An analysis of the associations between dietary and non-dietary variables and serum total cholesterol (Total-C) and high density lipoprotein cholesterol (HDL-C) was performed using data from the Scottish Heart Health Study-a cross-sectional survey of men (n = 5123) and women (n = 5236), aged 40-59. Subjects completed a questionnaire which provided health, socio-demographic and food frequency data. Nutrient intakes were calculated from UK food composition tables using standard portion sizes. For men, the significant independent dietary predictors of Total-C, after adjustment for all the other dietary variables, were saturated fat and cereal fibre, and after adjustment for the non-dietary variables, were cereal fibre, saturated fat and cholesterol. For women, intake of vegetable fibre, white fish and βcarotene were significant independent predictors of Total-C after adjustment for all the other dietary variables. Only βcarotene remained significant after adjustment for all the non-dietary variables. Alcohol intake and body mass index were respectively the strongest positive and negative predictors of HDL-C for both sexes. In conclusion: (1) certain dietary factors may affect serum cholesterol levels differently for men and women; (2) a possible role for the antioxidant vitamins and fibre in the prediction of serum cholesterol, may be indicated, in addition to the 'classical' role of dietary cholesterol and saturated fat and (3) confounding between the social and dietary variables does occur, and confirms the need for multiple adjustments in studies of this nature.
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