scholarly journals Evaluating the impact of a digital nutrition platform on cholesterol levels in users with dyslipidemia: A longitudinal study. (Preprint)

2021 ◽  
Author(s):  
Emily Ann Hu ◽  
Jared Scharen ◽  
Viet Nguyen ◽  
Jason Langheier
Keyword(s):  
Longitudinal Study ◽  
Total Cholesterol ◽  
Density Lipoprotein ◽  
Healthy Diet ◽  
Lipoprotein Cholesterol ◽  
Lipid Levels ◽  
Cholesterol Levels ◽  
Lipid Markers ◽  
Meal Planning ◽  
The Impact

BACKGROUND A strong association exists between consuming a healthy diet and lowering cholesterol levels among individuals with high cholesterol. However, implementation and sustaining a healthy diet in the real world is a major challenge. Digital technologies are at the forefront of changing dietary behavior on a massive scale. There is a lack of evidence that has examined the benefit of a digital nutrition intervention, especially one that incorporates nutrition education, meal planning, and food ordering, on cholesterol levels among individuals with dyslipidemia. OBJECTIVE The aim of this observational, longitudinal study was to characterize users with dyslipidemia and evaluate changes in total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), non-HDL-c, and triglycerides among individuals with dyslipidemia who used Foodsmart, a digital nutrition platform that integrates education, meal planning, and food ordering. METHODS We included 653 adults who used Foodsmart between January 2015 and February 2021 and reported a lipid marker twice. Participants self-reported age, gender, weight, usual dietary intake, and lipid values in a 53-item food frequency questionnaire. Dyslipidemia was defined as total cholesterol ≥ 200 mg/dL, HDL-c ≤ 40 mg/dL, LDL-c ≥ 100 mg/dL, or triglycerides ≥ 150 mg/dL. We retrospectively analyzed distributions of user characteristics and their associations with baseline dyslipidemia. We calculated mean and percent changes in lipid markers and the percent of participants with dyslipidemia at baseline who achieved normal lipid values, by enrollment duration. RESULTS We found that 68% of participants had dyslipidemia at baseline and 60% had dyslipidemia at the end of their program. Participants with dyslipidemia at baseline were more likely to be middle-aged (40-59 years old), be male, have a higher weight and BMI, and have a lower change in healthy diet score compared with participants with normal lipid levels. Participants in the program saw improvements across all six objectives: HDL-c improved by a 38.5% increase, total cholesterol decreased by 6.8%, cholesterol ratio decreased by 20.9%, LDL-c decreased by 5.8%, non-HDL-c decreased by 7.8%, and triglycerides decreased by 10.8%. Overall, 27.0% of participants with dyslipidemia at baseline achieved normal lipid levels at the end of enrollment. The percent of people with dyslipidemia at baseline who achieved normal lipid levels increased with longer enrollment duration. Males, older participants, and participants with obesity class 3 were more likely to have dyslipidemia at baseline. CONCLUSIONS This study suggests that usage of the Foodsmart platform is associated with improvements in lipid markers, most likely through improved diet quality, and longer enrollment duration was associated with greater improvements.

Abstract P102: Variability In Lipid Levels And Risk For Cardiovascular Disease: An Electronic Health Record-based Population Cohort Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Sheila M Manemann ◽  
Suzette J Bielinski ◽  
Ethan D Moser ◽  
Jennifer L St. Sauver ◽  
Paul Y Takahashi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Electronic Health Record ◽  
Total Cholesterol ◽  
Index Date ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Health Record ◽  
Lipid Levels ◽  
Population Cohort ◽  
Increased Risk

Background: Larger within-patient variability of lipid levels has been associated with an increased risk of cardiovascular disease (CVD). However, measures of lipid variability are not currently used clinically. We investigated the feasibility of calculating lipid variability within a large electronic health record (EHR)-based population cohort and assessed associations with incident CVD. Methods: We identified all individuals ≥40 years of age who resided in Olmsted County, MN on 1/1/2006 (index date) without prior CVD. CVD was defined as myocardial infarction, coronary artery bypass graft surgery, percutaneous coronary intervention or stroke. Patients with ≥3 measurements of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and/or triglycerides during the 5 years before the index date were retained in the analyses. Lipid variability was calculated using variability independent of the mean (VIM). Patients were followed through 9/30/2017 for incident CVD (including CVD death). Cox regression was used to investigate the association between quintiles of lipid VIMs and incident CVD. Results: We identified 18,642 individuals (mean age 60; 55% female) who were free of CVD at baseline and VIM calculated for at least one lipid measurement. After adjustment, those in the highest VIM quintiles of total cholesterol had a 25% increased risk of CVD (Q5 vs. Q1 HR: 1.25, 95% CI: 1.08-1.45; Table). We observed similar results for LDL-C (Q5 vs. Q1 HR: 1.20, 95% CI: 1.04-1.39) and HDL-C (Q5 vs. Q1 HR: 1.25, 95% CI: 1.09-1.43). There was no association between triglyceride variability quintiles and CVD risk. Conclusion: In a large EHR-based population cohort, high variability in total cholesterol, HDL-C and LDL-C was associated with an increased risk of CVD, independently of traditional risk factors, suggesting it may be a target for intervention. Lipid variability can be calculated in the EHR environment but more research is needed to determine its clinical utility.

scholarly journals Maternal lipid profile in early pregnancy is associated with foetal growth and the risk of a child born large-for-gestational age: a population-based prospective cohort study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Maria C. Adank ◽  
Laura Benschop ◽  
Alet W. Kors ◽  
Kelly R. Peterbroers ◽  
Anna M. Smak Gregoor ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Gestational Age ◽  
Density Lipoprotein ◽  
Population Based ◽  
Lipoprotein Cholesterol ◽  
Large For Gestational Age ◽  
Lipid Levels ◽  
Foetal Growth ◽  
Cholesterol Levels ◽  
Remnant Cholesterol

Abstract Background Lipids such as cholesterol and triglycerides play an important role in both maternal and foetal energy metabolism. Little is known about maternal lipid levels in pregnancy and their effect on foetal growth. The aim of this study was to assess maternal lipid levels, foetal growth and the risk of small-for-gestational age (SGA) and large-for-gestational age (LGA). Methods We included 5702 women from the Generation R Study, a prospective population-based cohort. Maternal lipid levels (total cholesterol, triglycerides and high-density lipoprotein cholesterol [HDL-c]) were measured in early pregnancy (median 13.4 weeks, 90% range [10.5 to 17.2]). Low-density lipoprotein cholesterol (LDL-c), remnant cholesterol and non-HDL-c were calculated. Foetal growth was measured repeatedly by ultrasound. Information on birth anthropometrics was retrieved from medical records. A birth weight below the 10th percentile was defined as SGA and above the 90th percentile as LGA. Results Maternal triglyceride and remnant cholesterol levels were associated with increased foetal head circumference and abdominal circumference growth rates. Triglycerides and remnant cholesterol were positively associated with the risk of LGA (odds ratio [OR] 1.11, 95% confidence interval [CI] [1.01 to 1.22] and OR 1.11, 95% CI [1.01 to 1.23], respectively). These associations were independent of maternal pre-pregnancy body mass index, but not maternal glucose levels. We observed no association between maternal lipids in early pregnancy and SGA. Conclusions Our study suggests a novel association of early pregnancy triglyceride and remnant cholesterol levels with foetal growth, patterns of foetal growth and the risk of LGA. Future studies are warranted to explore clinical implication possibilities.

scholarly journals Lipid levels and the risk of hemorrhagic stroke among women

Neurology ◽  
2019 ◽  
Vol 92 (19) ◽  
pp. e2286-e2294 ◽  
Author(s):  
Pamela M. Rist ◽  
Julie E. Buring ◽  
Paul M Ridker ◽  
Carlos S. Kase ◽  
Tobias Kurth ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Hemorrhagic Stroke ◽  
Stroke Risk ◽  
Density Lipoprotein ◽  
Cox Proportional Hazards ◽  
Lipoprotein Cholesterol ◽  
Health Study ◽  
Lipid Levels ◽  
Increased Risk ◽  
Multivariable Adjustment

ObjectiveTo examine the association between lipid levels and hemorrhagic stroke risk among women.MethodsWe performed a prospective cohort study among 27,937 women enrolled in the Women's Health Study with measured total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), as well as triglycerides. Strokes were confirmed by medical record review. We used Cox proportional hazards models to analyze associations between lipid categories and hemorrhagic stroke risk.ResultsDuring a mean of 19.3 years of follow-up, 137 hemorrhagic strokes occurred. Compared to those with LDL-C levels 100–129.9 mg/dL, after multivariable adjustment, those with LDL-C levels <70 mg/dL had 2.17 times the risk (95% confidence interval [CI] 1.05, 4.48) of experiencing a hemorrhagic stroke. No significant increase in risk was seen for those with LDL-C levels 130–159.9 mg/dL (relative risk [RR] 1.14; 95% CI 0.72, 1.80) or 70–99.9 mg/dL (RR 1.25; 95% CI 0.76, 2.04). There was a suggestion, although not significant, of increased risk for those with LDL-C levels ≥160 mg/dL (RR 1.53; 95% CI 0.92, 2.52). Women in the lowest quartile of triglycerides had a significantly increased risk of hemorrhagic stroke compared to women in the top quartile after multivariable adjustment (RR 2.00; 95% CI 1.18, 3.39). We observed no significant associations between total cholesterol or HDL-C levels and hemorrhagic stroke risk.ConclusionLDL-C levels <70 mg/dL and low triglyceride levels were associated with increased risk of hemorrhagic stroke among women.

scholarly journals Long-Term Burden of Increased Body Mass Index from Childhood on Adult Dyslipidemia: The i3C Consortium Study

2019 ◽  
Vol 8 (10) ◽  
pp. 1725 ◽  
Author(s):  
Yinkun Yan ◽  
Lydia A. Bazzano ◽  
Markus Juonala ◽  
Olli T. Raitakari ◽  
Jorma S. A. Viikari ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Early Life ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Lipid Levels ◽  
Increased Risk ◽  
The Impact

Background: Data are limited regarding the association of cumulative burden and trajectory of body mass index (BMI) from early life with adult lipid disorders. Methods: The study cohort consisted of 5195 adults who had BMI repeatedly measured 4 to 21 times from childhood and had blood lipid measurements of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) and information on lipid-lowering medications in the last adult survey. The area under the curve (AUC) was calculated as a measure of long-term burden (total AUC) and trends (incremental AUC) of BMI. Results: Participants with dyslipidemia, high LDL-C, low HDL-C and high TG had consistently and significantly higher BMI levels from childhood to adulthood compared to those with normal lipid levels. After adjusting for age, race, sex, and cohort, increased risk of adult dyslipidemia was significantly associated with higher values of childhood BMI, adulthood BMI, total AUC and incremental AUC, with odds ratio (95% confidence interval) = 1.22 (1.15–1.29), 1.85 (1.74–1.97), 1.61 (1.52–1.71), and 1.59 (1.50–1.69), respectively, and p < 0.001 for all. The association patterns were similar in most race–sex subgroups. Conclusions: Adults with dyslipidemia versus normal lipid levels have consistently higher levels and distinct life-course trajectories of BMI, suggesting that the impact of excessive body weight on dyslipidemia originates in early life.

scholarly journals Comparison of the effects of high- and low-methoxyl pectins on blood and faecal lipids in man

1982 ◽  
Vol 48 (3) ◽  
pp. 451-458 ◽  
Author(s):  
Patricia A. Judd ◽  
A. S. Truswell
Keyword(s):  
Young Adults ◽  
Bile Acid ◽  
High Density Lipoprotein ◽  
Total Cholesterol ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cholesterol Levels ◽  
Steroid Excretion ◽  
Cholesterol Lowering Effect

1. The effects on blood and faecal lipids of the addition of 15 g of either high- or low-methoxyl pectin to the habitual diets of ten healthy young adults have been studied.2. Serum total cholesterol levels were reduced by a mean of 16% during consumption of low-methoxyl pectin and 18% during consumption of high-methoxyl pectin. High density lipoprotein cholesterol levels and triglyceride levels were unchanged.3. There was no difference in faecal fat and steroid excretion between the two pectins.4. The results suggest that it is the gel-forming properties of the pectins which are important in the cholesterol-lowering effect rather than differences in bile acid bindingdue to different methoxyl contents.

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