Dietary Cholesterol in the Elderly Chinese Population: An Analysis of CNHS 2010-2012

Abstract

Dietary cholesterol intake increased dramatically over the past two decades in the elderly Chinese population. However, the nationwide dietary cholesterol intake and its related factors seldom been investigated. Based on data from 16,594 participants aged 60 years or older (49.0% male, 54.8% urban residents) from the China National Nutrition and Health Survey (CNHS) 2010-2012, we aimed to describe the intake of cholesterol and major food contributions, as well as its association with serum cholesterol level and relationship with protein intake. Mean daily cholesterol intake for all participants was 217.4 mg, the mean cholesterol intakes in urban and rural areas were 264.0 mg and 168.8 mg, respectively. Cholesterol intake levels varied by age, gender, BMI and region (p < 0.001). In addition, the proportion of all participants who consumed greater than 300 mg of cholesterol per day was 26.6%. Eggs, red meats, and seafood were the top three food sources and their contributions to total daily cholesterol intake were 57.7%, 24.0% and 10.9% respectively. Serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were related to dietary cholesterol intake, with each 100 mg increase in dietary cholesterol intake apparently leading to a 0.035 mmol/L (p = 0.001) increase in serum TC and a 0.038 mmol/L (p < 0.001) increase in LDL-C. The partial correlation coefficients between dietary cholesterol and total protein, high-quality protein, intake of protein per kilogram body weight (BW), and high-quality protein percentage were 0.538, 0.580, 0.426, and 0.548, respectively, after adjusting for age, gender, and energy, fat and carbohydrate intakes (p < 0.001). In conclusion, there was a substantial urban-rural difference in cholesterol intake. Eggs and red meat were the main sources of dietary cholesterol intake. Serum TC and LDL-C were associated with dietary cholesterol and the response was linear. Dietary cholesterol intake was closely related to the intake of high-quality protein.

Keywords: dietary cholesterol; elderly population; food source; high-quality protein.

Figure 1

Food sources of dietary cholesterol among the Chinese elderly population by age, gender and residence.

Figure 2

Food sources of dietary cholesterol by levels of cholesterol intake. *: Compared with the group of ≥300 mg/day, p < 0.001.

Figure 3

Relationship of dietary cholesterol and serum cholesterol levels. The graph represents the effect of a change in dietary cholesterol intake (per 100 mg) on serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein (HDL-C). Linear regression models were used to study the effect of dietary cholesterol on serum TC, LDL-C, and HDL-C. β represents Standardized Coefficients for per 100 mg dietary cholesterol intake.