Customary diet, anthropometry, and dyslipoproteinemia in selected North American populations. The Lipid Research Clinics Program Prevalence Study.

The intake of nutrients, determined by 24 hr diet recall, and body measurements were obtained in 8250 free-living white study participants divided into 20 to 49 and 50 + age groups for males and female nonusers and users of gonadal hormones. They were classified into dyslipoproteinemia (DLP) phenotypes: hyperHDL, hypoHDL, IIA, hpypoLDL, IV, and normal. The dyslipoproteinemia DLP phenotypes, compared with the normal, had biologically meaningful differences in nutrient intake and indexes of obesity that were most marked for males aged 20 to 49 years as shown in the table (below). Those with the hyperHDL phenotype were thinner and ingested more energy and more alcohol and less carbohydrate as percent kilocalories (%kcal). Individuals classified as hypoHDL were fatter and tended to ingest less energy and less alcohol as %kcal. Persons with the type II phenotype were fatter and ingested less energy. Those with hypoLDL tended to be thinner and ingested more energy. Individuals with the type IV phenotype were fatter, ingested less energy and carbohydrate and more alcohol as %kcal. Similar trends were observed in female nonusers of hormones aged 20 to 49 and to a lesser extent in the 50 + age groups and in female users of hormones. Dietary protein, cholesterol, total fat, and polyunsaturated and saturated fatty acids had no consistent associations with DLP phenotype, and sucrose and starch had no association independent of total carbohydrate. This is the first evidence of an association of customary diet and DLP phenotypes in the free-living population. Equating energy intake with energy expenditure, persons with the high-risk phenotypes, IIA, IV, and hypoHDL, compared with the normal, had decreased energy expenditure and were fatter, whereas those with the low-risk phenotypes, hyperHDL and hypoLDL, had increased energy expenditure and were thinner.