— 健康促進與維護 · MEDIUM · MCQ —
護理師在社區進行營養衛教。下列哪項飲食調整對於降低低密度脂蛋白（LDL）膽固醇最有效？
A nurse is teaching a community group about healthy nutrition. Which dietary change is the most effective for lowering low-density lipoprotein (LDL) cholesterol?
- AIncreasing intake of soluble fiber✓ 正解增加可溶性纖維的攝取量
- BEliminating all cholesterol-rich foods消除所有富含膽固醇的食物
- CReducing total fat intake to below 20%將總脂肪攝取量減少至20%以下
- DConsuming more polyunsaturated fats攝取更多多不飽和脂肪酸
— Explanation · 中文詳解 —
水溶性纖維（如燕麥、豆類）能與膽汁酸結合並加速其排出，強迫肝臟消耗循環中的膽固醇來合成膽汁酸，從而顯著降低血清 LDL。總脂肪限制（C）若過低可能影響賀爾蒙分泌，消除所有膽固醇（B）並不符合現代營養學原則。
Soluble fiber (such as that found in oats and legumes) binds bile acids and accelerates their excretion, forcing the liver to use cholesterol from the circulation to synthesize new bile acids, thereby significantly lowering serum LDL. Restricting total fat (C) too aggressively may impair hormone production, and eliminating all cholesterol (B) is inconsistent with modern nutritional principles.
✦ 台美臨床差異
美國飲食指引明確強調纖維攝取；台灣臨床則更偏重整體總熱量控制與烹調方式（少油炸）。