Relationship of Lifestyle Medical Advice and Non-HDL Cholesterol Control of a Nationally Representative US Sample with Hypercholesterolemia by Race/Ethnicity

Objective. The main purpose of this study was to evaluate the associations of lifestyle medical advice and non-HDL cholesterol control of a nationally representative US sample of adults with hypercholesterolemia by race/ethnicity. Methods. Data were collected by appending sociodemographic, anthropometric, and laboratory data from two cycles of the National Health and Nutrition Survey (2007-2008 and 2009-2010). This study acquired data from male and female adults aged ≥ 20 years (N = 11,577), classified as either Mexican American (MA), (), other Hispanic (OH) (), Black non-Hispanic (BNH) (), or White non-Hispanic (WNH) (). Results. Minorities were more likely to report having received dietary, weight management, and exercise recommendations by healthcare professionals than WNH, adjusting for confounders. Approximately 80% of those receiving medical advice followed the recommendation, regardless of race/ethnicity. Of those who received medical advice, reporting “currently controlling or losing weight” was associated with lower non-HDL cholesterol. BNH who reported “currently controlling or losing weight” had higher non-HDL cholesterol than WNH who reported following the advice. Conclusion. The results suggest that current methods of communicating lifestyle advice may not be adequate across race/ethnicity and that a change in perspective and delivery of medical recommendations for persons with hypercholesterolemia is needed.

Relationship of Lifestyle Medical Advice and Non-HDL Cholesterol Control of a Nationally Representative US Sample with Hypercholesterolemia by Race/Ethnicity

Objective: The main purpose of this study was to evaluate the associations of lifestyle medical advice and non-HDL cholesterol control of a nationally representative US sample of adults with hypercholesterolemia by race/ethnicity. Methods: Data were collected by appending sociodemographic, anthropometric, and laboratory data from two cycles of the National Health and Nutrition Survey (2007-2008 and 2009-2010). This study acquired data from male and female adults aged ≥ 20 years (N = 11,577), classified as either Mexican American (MA), (), other Hispanic (OH) (), Black non-Hispanic (BNH) (), or White non-Hispanic (WNH) (). Results: Minorities were more likely to report having received dietary, weight management, and exercise recommendations by healthcare professionals than WNH, adjusting for confounders. Approximately 80% of those receiving medical advice followed the recommendation, regardless of race/ethnicity. Of those who received medical advice, reporting “currently controlling or losing weight” was associated with lower non-HDL cholesterol. BNH who reported “currently controlling or losing weight” had higher non-HDL cholesterol than WNH who reported following the advice. Conclusion: The results suggest that current methods of communicating lifestyle advice may not be adequate across race/ethnicity and that a change in perspective and delivery of medical recommendations for persons with hypercholesterolemia is needed.

Dietary Intake Of Flavonoids And HDL- And LDL- Cholesterol In Two Black Ethnicities With And Without Type 2 Diabetes

Flavonoids are a class of over 6,500 plant metabolites that have been associated with reduced mortality from cardiovascular disease. A cross-sectional analysis of dietary flavonoids and serum cholesterol in 507 Blacks with and without type 2 diabetes (258 Haitian-Americans and 249 African-Americans) showed differences by ethnicity and diabetes status. Haitian-Americans consumed more of most flavonoids as compared to African-Americans. Individuals with type 2 diabetes consumed less of most flavonoids as compared to those without diabetes. Flavonoids were differentially associated with low-density lipoprotein cholesterol (LDL) and high-density lipoprotein cholesterol (HDL) by diabetes status. Flavanones were associated with lower LDL for participants without diabetes and higher LDL for those with diabetes, independent of ethnicity and adjusted for age, gender, cholesterol medications, daily energy, dietary fat, body mass index (BMI), and smoking. Flavan-3-ols were positively related to LDL while polyflavonoids (theaflavin and polymers, proanthocyanidins) were inversely related to LDL for the group without diabetes only. Higher anthocyanidins and flavan-3-ols and lower polyflavonoids were associated with higher HDL (same adjustments) for those without diabetes, whereas no flavonoids were associated with HDL for individuals with type 2 diabetes.