On the basis of epidemiological data indicating that Americans and Europeans have a higher fat intake and show lower HDL-cholesterol levels than Japanese, we examined the hypothesis that a high fat intake is associated with low HDL-cholesterol levels. To examine the relationship between diet and the serum HDL-cholesterol level, 24-h dietary recall and examination of serum lipids were conducted on middle-aged healthy women in two rural communities. Mean values of cardiovascular risk characteristics and intake of nutrients and foods were compared among three HDL-cholesterol groups, stratified according to menopausal status. In both communities, regardless of menopausal status, mean values of relative body weight index and serum triglyceride were lower, and that of serum total cholesterol was higher in women with higher, than in those with lower HDL-cholesterol levels. Intake of total fat, animal fat, polyunsaturated fatty acids, saturated fatty acids, and percentage energy of total fat were positively associated with HDL-cholesterol levels, whereas percentage energy of carbohydrate was inversely associated. Although there was no significant association between intake of a single food and HDL-cholesterol, there was a weak positive association between meat or vegetable intake and HDL-cholesterol. Thus in contrast to our prior hypothesis, fat intake was found to be positively associated with high HDL-cholesterol levels in middle-aged rural Japanese women.
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