Abstract
Aim: The positive relationship between dietary cholesterol and serum cholesterol has been questioned by a set of recent cohort studies. This study aimed to investigate how employment status and education years relate to the association between dietary cholesterol and serum low-density lipoprotein cholesterol (LDL-C) in a Japanese population. Methods: A population-based, random sample, cross-sectional study (INTERLIPID) was performed. Among 1,145 Japanese individuals aged 40-59 years, 106 were excluded because of special diets, use of lipid-lowering drugs, hormone replacement, and missing data, leaving 1,039 individuals (533 men and 506 women). Dietary cholesterol was assessed from four 24-h dietary recalls, and LDL-C was measured enzymatically with an autoanalyzer. A standard questionnaire inquired about employment status and education years. Results: In men, a 1 standard deviation (SD) higher dietary cholesterol was associated with 3.16 mg/dL lower serum LDL-C (P=0.009; unadjusted model). After adjustment for covariates, higher serum LDL-C was estimated per 1 SD higher intake of dietary cholesterol in nonemployed men [self-employed, homemakers, farmers, fishermen, and retired employees; β = +9.08, 95% confidence interval (CI) = +0.90-+17.27] and less educated men (β =+4.46, 95% CI= -0.97-+9.90), whereas an inverse association was observed in employed men (β =-3.02, 95% CI= -5.49--0.54) and more educated men (β =-3.66, 95% CI= -6.25--1.07). Conclusions: In men who were nonemployed and less educated, a higher intake of dietary cholesterol was associated with elevated concentrations of serum LDL-C, whereas an inverse association was observed in men who were employed and more educated.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 170-182 |
| Number of pages | 13 |
| Journal | Journal of atherosclerosis and thrombosis |
| Volume | 26 |
| Issue number | 2 |
| DOIs | |
| State | Published - 2019 |
Funding
We thank Dr. Hisatomi Arima, Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University and Dr. Akira Fujiyo-shi, Department of Public Health, Shiga University of Medical Science for the critical revision to the manuscript, and Dr. Robert Douglas Abbott, Center for Epidemiologic Research in Asia, Shiga University of Medical Science and Dr. Sachiko Tanaka, Department of Public Health, Shiga University of Medical Science for their statistical expertise and advice, neither of whom were compensated for their contributions. Prof. Paul Elliott is the director of MRC-PHE Centre for Environment and Health and acknowledges support from the Medical Research Council and Public Health England (MR/L01341X/1). He is a Professor at UK Dementia Research Institute (DRI), UK DRI at Imperial College London. UK DRI is funded by the Medical Research Council, Alzheimer\u2019s Society and Alzheimer\u2019s Research, UK. The INTERMAP/INTER-LIPID study has been accomplished through the fine work of the staff at local, national, and international centers; a partial listing of colleagues is given in the References9, 16) of this manuscript. This work was supported partly by a grant-in-aid for Scientific Research (A); the Ministry of Education, Science, Sports, and Culture of Japan (No. 090357003); and the Suntory Company. The INTERMAP study was supported by the National, Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA (Grant 2-RO1-HL50490), as well as national and local agencies in the four countries. We thank Dr. Hisatomi Arima, Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University and Dr. Akira Fujiyoshi, Department of Public Health, Shiga University of Medical Science for the critical revision to the manuscript, and Dr. Robert Douglas Abbott, Center for Epidemiologic Research in Asia, Shiga University of Medical Science and Dr. Sachiko Tanaka, Department of Public Health, Shiga University of Medical Science for their statistical expertise and advice, neither of whom were compensated for their contributions. Prof. Paul Elliott is the director of MRC-PHE Centre for Environment and Health and acknowledges support from the Medical Research Council and Public Health England (MR/L01341X/1). He is a Professor at UK Dementia Research Institute (DRI), UK DRI at Imperial College London. UK DRI is funded by the Medical Research Council, Alzheimer\u2019s Society and Alzheimer\u2019s Research, UK. The INTERMAP/INTERLIPID study has been accomplished through the fine work of the staff at local, national, and international centers; a partial listing of colleagues is given in the References
Keywords
- Cholesterol
- Education
- Employment
- Lifestyle modification
- Reverse causality
ASJC Scopus subject areas
- Internal Medicine
- Cardiology and Cardiovascular Medicine
- Biochemistry, medical