A Cross-Sectional Study on the Dietary Pattern Impact on Cardiovascular Disease Biomarkers in Malaysia

We conducted this cross-sectional population study with a healthy multi-ethnic urban population (n = 577) in Malaysia, combining nutritional assessments with cardiometabolic biomarkers defined by lipid, atherogenic lipoproteins, inflammation and insulin resistance. We found diametrically opposing associations of carbohydrate (246.6 +/- 57.7 g, 54.3 +/- 6.5%-TEI) and fat (total = 64.5 +/- 19.8 g, 31.6 +/- 5.5%-TEI; saturated fat= 14.1 +/- 2.7%-TEI) intakes as regards waist circumference, HDL-C, blood pressure, glucose, insulin and HOMA2-IR as well as the large-LDL and large-HDL lipoprotein particles. Diets were then differentiated into either low fat (LF, <30%TEI or <50 g) or high fat (HF, >35%TEI or >70 g) and low carbohydrate (LC, <210 g) or high carbohydrate (HC, >285 g) which yielded LFLC, LFHC, HFLC and HFHC groupings. Cardiometabolic biomarkers were not significantly different (P> 0.05) between LFLC and HFLC groups. LFLC had significantly higher large-LDL particle concentrations compared to HFHC. HOMA-IR2 was significantly higher with HFHC (1.91 +/- 1.85, P < 0.001) versus other fat-carbohydrate combinations (LFLC =1.34 +/- 1.07, HFLC =1.41 +/- 1.07; LFHC = 1.31 +/- 0.93). After co-variate adjustment, odds of having HOMA2-IR >1.7 in the HFHC group was 2.43 (95% CI: 1.03, 5.72) times more compared to LFLC while odds of having large-LDL <450 nmol/L in the HFHC group was 1.91(95% CI: 1.06, 3.44) more compared to latter group. Our data suggests that a HFHC dietary combination in Malaysian adults is associated with significant impact on lipoprotein particles and insulin resistance.