Abstract 11339: Association of Statin With Total and Non-HDL Cholesterol is Enhanced in Adult Whole Grain Consumers

Abstract

Background Studies have demonstrated the cholesterol-lowering effects of whole grains, but the potential for a diet rich in whole grains to enhance the effects of statins on lipoprotein profiles has not been investigated.

Methods In this cross-sectional study, we used data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002 to assess the interaction between statins and whole grain intake in relation to cholesterol levels in adults aged>40 years with reliable dietary data. Whole-grain intake was estimated from a 24-hour diet recall using the MyPyramid Equivalents Database, and participants who consumed>16g whole grain ingredients (i.e. 1oz equivalent) were defined as consumers. Participants self-reported their statin use. Total cholesterol (TC) and HDL were measured in serum samples from all adult participants. Non-HDL cholesterol levels were calculated as TC minus HDL. Adults who took cholesterol-lowering drugs other than statins were excluded.

Results Median [range] whole grain intake among the 783 users and 4,738 non-users of statins were 5.0 [0, 232.6] g and 2.4 [0, 197.9] g, respectively. Among non-consumers of whole grains, TC was 15 mg/dL lower in statin users as compared to non-users (P<0.001) after adjustment for demographic and lifestyle factors (Table). The difference in TC associated with statin use was greater, however, among whole grain consumers (difference=25 mg/dL, P_interaction=0.01). Similarly, the difference in non-HDL cholesterol between statin users and non-users was larger in consumers of whole grains (difference=20 mg/dL) as compared to non-consumers (difference=11 mg/dL, P_interaction=0.04). Further adjustment for body mass index did not materially influence the results.

Conclusions Whole grain intake may enhance the effect of statins on TC and non-HDL cholesterol.