal protein); low in trans-fats, fried foods, fatty meat, processed meats or fish products (e.g., sausage, bacon, ham and hot dogs), and added/refined sugars.50e54 Meta-analysis indicated that low-carbohydrate diets may help weight loss and improve HDL-C and TG levels.55 However, the potential consequence of elevated LDL-C and total cholesterol (TC) is a major concern. In the past decades, the modest association between eggs consumption and the development of ASCVD has been established but remains controversial. Eggs are not only low in saturated fatty acid but also rich in protein and various micronutrients, which have been shown to promote the formation of large LDL-C, which is less atherogenic.56,57 Since there may still be a moderate doseeresponse relationship, the appropriate amount of egg consumption should be individualized based on individual’s LDL-C target and nutrition status. Besides, the effect of dairy consumption is also controversial due to previous observation relating the saturated fatty acid content to increase LDL-C levels.58 Recent meta-analyses revealed either positive or neutral effects on CV outcomes from consumption of dairy products, while a Taiwanese prospective study showed protective association.47 Dairy, including fermented and preferably no-fat or low-fat products, may be consumed moderately as part of a healthy diet.59
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