Importance of a healthy diet in avoiding high blood cholesterol: Findings from the 2005 Behavioral Risk Factor Survey

Background: Having high blood cholesterol (HBC) is a leading risk factor for cardiovascular disease; accordingly, Healthy People 2010 calls for a reduction in the proportion of adults with HBC. This study describes HBC prevalence, as well as factors associated with HBC, among California Behavioral Risk Factor Survey respondents. Particular attention is paid to respondents' eating habits and HBC.

Methods: The 6,098 survey respondents (2005) were classified as having/not having HBC, and, for each respondent, a healthy-diet-index was created using fruit, vegetable, and fruit juice consumption data. Stratified HBC prevalences were calculated, and logistic regression was used to describe factors associated with HBC, including having/not having a healthy diet.

Results: For all respondents, 42.8% (95%CI=41.5%-44.1%) of whom were classified as having a healthy diet, the prevalence of HBC is 25.7% (24.6%-26.8%), with a slight gender difference (male: 26.0%, 24.2%-27.8%; female: 25.3%, 23.9%-26.7%). HBC prevalence is highest among African-American females, 33.1% (25.7%-40.5%) and lowest among Hispanic males, 16.6% (13.4%-19.8%). Several factors are associated with HBC: diabetes (OR=1.94, 95%CI=1.41-2.68); health insurance (1.84, 1.16-2.91); and multiple hypertension diagnoses (1.61, 1.22-2.13). Further, Hispanics (0.52, 0.38-0.71) and smokers (0.69, 0.49-0.96) are less likely to report HBC, as are individuals who exercise (0.69, 0.53-0.90) and individuals with a healthy diet (0.77, 0.60-0.98).

Conclusions: While some co-morbid factors (i.e., diabetes and hypertension) are associated with having HBC, certain positive behavioral factors, including exercising and eating a healthy diet, are protective against HBC. These protective factors should be included among the strategies employed to reduce the burden of HBC.