At-risk serum cholesterol profile at both ends of the nutrition spectrum in West African adults? The Benin study

• Published in: Nutrients Vol. 5; no. 4; pp. 1366 - 1383
• Main Authors: Delisle, Hélène, Ntandou, Gervais, Sodjinou, Roger, Couillard, Charles, Després, Jean-Pierre
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 19.04.2013; MDPI
• Subjects: Adult; African Continental Ancestry Group; Benin - epidemiology; Biomarkers - blood; Body Mass Index; Chi-Square Distribution; Cholesterol; Cholesterol, HDL - blood; Cross-Sectional Studies; Developing countries; Diet - adverse effects; dietary quality; double burden of malnutrition; Dyslipidemias - blood; Dyslipidemias - ethnology; Dyslipidemias - physiopathology; Female; HDL-cholesterol; Health care; High density lipoprotein; Homocysteine - blood; Humans; Insulin resistance; Insulin Resistance - ethnology; LDCs; Life Style; lifestyle; Linear Models; Male; Malnutrition; Metabolic disorders; Metabolic syndrome; Micronutrients - administration & dosage; Middle Aged; Multivariate Analysis; Nutrition research; nutrition transition; nutritional status; Nutritional Status - ethnology; Obesity; Obesity, Abdominal - blood; Obesity, Abdominal - ethnology; Obesity, Abdominal - physiopathology; Odds Ratio; Overweight; Risk Assessment; Risk Factors; Socioeconomic Factors; Thinness - blood; Thinness - ethnology; Thinness - physiopathology; West Africa; Women; Benin; Canada; Montreal Quebec Canada; West Africa; Quebec City Quebec Canada
• DOI: 10.3390/nu5041366
• ISSN: 2072-6643

Low HDL-cholesterol (HDL-C), using as cut-offs 1.03 mmol/L in men and 1.29 mmol/L in women, was observed in more than 25% apparently healthy adults (n = 541) in a cross-sectional study on nutrition transition and cardiometabolic risk factors (CMRF) in Benin, West Africa. Both overweight/obesity (35.3%) and underweight (11.3%) were present, displaying the double burden of malnutrition. We examined in more depth the association of low HDL-C with nutrition and with other CMRF. Metabolic syndrome components were assessed, plus the ratio of total cholesterol (TC)/HDL-C and serum homocysteine. Insulin resistance was based on Homeostasis Model Assessment. We also measured BMI and body composition by bio-impedance. Dietary quality was appraised with two non-consecutive 24 h recalls. Low HDL-C was associated with much higher TC/HDL-C and more abdominal obesity in men and women and with more insulin resistance in women. The rate of low HDL-C was highest (41.9%) among the overweight/obese subjects (BMI ≥ 25), but it also reached 31.1% among the underweight (BMI < 18.5), compared with 17.3% among normal-weight subjects (p < 0.001). Lower dietary micronutrient adequacy, in particular, in vitamins A, B3, B12, zinc and calcium, was associated with low HDL-C when controlling for several confounders. This suggests that at-risk lipoprotein cholesterol may be associated with either underweight or overweight/obesity and with poor micronutrient intake.