Associations of Energy Intake and Type 2 Diabetes with Hypertryglyceridemia in Older Adults Living in the Mediterranean Islands: The Medis Study

Abstract

The aim of the present work was to evaluate the associations of bio-clinical, dietary, and other lifestyle characteristics with the prevalence of hypertriglyceridemia among older individuals living in the Mediterranean islands. Information was collected for an extensive array of demographic, bio-clinical, and dietary characteristics, including serum lipids, body weight and height, and food group and nutrient information derived from a food frequency questionnaire. Serum lipid analyses showed that 37% and 35% of males and females, respectively, had elevated triglyceride (TG) levels. After adjustment for a variety of potential confounders, including age, gender, hypertension, physical activity, smoking, and energy consumption, individuals with type 2 diabetes (T2D) had a 112% higher likelihood of hypertriglyceridemia (95% CI 1.28–3.51). When reported energy intake was quantified in tertiles of consumption, those in the highest tertile (i.e., intakes > 1300 kcal) had a 156% higher (p < 0.01) likelihood of having hypertriglyceridemia compared to the lowest tertile (i.e., <1000 kcal). Analysis by gender showed that energy intake did not predict hypertriglyceridemia in females (p = 0.31) or in those who were normal weight (p = 0.16) or overweight (p = 0.96). However, in males (odds ratio per 1 kcal = 1.001, 95% CI 1.000–1.002) and obese participants (odds ratio per 1 kcal = 1.001, 95% CI 1.000–1.002), excess energy consumption was associated with elevated TG. In conclusion, we found that a considerable proportion of the older adults living in the Mediterranean islands and participating in this study had elevated TG levels. Furthermore, the energy intake and a finding of T2D were positively associated with occurrence of hypertriglyceridemia.

KEYWORDS:

• diet
• energy
• hypertriglyceridemia
• nutrients
• older adults
• triglycerides

Acknowledgments

The Study is funded by Research grants from the Hellenic Heart Foundation, and therefore we would also like to thank Prof. Pavlos Toutouzas, Director of the Foundation.

Notes

*CHO = carbohydrate.

The principal investigators of MEDIS study (D. Panagiotakos, C. Lionis, and E Polychronopoulos) are, particularly, grateful to the men and women from the islands of Cyprus, Mitilini, Samothraki, Crete, Corfu, Lemnos, Zakynthos and Cephalonia, who participated in and collaborated on this research. They also wish to express their gratitude to: M. Tornaritis, A. Polystipioti, N. Papairakleous, M. Economou, (field investigators from Cyprus), A. Zeimbekis, K. Gelastopoulou, I. Vlachou (field investigator from Mitilini), I. Tsiligianni, M. Antonopoulou, N. Tsakountakis, K. Makri (field investigators from Crete), E. Niforatou, V. Alpentzou, M. Voutsadaki, M. Galiatsatos (field investigators from Cephalonia), K. Voutsa, E. Lioliou, M. Miheli (field investigator from Corfu), A. Katsarou, G. Pounis, S. Tyrovolas, E. Papavenetiou, E. Apostolidou, G. Papavassiliou, P. Stravopodis (field investigators from Zakynthos), for their substantial assistance in the enrolment of the participants.