Nutrient intake comparisons between Framingham and rural and Urban Puriscal, Costa Rica. Associations with lipoproteins, apolipoproteins, and low density lipoprotein particle size.

Abstract

To assess cross-cultural relations between dietary intake and plasma lipoproteins, we randomly selected 222 men and 243 women from the urban and rural areas of Puriscal, Costa Rica; related their dietary composition (assessed by a food-frequency questionnaire), fitness level, and body fat to plasma lipids, apolipoproteins, and low density lipoprotein (LDL) particle size; and compared these data with those from a subsample of 280 adults from the Framingham Offspring Study. Total cholesterol and LDL cholesterol levels were significantly (p<0.0001) higher in Framingham (207 and 137 mg/dl, respectively) than in Puriscal (184 and 114 mg/dl, respectively) residents. Elevated triglyceride and apolipoprotein (apo) B levels (25% and 16% higher), low HDL cholesterol and apo A-I levels (12% and 29% lower), and smaller LDL particles (17%) were more frequent in Puriscal than in Framingham residents. Urban Puriscal residents had a significantly lower fitness level; increased body fat, total cholesterol, and triglyceride levels; decreased HDL cholesterol in men; and higher apo B levels in women compared with rural Puriscal residents. Body fat, animal fat, and saturated fat intakes were significantly correlated with total cholesterol, LDL cholesterol, and apo B levels in both men and women in Puriscal. Intakes of protein and animal fat were higher among urban (10.7% and 14.1%, respectively) compared with rural (8.9% and 9.9%, respectively) Puriscal residents and in Framingham (16.0% and 20.8%, respectively) compared with Puriscal residents. No significant differences were found in dietary cholesterol. Saturated fat (largely from palm oil in Puriscal) intakes were significantly different among the three groups: rural Puriscal, 10.7% of calories; urban Puriscal, 11.6%; and Framingham residents, 12.9%. These data indicate that the more atherogenic plasma lipid profile among urban compared with Puriscal residents was largely explained by increased adiposity, decreased fitness level, and higher saturated fatty acid intake. Puriscal residents consumed less animal fat and more carbohydrate than did Framingham residents, and these differences were associated with a 21% lower LDL cholesterol level, a 12% lower HDL cholesterol level, a 29% lower apo A-I level, a 25% higher triglyceride level, a 16% higher apo B level, and a 17% smaller LDL particle size. Some of these cross-cultural differences may be due to differences in ethnic background and physical activity as well. (Arteriosclerosis and Thrombosis 1991;ll:1089-1099)

Metabolic origins and clinical significance of LDL heterogeneity

“…In addition to age and gender, effects on LDL particle size and density distribution have been shown for abdominal adiposity (149), estrogen (150), and oral contraceptive use (151). Dietary intervention studies have shown that variation in dietary fat and carbohydrate can strongly influence expression of the small LDL phenotype (152,153), and contribute to variations in LDL particle size distribution that are observed among individuals and population groups (154). It has been demonstrated in offspring genetically predisposed to phenotype B that a very low fat, high carbohydrate diet can induce expression of this phenotype (155,156).…”

Dietary patterns and risk of nonfatal acute myocardial infarction in Costa Rican adults

“…All frequencies were converted to number of times per day. The questionnaire, administered by trained interviewers in the subjects' home, included specific items from the Costa Rican diet (Campos et al, 1991), such as rice, beans, plantains, corn tortillas, white bread, salads, chopped vegetables, meat, eggs, cheese, and sugar-sweetened tropical fruit beverages. Subjects selected only one type of fat that was used most frequently for cooking at home.…”

Comparison of dietary intakes of micro- and macronutrients in rural, suburban and urban populations in Costa Rica

“…The performance of the FFQ in Costa Rica has been further validated and found satisfactory 14 . The United States Department of Agriculture food composition tables were used at the Channing Laboratory to estimate total energy and nutrient intakes for each subject as described previously 12,13 . The subjects were asked to select only one type of fat or oil that is most frequently used for home cooking or frying.…”