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Association of dietary lipid intake with low-density lipoprotein cholesterol levels: analysis of two independent population-based studies

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Abstract

Purpose

Serum low-density lipoprotein cholesterol (LDL-C) concentration is associated with the risk of cardiovascular disease. However, whether cholesterol and fat intake independently affect serum LDL-C levels remains controversial. We aimed to explore the differential effects of dietary cholesterol and fats on blood lipid profiles according to the presence of dyslipidemia.

Methods

A cross-sectional study was conducted based on data from the sixth Korean National Health and Nutrition Examination Survey (2013–2015), and a prospective cohort study was conducted using data from the Korean Genome Epidemiology Study. The analyses used data from 10,068 adults and from 9652 adults, respectively. Adjusted mean values of blood lipids were calculated according to cholesterol and fat intake using analysis of covariance. A repeated-measures covariance pattern linear mixed model with unstructured covariance within participants was used to examine longitudinal associations between cholesterol intake and serum concentrations of total cholesterol and LDL-C. Substitutional analysis was conducted to estimate carbohydrate substitution with saturated fat or unsaturated fat.

Results

Serum LDL-C level was significantly higher in dyslipidemic subjects who consumed more than 300 mg cholesterol per day than in those who consumed less than 300 mg cholesterol per day. At a mean 9-year follow-up, levels of total cholesterol and LDL-C were significantly higher in dyslipidemic individuals with higher baseline cholesterol intake after adjustment for potential confounders. In regard to dietary fats, replacing carbohydrate with unsaturated fat was associated with lower level of LDL-C in subjects with dyslipidemia.

Conclusions

Serum LDL-C is associated with the intake of dietary cholesterol, especially in individuals with dyslipidemia.

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Acknowledgements

This research was supported by the Bio and Medical Technology Development Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning (NRF-2018R1D1A1B07049223). This work was supported by the Technology Innovation Program (20002781, A Platform for Prediction and Management of Health Risk Based on Personal Big Data and Lifelogging) funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea). It was supported by a 2018 Faculty Research Grant from Yonsei University College of Medicine (6-2018-0090) to Yu-Jin Kwon.

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Authors and Affiliations

  1. Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Yu-Jin Kwon & Ji-Won Lee

  2. Department of Medicine, Graduate School of Yonsei University, Seoul, Korea

    Yu-Jin Kwon

  3. Department of Family Medicine, Yongin Severance Hospital, Yongin, Republic of Korea

    Yu-Jin Kwon

  4. Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hye Sun Lee

  5. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hyuk-Jae Chang

  6. Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hyuk-Jae Chang

  7. Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea

    Sang-Baek Koh

  8. Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea

    Sang-Baek Koh

  9. Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Republic of Korea

    Ji-Won Lee

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  1. Yu-Jin Kwon
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Contributions

Y-JK, H-SL, H-JC, S-BK, and J-WL contributed to the conception and design of the study; advised on all statistical aspects and interpreted the data; reviewed the manuscript and approved the final version to be published; had full access to all the data in the study; and take responsibility for the integrity of the data and the accuracy of the data analysis. Y-JK, H-SL, and J-WL performed the statistical analysis and drafted the manuscript.

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Correspondence to Ji-Won Lee.

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Kwon, YJ., Lee, H., Chang, HJ. et al. Association of dietary lipid intake with low-density lipoprotein cholesterol levels: analysis of two independent population-based studies. Eur J Nutr 59, 2557–2567 (2020). https://doi.org/10.1007/s00394-019-02104-3

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  • DOI: https://doi.org/10.1007/s00394-019-02104-3

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