Dietary and modifiable factors contributing to hyper-LDL-cholesterolemia prevalence in nationwide time series data and the implications for primary prevention strategies.

BACKGROUND/OBJECTIVES: A number of studies examined secular trends in blood lipid profiles using time series data of national surveys whereas few studies investigated individual-level factors contributing to such trends. The present study aimed to examine secular trends in dietary and modifiable factors and hyper-LDL-cholesterolemia (HC) prevalence and evaluate their associations using time series data of nationwide surveys.

SUBJECTS/METHODS: The study included 41,073 Korean adults aged ≥ 30 years from the 2005, 2007-2009, 2010-2012, 2013-2015, and 2016 Korea National Health and Nutrition Examination Surveys. Stepwise logistic regression analysis was performed to select significant factors associated with HC, which was defined as serum LDL cholesterol levels ≥130 mg/dL.

RESULTS

The following factors showed a positive association with HC ( < 0.05): for men having higher body mass index (BMI), being married, having an office job, and consuming higher dairy and vegetable oil products; for women having higher age or BMI, having no job or a non-office job, not in a low-income household, and consuming higher dairy products. In the given model, the 2016 survey data showed that a 2 kg/m reduction in BMI of obese persons resulted in a decreased HC prevalence from 30.8% to 29.3% among men and from 33.6% to 32.5% among women.

CONCLUSIONS

Based on these findings, it is suggested that primary prevention programs should advocate having proper BMI for Korean adults with a high-risk of HC. However, whether discouraging consumption of dairy and vegetable oil products can reduce HC prevalence warrants further studies with a prospective longitudinal design.