Diet, smoking, and blood lipids in patients with combined familial hyperlipidaemia

This study analysed the diet (based on a 7-day-record), smoking habits and basic anthropometric parameters of patients with familial combined hyperlipidaemia (N = 154, 52% men, 48% women, mean age 55.73 +/- 12.95). These data were correlated with blood lipids and lipoproteins. In high-risk patients' diets we found not quantitative, but mostly qualitative shortcomings: the average energy intake was 104% of the recommended daily intake (RDI), but 34% of the energy was derived from fats. The daily fat intake represented 137% of RDI, and 60 g were of animal and 24 g of vegetable origine. The protein intake was 120% of RDI (155% animal, 75% vegetable protein), the carbohydrate intake was only 86% and the fibre intake 71% of RDI. A very high intake both of cholesterol--139% of RDI and NaCl 151% of RDI--was recorded, while the intake of antioxidant vitamins C and E was only 82% and 35% of RDI, respectively. Current smoking was recorded in 51% of patients. Smokers had also a poorer diet: higher animal fat and protein, as well as a higher cholesterol intake, lower vegetable fat, protein, fibre and vitamin E intake. Surprisingly smokers were found to ingest more vitamin C than non-smokers. As to blood lipids: smokers vs. non-smokers had the following values in mmol/l (SD): total cholesterol 7.8 (+/- 1.3) vs. 7.7 (+/- 1.82), triacylglycerols 3.27 (+/- 2.13) vs. 3.2 (+/- 3.11), HDL-cholesterol 1.25 (+/- 0.39) vs. 1.36 (+/- 0.43), LDL-cholesterol 5.11 (+/- 1.39) vs. 4.95 (+/- 1.51), and, in g/l, apolipoprotein A1 1.8 (+/- 0.30) vs. 1.66 (+/- 0.35), apolipoprotein B 1.66 (+/- 0.35) vs. 1.52 (+/- 0.44), lipoprotein (a) 0.36 (+/- 0.27) vs. 0.43 (+/- 0.50), all without statistical significance. For smokers vs. non-smokers anthropometric data were as follows (mean, SD): body mass index (BMI) 27.74 (+/- 3.77) vs. 27.02 (+/- 3.30), waist/hip ratio (WHR) 0.895 (+/- 0.086) vs. 0.911 (+/- 0.093), and % of body fat 29.6 (+/- 7.4) vs. 27.9 (+/- 7.9). Our conclusions suggest, that lifestyle choice are of great importance for patients with this serious genetic lipid metabolism disorder and that it is important to recognise the danger of risk factor cumulation in connection with cardiovascular diseases.