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Samaha et al. Hyperlipidemia in Lebanon

may explain the higher prevalence of these consumption was ≥ 4 servings/week. Therefore, in
dyslipidemias in males versus females. This would the Lebanese population, consuming an average
be supported by our observation that smoking is of one or more eggs per day is likely to negatively
more common among men than women in the study impact lipid profile. It is important to note that egg
participants. This is not surprising since smoking consumption itself is reported to increase intake
is still not socially very acceptable for women in of total fat or cholesterol. [50] Further studies are
some regions of Lebanon, particularly in some rural warranted to determine if this effect is modulated by
areas. Surprisingly, when we adjusted for smoking, other factors, like gender, age, or other dietary and
females were found to be at higher risk of developing lifestyle related factors.
hyperlipidemias. However, it is important to note that
the prevalence of hyperlipidemia is not always higher Previous studies have suggested that consumption of
in smokers versus non-smokers. For instance, the skimmed milk does not modulate serum cholesterol
prevalence of hyperlipidemia among smokers was level. However, another study showed lower levels
[51]
not significantly higher than that in non-smokers in an of serum cholesterol and LDL-C after isocaloric
Asian population. On the contrary, in a Romanian substitution of whole with skimmed milk. In this
[40]
[52]
population, current smokers appear to have a worse report, we found that consumption of whole milk
lipid profile in both men and women. [41] or skimmed milk did not affect the prevalence of
hypercholesterolemia. Nonetheless, consumption of
Contrary to cholesterol’s and TG’s prevalence, LDL-C skimmed milk decreased the prevalence of high TG
was more prevalent in females than males. This may and high LDL-C but whole milk consumption increased
be due to the higher BMI in females [Table 1]. Indeed, this prevalence.
we observed that high levels LDL-C are more prevalent
in individuals with higher BMI (data not shown). This Consumption of a diet rich in fruits and vegetables
is consistent with the well-known notion that high BMI is reported to favorably modulate the lipid
correlates with unfavorable lipid profile. [42,43] profile in humans. Indeed, high fruit intake is
[53]
significantly associated with reduced odds of
Levels of LDL-C and TG increased with age, in both hypertriglyceridemia. This is further supported by
[54]
males and females. However, the sex difference in the a recent study in the Korean population showing
values of LDL-C and TG becomes insignificant in the strong association between fruit intake and reduced
oldest age group (≥ 55 years). This could be explained prevalence of hypertriglyceridemia. Interestingly,
[55]
by the aforementioned presumed effects of estrogen this study reported no association between the
and/or testosterone, since both of these hormones [55]
dramatically decrease with age. Importantly and consumption of vegetables and blood lipid levels.
perhaps not unexpectedly, the vast majority (> 89%) However, several other studies report little or no
of individuals within this age group were sedentary. effects of fruits and vegetable consumption on
[56-58]
We report herein that prevalence of high TG or LDL-C lipid profile. More recently, soya products were
levels is lower in individuals with a physically active shown to favorably modulate lipid levels of TC,
[59]
lifestyle. Taken together, these findings suggest that TG, and LDL-C and HDL-C. These seemingly
the sedentary lifestyle in this age group may account, paradoxical results could be the result of different
[60]
at least in part, for the insignificant differences between study designs as well as the data analysis. It may
both genders. also depend on whether the consumed vegetables
are cooked/boiled or not, as boiling reduces some
[61]
The levels of HDL-C remained relatively constant in all of the bioactive phytochemicals. In this study, we
age groups, regardless of the gender (data not shown). found that the prevalence of hypertriglyceridemia
This is consistent with what is previously reported in and elevated LDL-C was lower in the group with the
other population groups. [23,44] high consumption of fruits and vegetables.

Data on the impact of egg consumption on lipid profile It was strikingly surprising that most of the participants
is inconsistent. Some report a positive association were unaware of their lipid profiles. This is perhaps
between egg consumption and unfavorable lipid profile; owing to the absence of effective patient and public
while others suggest a negative or no association. [45-49] education. This is also in line with other reports
Because of this inconsistency, we investigated indicating that some types of dyslipidemias are both
[62]
whether egg consumption affects the prevalence underdiagnosed and under-treated. It is hoped that
of different hyperlipidemias. The prevalence of this study will increase the awareness of the Lebanese
hypercholesterolemia, hypertriglyceridemia and community with respect to hyperlipidemia and its
elevated LDL-C was higher in the group where egg detrimental consequences. It is recommended that
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