A Cross-Sectional Study on the Dietary Pattern Impact on Cardiovascular Disease Biomarkers in Malaysia

Abstract

We conducted this cross-sectional population study with a healthy multi-ethnic urban population (n = 577) in Malaysia, combining nutritional assessments with cardiometabolic biomarkers defined by lipid, atherogenic lipoproteins, inflammation and insulin resistance. We found diametrically opposing associations of carbohydrate (246·6 ± 57·7 g, 54·3 ± 6·5%-TEI) and fat (total = 64·5 ± 19·8 g, 31·6 ± 5·5%-TEI; saturated fat = 14·1 ± 2·7%-TEI) intakes as regards waist circumference, HDL-C, blood pressure, glucose, insulin and HOMA2-IR as well as the large-LDL and large-HDL lipoprotein particles. Diets were then differentiated into either low fat (LF, <30% TEI or <50 g) or high fat (HF, >35% TEI or >70 g) and low carbohydrate (LC, <210 g) or high carbohydrate (HC, >285 g) which yielded LFLC, LFHC, HFLC and HFHC groupings. Cardiometabolic biomarkers were not significantly different (P > 0.05) between LFLC and HFLC groups. LFLC had significantly higher large-LDL particle concentrations compared to HFHC. HOMA-IR2 was significantly higher with HFHC (1·91 ± 1·85, P < 0·001) versus other fat-carbohydrate combinations (LFLC = 1·34 ± 1·07, HFLC = 1·41 ± 1·07; LFHC = 1·31 ± 0·93). After co-variate adjustment, odds of having HOMA2-IR >1.7 in the HFHC group was 2.43 (95% CI: 1·03, 5·72) times more compared to LFLC while odds of having large-LDL <450 nmol/L in the HFHC group was 1.91 (95% CI: 1·06, 3·44) more compared to latter group. Our data suggests that a HFHC dietary combination in Malaysian adults is associated with significant impact on lipoprotein particles and insulin resistance.

Benchmarking the transparency, comprehensiveness and specificity of population nutrition commitments of major food companies in Malaysia

“…Almost 70% of Malaysia's population is urbanised [9] with increased market concentration of ultra-processed foods such as sweet and savoury snacks, carbonated drinks, packaged foods, biscuits and confectionery [6]. A recent population study in urban Malaysia highlighted that increased atherogenic and insulinemic risk profiles and obesity were associated with dietary patterns high in calories, fat, and sugars [10].…”

Associations of Eating Mode Defined by Dietary Patterns with Cardiometabolic Risk Factors in the Malaysia Lipid Study Population

“…The population setting was provided by the MLS [ 17 ]. MLS was conducted between November 2012 and November 2013, with the aim of recruiting a typical palm oil consuming adult population living in an urban setting.…”

“…MLS was conducted between November 2012 and November 2013, with the aim of recruiting a typical palm oil consuming adult population living in an urban setting. The methods used for MLS cohort formation and its baseline characteristics relating to macronutrient composition and cardiometabolic risk have been described elsewhere [ 17 ]. Essentially, this study population was multiracial in composition.…”

“…The parameters were body mass index (BMI), waist circumference (WC), lipid profile, plasma glucose and insulin, calculated homeostasis model assessment of insulin resistance (HOMA2-IR), high sensitivity C-reactive protein (hsCRP), systolic (SBP) and diastolic (DBP) blood pressure and lipoprotein particle size. The details of these measurements were reported in the primary paper [ 17 ]. These data allowed the computing of a range of cardiometabolic markers including the criteria for MetS diagnosis [ 22 ].…”

“…For the first time, Malaysian schoolteachers were examined for “Western” and “Prudent” dietary pattern practices, but the study in question did not explore associations with disease risk, nor did ethnic driven food patterns emerge from this analysis [ 16 ]. Recently, our group published findings from the Malaysia Lipid Study (MLS) showing atherogenic and cardiometabolic burden of high carbohydrate-high fat diets [ 17 ] in an urban-living cohort. The primary approach to the MLS data analyses was to report on macronutrient proportions congruent with cardiometabolic health risks but did not identify foods that carried this risk.…”