1. Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged and Elderly in the Guangxi Bai Ku Yao and Han Populations
Yin Ruixing, MD: Guangxi Medical University (GMU) Wu Jinzhen, MB: GMU Huang Yaoheng, MB: Baxu Health Station Tan Jing, MB: Nandan County People’s Hospital Wu Hai, MS: GMU Li Muyan, MB: GMU Li Yiyang, MD: GMU Fei Dongmei, MS: GMU Yang Hanjun, MB: Health Bureau of Nandan County Chen Yuming, MS: GMU
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing, Y, et al. J Am Diet Assoc. 108 (6), June 2008

2. Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged and Elderly in the Guangxi Bai Ku Yao and Han Populations
Background
There are fifty-six ethnic groups in China. Han is the largest group and Bai Ku Yao is the isolated subgroup of the Yao minority. Little is known about the difference in the prevalence of hyperlipidemia between the Han and other minority groups in the rural areas.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

3. Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged and Elderly in the Guangxi Bai Ku Yao and Han Populations
Objective
The aim of this study was to compare the associations of diet and lifestyle factors with hyperlipidemia for the middle-aged and elderly between the Guangxi Bai Ku Yao and Han populations.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

4. Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged and Elderly in the Guangxi Bai Ku Yao and Han Populations
Design
This is a cross-sectional study. A total of 485 subjects of Bai Ku Yao and 501 subjects of Han Chinese aged 40 and older were surveyed by a stratified cluster random sampling technique.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

5. Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged and Elderly in the Guangxi Bai Ku Yao and Han Populations
Methods
Information on demography, dietary intake, and lifestyle factors was collected by standard questionnaires. Blood pressure, height, weight, waist circumference, and serum lipids were measured, and body mass index (BMI) was calculated
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

6. Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged and Elderly in the Guangxi Bai Ku Yao and Han Populations
Results
The prevalence rates of hypercholesterolemia, hypertriglyceridemia, and hyperlipidemia in Bai Ku Yao and Han were 19.59% vs % (P<0.001), 13.81% vs % (P>0.05), and 28.45% vs % (P<0.001); respectively.
Hyperlipidemia was positively correlated with BMI, waist circumference, total energy, total fat, and saturated fatty acids intakes, and negatively associated with sex (female is higher), physical activity and total dietary fiber intake in Bai Ku Yao (P<0.05–0.001), whereas positively associated with BMI, waist circumference, total energy, total fat, and saturated fatty acids intakes, and negatively associated with physical activity and total dietary fiber intake in Han (P<0.05–0.001).
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

7. Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged and Elderly in the Guangxi Bai Ku Yao and Han Populations
Conclusions
The prevalence of hyperlipidemia was significantly lower in Bai Ku Yao than in Han, which might mainly attribute to the more favorable dietary patterns, lifestyle choices, and physical activity levels in the former ethnic group.
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

8. and Elderly in the Guangxi Bai Ku Yao and Han Populations
Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged
and Elderly in the Guangxi Bai Ku Yao and Han Populations
Demographic, dietary and lifestyle characteristics between Bai Ku Yao and Han
Characteristics
Bai Ku Yao
(N = 485)
Han Chinese
(N = 501)
Age (years)
54.24±10.87
54.55±10.94
Male/female
265/220
261/240
Education level (years)
3.13±2.33
4.56±2.68***
Physical activity (h/week)
47.36±13.22
45.13±12.58**
Height (cm)
151.72±7.17
154.02±8.08***
Weight (kg)
51.18±7.41
53.94±9.30***
Body mass index (kg/m2)
22.19±2.49
22.66±2.89**
>24 kg/m2 [n(%)]
102 (21.03)
132 (26.35)*
Waist circumference (cm)
71.47±7.15
74.38±8.23***
Systolic blood pressure (mmHg)
123.21±18.24
127.25±17.9***
Diastolic blood pressure (mmHg)
77.04±10.12
79.19±11.14**
Pulse pressure (mmHg)
46.17±13.74
48.06±12.63*
Hypertensive prevalence [n(%)]
106 (21.86)
145 (28.94)*
Alcohol consumption [n(%)]
236 (48.66)
242 (48.30)
<25 g/day
143(60.59)
136(56.20)
25–49 g/day
28(11.86)
50(20.66)
***P<0.001, **P<0.01 and *P<0.05 in comparison with the same subgroup of Bai Ku Yao
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

9. Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged and Elderly in the Guangxi Bai Ku Yao and Han Populations Demographic, dietary and lifestyle characteristics between Bai Ku Yao and Han (cont’d)
Characteristics
Bai Ku Yao
(N = 485)
Han Chinese
(N = 501)
59–99 g/day
49(20.76)
45(18.60)
≥100 g/day
16(6.78)
11(4.55)
(g/day)
27.70±6.13
29.03±5.37*
Cigarette smoking [n(%)]
147 (30.31)
169 (33.73)
Energy (kcal/day)
±85.36
±89.91***
Fat (% of energy)
10.2±2.3
13.5±3.4***
Carbohydrate (% of energy)
75.7±8.5
68.5±7.8***
Protein (% of energy)
9.6±2.2
12.3±3.1***
Alcohol (% of energy)
4.5±1.8
5.7±2.2***
Carbohydrate (g/day)
395.56±18.76
363.36±16.59***
Protein (g/day)
50.16±3.82
65.24±4.74***
Animal (%)
28.3±2.6
35.5±3.4***
Plant (%)
71.7±4.3
64.5±3.8***
Total fat (g/day)
23.69±3.85
31.83±4.36***
Saturated (g/day)
6.35±2.26
8.78±2.87***
Monounsaturated (g/day)
7.78±2.38
10.37±3.42***
Polyunsaturated (g/day)
9.56±3.24
12.68±4.73***
Dietary cholesterol (mg/day)
181.26±106.45
199.22±110.77**
Total dietary fiber (g/day)
9.76±3.26
8.13±2.18***
Sodium intake (g/day)
6.88±2.16
7.69±2.43***
1 kcal = kJ
***P<0.001, **P<0.01 and *P<0.05 in comparison with the same subgroup of Bai Ku Yao
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

10. and Elderly in the Guangxi Bai Ku Yao and Han Populations
Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged
and Elderly in the Guangxi Bai Ku Yao and Han Populations
Prevalence of unfavorable cardiovascular risk factor levels in the Bai Ku Yao and Han populations and in subgroups [n(%)]
TC = total cholesterol; TG = triglyceride; LDL-C = low-density lipoprotein cholesterol; Apo A1 = apolipoprotein A1; Apo B = apolipoprotein B; HDL-C = high-density lipoprotein cholesterol; Apo A1/B = the ratio of apolipoprotein A1 to apolipoprotein B; BMI = body mass index; WC = waist circumference; *P ***P < 0.001, **P < 0.01 and *P < 0.05 in comparison with men, BMI≤24 (kg/m2), WC (lower), normotensive, no drinking, or nonsmoker of the same ethnic group; a P < 0.001, b P < 0.01 and c P < 0.05 in in comparison with the same subgroup of Bai Ku Yao
Characteristics n
TC>199.92
mg/dl
TG>
150.57
LDL-C>
123.74
Apo A1
<1.0 g/L
Apo B
>1.14 g/L
HDL-C>
69.99
Apo A1/Apo B
>2.50
Bai Ku Yao
485
95(19.59)
67(13.81)
51(10.52)
41(8.45)
178(36.70)
47(9.69)
Men
265
47(17.74)
17(6.42)
52(19.62)
30(11.32)
20(7.55)
77(29.06)
10(3.77)
Women
220
48(21.82)
50(22.73)***
43(19.55)
21(9.55)
101(45.91)***
37(16.82)***
BMI≤24 (kg/m2)
383
64(16.71)
44(11.49)
67(17.49)
43(11.23)
30(7.83)
142(37.08)
39(10.18)
BMI>24 (kg/m2)
102
31(30.39)**
23(22.55)**
28(27.45)*
8(7.84)
11(10.78)
36(35.29)
WC (lower)
357
53(14.85)
40(11.20)
58(16.25)
39(10.92)
24(6.72)
136(38.10)
WC (higher)
128
42(32.81)***
27(21.09)**
37(28.91)**
12(9.38)
17(13.28)*
42(32.81)
8(6.25)
Normotensive
379
70(18.47)
43(11.35)
45(11.87)
30(7.92)
140(36.94)
34(8.97)
Hypertensive
106
25(23.58)
24(22.64)**
6(5.66)
11(10.38)
38(35.85)
13(12.26)
No drinking
249
42(16.87)
16(6.43)
50(20.08)
34(13.65)
20(8.03)
73(29.32)
8(3.21)
Alcohol intake
236
53(22.46)
51(21.61)***
45(19.07)
17(7.20)*
21(8.90)
105(44.49)***
39(16.53)***
Nonsmoker
338
65(19.23)
36(10.65)
35(10.36)
28(8.28)
110(32.54)
26(7.69)
Cigarette smoking
147
30(20.41)
31(21.09)**
16(10.88)
13(8.84)
68(46.26)**
21(14.29)*
Age 40–49
210
42(20.00)
34(16.19)
20(9.52)
16(7.62)
83(39.52)
22(10.48)
50–59
139
30(21.58)
15(10.79)
32(23.02)
17(12.23)
13(9.35)
50(35.97)
12(8.63)
≥60
136
23(16.91)
18(13.24)
21(15.44)
14(10.29)
12(8.82)
45(33.09)
13(9.56)
Χ2 for 3 age subgroups –
0.992
2.101
2.548
0.661
0.358
1.516
0.328
P for 3 age subgroups
0.609
0.350
0.280
0.719
0.836
0.469
0.849
TC, HDL-C and LDL-C: 1 mmol/L=38.67 mg/dl; TG: 1 mmol/L=88.57
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

11. and Elderly in the Guangxi Bai Ku Yao and Han Populations
Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged
and Elderly in the Guangxi Bai Ku Yao and Han Populations
Prevalence of unfavorable cardiovascular risk factor levels in the Bai Ku Yao and Han populations and in subgroups [n(%)] (cont’d)
Characteristics n
TC>199.92
mg/dl
TG>
150.57
LDL-C>
123.74
Apo A1
<1.0 g/L
Apo B
>1.14 g/L
HDL-C>
69.99
Apo A1/Apo B
>2.50
Han Chinese
501
181(36.13)a
85(16.97)
116(23.15)
2(0.40)a
93(18.56)a
311(62.08)a
26(5.19)b
Men
261
92(35.25)a
52(19.92)a
57(21.84)
1(0.38)a
44(16.86)a
152(58.24)a
13(4.98)
Women
240
89(37.08)a
33(13.75)c
59(24.58)
1(0.42)a
49(20.42)a
159(66.25)a
13(5.42)a
BMI≤24 (kg/m2)
369
115(31.17)a
49(13.28)
69(18.70)
1(0.27)a
59(15.99)a
243(65.85)a
23(6.23)
BMI>24 (kg/m2)
132
66(50.00)***b
36(27.27)***
47(35.61)***
1(0.76)c
34(25.76)*a
68(51.52)**a
3(2.27)
WC (lower)
343
98(28.57)a
44(12.83)
61(17.78)
1(0.29)a
52(15.16)a
234(68.22)a
21(6.12)c
WC (higher)
158
83(52.53)***a
41(25.95)***
55(34.81)***
1(0.63)a
41(25.95)**b
77(48.73)***b
5(3.16)
Normotensive
356
120(33.71)a
54(15.17)
77(21.63)
1(0.28)a
59(16.57)a
226(63.48)a
15(4.21)
Hypertensive
145
61(42.07)b
31(21.38)
39(26.90)
1(0.69)c
34(23.45)a
85(58.62)a
11(7.59)
No drinking
259
100(38.61)a
43(16.60)a
75(28.96)c 0a
53(20.46)a
157(60.62)a
14(5.41)
Alcohol intake
242
81(33.47)b
42(17.36)
41(16.94)**
2(0.83)a
40(16.53)c
154(63.64)a
12(4.96)a
Nonsmoker
332
131(39.46)a
51(15.36)
90(27.11)c
1(0.30)a
70(21.08)a
214(64.46)a
13(3.92)
Cigarette smoking
169
50(29.59)*
34(20.12)
26(15.38)**
1(0.59)a
23(13.61)*
97(57.40)a
13(7.69)
Age 40–49
208
79(37.98)a
41(19.71)
51(24.52)
1(0.48)a
38(18.27)b
130(62.50)a
11(5.29)c
50–59
139
52(37.41)b
22(15.83)
40(28.78)
30(21.58)b
87(62.59)a
7(5.04)
≥60
164
50(30.49)b
22(13.41)
25(15.24)
1(0.61)a
94(57.32)a
8(4.88)
Χ 2 for 3 age subgroups –
2.581
2.712
8.514
0.789
2.032
1.274
0.033
P for 3 age subgroups
0.275
0.258
0.014
0.674
0.362
0.529
0.984
TC = total cholesterol; TG = triglyceride; LDL-C = low-density lipoprotein cholesterol; Apo A1 = apolipoprotein A1; Apo B = apolipoprotein B; HDL-C = high-density lipoprotein cholesterol; Apo A1/B = the ratio of apolipoprotein A1 to apolipoprotein B; BMI = body mass index; WC = waist circumference; *P ***P < 0.001, **P < 0.01 and *P < 0.05 in comparison with men, BMI≤24 (kg/m2), WC (lower), normotensive, no drinking, or nonsmoker of the same ethnic group; a P < 0.001, b P < 0.01 and c P < 0.05 in in comparison with the same subgroup of Bai Ku Yao
TC, HDL-C and LDL-C: 1 mmol/L=38.67 mg/dl; TG: 1 mmol/L=88.57
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

12. and Elderly in the Guangxi Bai Ku Yao and Han Populations
Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged
and Elderly in the Guangxi Bai Ku Yao and Han Populations
Correlation of hyperlipidemia with demographic, dietary and lifestyle factors between Bai Ku Yao and Han
Populations
Risk factors
Regression
coefficient
Standard
error
Wald P OR
95%CI
Han plus Bai
Ethnic group
0.589
0.138
18.120
0.000
1.802
1.374–2.363
Sex
0.329
0.183
3.240
0.072
1.389
0.971–1.987
Age
–0.095
0.069
1.909
0.167
0.910
0.795–1.040
Education level
–0.121
0.054
0.005
0.988
1.016
0.913–1.417
Physical activity
–0.211
0.068
8.421
1.229
1.032–2.447
Cigarette smoking
–0.008
0.070
0.014
0.907
0.992
0.864–1.138
Alcohol consumption
0.021
0.071
0.090
0.764
1.022
0.889–1.174
Body mass index
0.685
0.159
18.560
1.984
1.453–2.710
Waist circumference
0.555
0.224
5.576
0.017
1.742
1.314–2.159
Hypertension
0.375
0.160
5.477
0.019
1.455
1.063–1.991
Total energy
0.489
0.188
7.174
0.008
1.635
1.266–2.396
Total fat
0.331
0.155
5.113
0.028
1.412
1.118–1.643
Saturated fatty acids
0.591
10.777
0.002
1.809
1.322–2.614
Dietary cholesterol
0.142
0.152
1.324
0.338
0.876
0.916–1.435
Total dietary fiber
–0.298
0.122
5.886
0.023
0.978
1.058–2.379
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

13. and Elderly in the Guangxi Bai Ku Yao and Han Populations
Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged
and Elderly in the Guangxi Bai Ku Yao and Han Populations
Correlation of hyperlipidemia with demographic, dietary and lifestyle factors between Bai Ku Yao and Han (cont’d)
Populations
Risk factors
Regression coefficient
Standard error
Wald P OR
95%CI
Han Chinese
Sex
0.106
0.236
0.202
0.653
1.112
0.700–1.766
Age
–0.101
0.090
1.529
0.262
0.904
0.758–1.078
Education level
–0.039
0.031
0.232
0.652
1.012
0.782–1.133
Physical activity
–0.161
0.088
4.832
1.214
1.015–2.381
Cigarette smoking
–0.041
0.093
0.196
0.658
0.960
0.799–1.152
Alcohol consumption
–0.076
0.096
0.638
0.424
0.926
0.768–1.117
Body mass index
0.719
0.212
11.517
0.001
2.052
1.355–3.107
Waist circumference
0.667
0.221
9.767
0.003
1.978
1.212–2.775
Hypertension
0.378
0.209
3.273
0.070
1.459
0.969–2.198
Total energy
0.615
0.258
7.846
0.006
1.897
1.533–2.454
Total fat
0.535
0.276
5.112
1.772
1.213–2.285
Saturated fatty acids
0.692
0.285
6.112
0.013
2.002
1.317–2.321
Dietary cholesterol
0.126
0.078
1.121
0.542
0.979
0.912–1.124
Total dietary fiber
–0.242
0.073
6.221
0.018
1.245
1.033–2.078
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008

14. and Elderly in the Guangxi Bai Ku Yao and Han Populations
Associations of Diet and Lifestyle with Hyperlipidemia for the Middle-Aged
and Elderly in the Guangxi Bai Ku Yao and Han Populations
Correlation of hyperlipidemia with demographic, dietary and lifestyle factors between Bai Ku Yao and Han (cont’d)
Populations
Risk factors
Regression coefficient
Standard error
Wald P OR
95%CI
Bai Ku Yao
Sex
–0.636
0.289
4.856
0.028
1.890
1.073–3.328
Age
–0.088
0.107
0.677
0.411
0.916
0.743–1.129
Education level
–0.035
0.030
0.114
0.753
1.031
0.774–1.121
Physical activity
–0.296
0.121
6.762
0.013
1.315
1.238–2.269
Cigarette smoking
0.009
0.105
0.007
0.934
1.009
0.820–1.240
Alcohol consumption
0.102
0.106
0.927
0.336
1.018
0.899–1.365
Body mass index
0.635
0.247
6.630
0.010
1.887
1.164–3.058
Waist circumference
0.646
0.172
11.930
0.001
1.995
1.273–3.317
Hypertension
0.407
0.253
2.590
0.108
1.502
0.915–2.464
Total energy
0.521
4.674
0.038
1.696
1.068–2.312
Total fat
0.373
0.142
7.125
1.458
1.326–2.784
Saturated fatty acids
0.528
0.239
4.983
0.024
1.701
1.317–2.574
Dietary cholesterol
0.088
0.045
0.326
0.668
0.875
0.867–1.142
Total dietary fiber
–0.332
0.156
6.453
0.011
1.575
1.231–2.698
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION
Ruixing Y, et al. J Am Diet Assoc. 108 (6), June 2008