4.6 Article

Dietary Macronutrient Composition in Relation to Circulating HDL and Non-HDL Cholesterol: A Federated Individual-Level Analysis of Cross-Sectional Data from Adolescents and Adults in 8 European Studies

Journal

JOURNAL OF NUTRITION
Volume 151, Issue 8, Pages 2317-2329

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/jn/nxab077

Keywords

energy density models; substitution; blood lipids; dietary intake; fatty acids; carbohydrates; adults; adolescents; data sharing; data integration

Funding

  1. German Ministry of Food and Agriculture (BMEL) through the Federal Office for Agriculture and Food (BLE) [2814ERA01F]
  2. German Ministry of Education and Research (BMBF) [2814ERA03F]
  3. Helmholtz Centre Munich
  4. LMU Munich
  5. IUF -Leibniz Research-Institute for Environmental Medicine at the University of Dusseldorf
  6. Federal Ministry for Environment (IUF Dusseldorf) [FKZ 20462296]
  7. Federal Ministry for Education, Science, Research and Technology
  8. Commission of the European Communities, the 7th Framework Program: MeDALL project
  9. Mead Johnson
  10. Helmholtz Centre for Environmental Research -UFZ, Leipzig
  11. FWO Research Foundation Flanders [G0D4815N]
  12. Chinese Scholarship Council
  13. Nestle
  14. TU Munich
  15. Helmholtz Centre for Environmental Research -UFZ, Leipzig, Pediatric Practice, Bad Honnef
  16. IUF -Leibniz Research-Institute for Environmental Medicine at the University of Dusseldorf,

Ask authors/readers for more resources

The study found that replacing dietary carbohydrates with total fats or monounsaturated fats (MUFAs) significantly increased HDL cholesterol levels, while being unrelated to non-HDL cholesterol levels. Saturated fats (SFAs) were significantly associated with higher non-HDL cholesterol levels, while polyunsaturated fats (PUFAs) were associated with lower non-HDL cholesterol levels.
Background: Associations between increased dietary fat and decreased carbohydrate intake with circulating HDL and non-HDL cholesterol have not been conclusively determined. Objective: We assessed these relations in 8 European observational human studies participating in the European Nutritional Phenotype Assessment and Data Sharing Initiative (ENPADASI) using harmonized data. Methods: Dietary macronutrient intake was recorded using study-specific dietary assessment tools. Main outcome measures were lipoprotein cholesterol concentrations: HDL cholesterol (mg/dL) and non-HDL cholesterol (mg/dL). A cross-sectional analysis on 5919 participants (54% female) aged 13-80 y was undertaken using the statistical platform DataSHIELD that allows remote/federated nondisclosive analysis of individual-level data. Generalized linear models (GLM) were fitted to assess associations between replacing 5% of energy from carbohydrates with equivalent energy from total fats, SFAs, MUFAs, or PUFAs with circulating HDL cholesterol and non-HDL cholesterol. GLM were adjusted for study source, age, sex, smoking status, alcohol intake and BMI. Results: The replacement of 5% of energy from carbohydrates with total fats or MUFAs was statistically significantly associated with 0.67 mg/dL (95% CI: 0.40, 0.94) or 0.99 mg/dL (95% CI: 0.37 1.60) higher HDL cholesterol, respectively, but not with non-HDL cholesterol concentrations. The replacement of 5% of energy from carbohydrates with SFAs or PUFAs was not associated with HDL cholesterol, but SFAs were statistically significantly associated with 1.94 mg/dL (95% CI: 0.08, 3.79) higher non-HDL cholesterol, and PUFAs with -3.91 mg/dL (95% CI: -6.98, -0.84) lower non-HDL cholesterol concentrations. A statistically significant interaction by sex for the association of replacing carbohydrates with MUFAs and non-HDL cholesterol was observed, showing a statistically significant inverse association in males and no statistically significant association in females. We observed no statistically significant interaction by age. Conclusions: The replacement of dietary carbohydrates with fats had favorable effects on lipoprotein cholesterol concentrations in European adolescents and adults when fats were consumed as MUFAs or PUFAs but not as SFAs.

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