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For the past 30 years, everyone has been talking about this topic, further validating that this is one health problem that many people are suffering from.

Among the many reasons why cholesterol is a health topic that attracts our primary concern is that in many studies, cholesterol is considered as the number one risk factor in heart attack cases. It’s important to note here that cholesterol is not the cause of strokes, but mostly of heart related problems. During the time of these studies, every few years, the government would release a nutritional guide to better heart health. In this guide, they suggested people to avoid fat, because fat eventually leads to cholesterol which can cause heart problems. However, in the past few years, they also conducted studies of people who had suffered from heart attacks and noted that only 50% of those people had high cholesterol levels, the remaining half did not. From that, they inferred cholesterol may not be the primary risk factor, nor does it play a primary role in causing heart attacks, and that perhaps it’s only one among the many other risk factors.

Based on these new studies, a new nutrition guideline to be released this year will not have the section that encourages people to go low fat. In the past, health care professionals have always suggested for us to consume about 300 mg of cholesterol per day, meanwhile an egg already has about 200 mg of cholesterol. So, why did many studies in the past point to cholesterol as the number one culprit? If we check upon these studies, we will see that many of these researches were sponsored by pharmaceutical companies that produce cholesterol lowering drugs.

Furthermore, they studied the 50% of the patients who suffered from heart attacks that didn’t have high cholesterol, and tried to see whether cholesterol pills could help decrease the patients’ risk factors. They discovered that the risk factor only decreased by 6% in men from 40-60 years old. There was no difference in risk factor for women between those ages who were taking cholesterol lowering pills and those who weren’t. However, cholesterol lowering drugs are still the number one, most prescribed medication by doctors worldwide, and I am one of them (laughs).

Of course, those who are smokers, have high blood pressure, diabetes, cancers, heart diseases or a family history of heart diseases, should try to keep their cholesterol levels as low as possible to maintain their health and decrease their chances of getting other diseases. Unlike how we used to think before, cholesterol level should not be a main concern for people who have a normal health condition, and are not suffering from any major illnesses nowadays.

When we talk about maintaining a low cholesterol level, we should know that 15-20% of the cholesterol in our bodies come from food consumption, the other 80% are produced by our liver. Therefore, even if we try our best to lower the cholesterol level to the max, we can only lower it so much, and its improvement won’t have a big effect on our health in general, especially when the Vietnamese diet doesn’t include much fat anyway, because we don’t eat bacon or lobster every day.

Knowing this shouldn’t make you feel you can eat fat freely (laughs), but it’s for you not to feel overly worried about the issue of cholesterol. The important thing to take away is when you are too obsessed with avoiding fat, you tend to choose foods with “low fat” labels, and forget that these foods contain a very high sugar level. Low fat selections are processed to eliminate the fat from natural ingredients; therefore, they put a lot of sugar in them to make the taste more appealing. In fact, sugar is the ultimate factor that causes obesity because when the government released nutritional guides suggesting people to go low fat, the population became increasingly more obese.

So, if cholesterol only contributes to 1/3 of the risk factor for heart attacks, what are the other two factors? One is what we call inflammation, similar to how the Vietnamese refer to as “having hot internal organs.” When we consume “hot” foods, our body will burn more often, and release free radicals which damage the blood vessel’s walls. When these walls are damaged, cholesterol that happens to pass by will become attached to them. If these walls are smooth, even if a large amount of cholesterol passes through, it won’t get sucked in and cause clotting. Anti-inflammatory elements can be found in antioxidants, Omega 3, etc., and you can get these from eating fresh, colorful fruits and vegetables, fish and fish oil. The second risk factor can be found in the bacteria inside our stomach. It has recently been discovered that when our bacteria come into contact with the compound Carnitine, they will consume it and release a compound called TMAO, and this attracts cholesterol that passes through the blood vessels. Carnitine can be found in red meat such as beef. If you ask me whether I eat red meat sometimes, the answer is yes, but I have always believed if we are going to eat unhealthy food, we should eat the best quality available so I only eat wagyu beef because that’s the best tasting beef available (laughs out loud).

In summary, I encourage you to consult with your family doctor whether you really need to take cholesterol pills or not because this type of medication has many harmful side effects, such as muscle pain and liver damage. Further, I am not sure if taking medication will help improve your existing cholesterol condition. If you have fairly normal health, you can lower your cholesterol by eating a lot of fresh fruits and vegetables, and most importantly, you should exercise regularly. Maybe, if you throw away your chair at home or at the office, that could be your best chance of lowering cholesterol without the need for me to prescribe anything (laughs).

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Dr. Khoi Nguyen
Dr. Khoi holds a Science Degree from the University of Toronto and received his medical degree in 1988. He is currently seeing patients at his private family medicine practice. In 2010, he received the Canada’s Citizenship Award for his numerous contributions to the community. Bác sĩ Khôi tốt nghiệp ngành khoa học tại University of Toronto và tốt nghiệp y khoa năm 1988. Hiện nay ông đang làm việc tại phòng mạch tư chuyên về sức khỏe gia đình, và đã được vinh dự nhận giải thưởng Canada’s Citizenship Award năm 2010.