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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

Lookup NU author(s): Dr Demetris AvraamORCiD, Emeritus Professor Paul BurtonORCiD


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© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. 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.

Publication metadata

Author(s): Pinart M, Jeran S, Boeing H, Stelmach-Mardas M, Standl M, Schulz H, Harris C, von Berg A, Herberth G, Koletzko S, Linseisen J, Breuninger TA, Nothlings U, Barbaresko J, Benda S, Lachat C, Yang C, Gasparini P, Robino A, Rojo-Martinez G, Castano L, Guillaume M, Donneau A-F, Hoge A, Gillain N, Avraam D, Burton PR, Bouwman J, Pischon T, Nimptsch K

Publication type: Article

Publication status: Published

Journal: The Journal of Nutrition

Year: 2021

Volume: 151

Issue: 8

Pages: 2317-2329

Print publication date: 01/08/2021

Online publication date: 13/04/2021

Acceptance date: 01/03/2021

ISSN (print): 0022-3166

ISSN (electronic): 1541-6100

Publisher: Oxford University Press


DOI: 10.1093/jn/nxab077

PubMed id: 33847346


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