Abstract
Background: Cholesterol has a pivotal role in human physiology, exerting both structural and functional activity. However, higher blood cholesterol levels, especially low-density lipoprotein cholesterol (LDL-C), are a major cardiovascular risk factor. Therefore, special attention has been given to the effect of dietary factors in influencing LDL-C blood levels. In particular, much research has focused on dairy products, since they are a main component of different dietary patterns worldwide. A large body of evidence did not support the hypothesis that dairy products significantly increase circulating LDL-C, but no definitive data are available. Hence, we aimed to assess the relationships among LDL-C, habitual dairy food intake and anthropometric variables in a cohort representative of the general population in a Mediterranean area. Methods: We evaluated 802 healthy adults included in the ABCD_2 (Alimentazione, Benessere Cardiovascolare e Diabete) study (ISRCTN15840340), a longitudinal observational single-center study of a cohort representative of the general population of Palermo, Sicily. The habitual intake of dairy products was assessed with a validated food frequency questionnaire, and LDL-C serum levels and several anthropometric parameters were measured. Results: The group with high LDL-C serum concentrations (≥130 vs. <130 mg/dL) exhibited higher age, body mass index (BMI), waist-to-hip ratio (WHR), body fat percentage, systolic and diastolic blood pressure, carotid intima-media thickness and glycated hemoglobin. The habitual diet was not different between the groups in terms of macronutrient, cholesterol, egg and dairy food intake, with the exception of the weekly number of portions of milk (higher in the low LDL-C group vs. the high LDL-C group) and ricotta cheese (higher in the high LDL-C group vs. the LDL-C group). No significant correlation was found between LDL-C blood levels and the habitual intake of dairy products or the dietary intake of cholesterol and fats. The multivariate regression analyses (R2 = 0.94) showed that LDL-C blood levels were significantly associated with the habitual intake of milk (p < 0.005) and ricotta cheese (p < 0.001) and with BMI (p < 0.001). Conclusion: Our study reported that total dairy food consumption was not correlated with LDL-C blood levels. However, multivariate analyses showed an inverse association between serum LDL-C and milk intake as well as a positive association between ricotta cheese intake and LDL-C concentrations. More studies are needed to better characterize the relationship between dairy products and circulating LDL-C.
Highlights
Cardiovascular diseases (CVDs) are the main cause of death worldwide, representing nearly 25% of all deaths in both developing and developed countries [1]
A similar number of people did not habitually consume milk in the two groups (37.0% vs. 44.9%, low vs. high low-density lipoprotein cholesterol (LDL-C) group; p= 0.10); no difference was observed concerning the use of whole milk (6.1 vs. 5.2%), low-fat milk (53.5 vs. 45.5%) and skimmed milk (3.4 vs. 4.4%)
The multiple regression analysis demonstrated that age, body mass index (BMI), habitual intake of milk and ricotta cheese were independently associated with blood LDL-C concentrations (Table 3)
Summary
Cardiovascular diseases (CVDs) are the main cause of death worldwide, representing nearly 25% of all deaths in both developing and developed countries [1]. Blood levels of low-density lipoprotein cholesterol (LDL-C) are mainly responsible for atherosclerosis promotion and progression [4], and the strong association between serum LDL-C and CVD is well acknowledged [5]. Dietary intake has a pivotal role in influencing serum LDL-C concentrations, and many studies have demonstrated that dietary patterns are associated with blood lipid profiles [8]. Our aim was to investigate the relationship between LDL-C serum concentrations, anthropometric parameters and the habitual intake of dairy foods in a cohort of randomly selected healthy adults living in the Mediterranean area of Palermo (Sicily, Italy). Higher blood cholesterol levels, especially low-density lipoprotein cholesterol (LDL-C), are a major cardiovascular risk factor. We aimed to assess the relationships among LDL-C, habitual dairy food intake and anthropometric variables in a cohort representative of the general population in a Mediterranean area. The habitual intake of dairy products was assessed with a validated food frequency questionnaire, and LDL-C serum levels and several anthropometric parameters were measured
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