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Background and aims Dairy products are a very diverse food group with multiple effects on the cardiac health of men and women. The aim of this work was to evaluate the sex-specific association between dairy products (total and subtypes) and 10-year first fatal/nonfatal cardiovascular disease (CVD) incidence. Methods and results In 2001–2002, n = 1514 men and n = 1528 women (>18 years old) from greater Athens area, Greece, were enrolled. Dietary assessment was based on a validated semi-quantitative food frequency questionnaire. Dairy product consumption was examined in relation to 10-year CVD incidence. Follow-up (2011–2012) was achieved in n = 2020 participants (n = 317 CVD cases). Ranking from lowest ( 2 servings/day) total dairy intake, CVD incidence in men was 17.8%, 15.0%, and 10.9% (p = 0.41), while in women it was 14%, 6.0%, and 5.7% (p = 0.02). Multiadjusted analysis revealed that total dairy intake protected against CVD only in women [Hazard Ratio (HR) = 0.48 and 95% Confidence Interval (95% CI) (0.23, 0.90)], irrespective of the fat content. Further analysis revealed that only fermented products (yogurt and cheese), protected against CVD. For per 200 g/day yogurt consumption, CVD risk was 20%–30% lower with this claim being more evident in women, while for per 30 g/day cheese intake, about 5% lower risk was observed particularly in men. As for butter, nonsignificant associations were highlighted. These associations were mainly retained in the case of hepatic steatosis, insulin resistance, and systemic inflammation. Conclusions This work provides incentives for researchers to elucidate the diversity of ingredients and mechanisms through which dairy products exert their effect on cardiac health separately for men and women.

Objective To evaluate the effectiveness of two lifestyle, interventional approaches on metabolic abnormalities and eating habits of patients with metabolic syndrome. Materials/Methods This is a randomized controlled trial, involving a 6-month lifestyle intervention. Eighty-eight metabolic syndrome patients were randomized to one of the three groups: (i) “Increase - Decrease” group, (ii) “Increase” group, and (iii) “Minimum intervention” group. All patients received dietary and physical activity advice at baseline; patients in the first two groups also participated in individual counseling sessions. In the “Increase - Decrease” group, all recommended dietary and physical activity goals were targeted, whereas in the “Increase” group, only goals proposing an increase in dietary intake or physical activity were included. Patients received nutrition counseling through seven, one-to-one sessions, conducted every two weeks for the first 2 months, every month for the following 4 months. All participants underwent a full medical and nutritional assessment at baseline and at the end of the intervention. Results At 6 months, BMI and waist circumference were improved in the “Increase” and the “Increase - Decrease” groups, compared to the “Minimum Intervention” group. Additionally, “Increase - Decrease” group reduced blood systolic (p = 0.017), diastolic pressure (p = 0.005) and glucose concentrations (p = 0.015). Forty eight percent, 32%, and 19% of the patients in the “Increase - Decrease”, “Increase” and “Minimum Intervention” groups, respectively, ceased to fulfill the criteria for the metabolic syndrome (p = 0.031). Conclusions Promoting only the increase of the intake of healthy foods did not result in better outcome values compared to a conventional all-food approach.

BACKGROUND: Patients with the metabolic syndrome (MetS) can suffer from poor metabolic parameters through lack of adherence to requisite lifestyle changes in dietary and physical activity. Usually, interventions in MetS patients are infrequent face-to-face consultations. The low frequency or absence of counseling interviews leads to a shortage of information and motivation to adhere to the recommended lifestyle changes. Telephone interventions could be an additional low-cost tool for effective interventions. AIM: To evaluate the effectiveness of telephone intervention in improving lifestyle habits and metabolic parameters in MetS patients compared with similar face-to-face or a usual care interventions. METHODS: Eighty-seven MetS patients recruited from the outpatient clinic of a major public hospital were randomly assigned to one of the three intervention groups: “usual care”, “telephone” or “face-to-face”. At the beginning of the study, all patients were provided with a hypocaloric Mediterranean-type diet. Afterwards, patients in the telephone group received 7 dietary counseling calls, patients in the face-to-face group participated in 7 one-to-one dietary counseling sessions, while patients in the usual care group received no other contact until the end of the study, 6 months later. All patients underwent full medical and nutritional evaluation at the beginning and at the end of the intervention. RESULTS: At the end of the intervention, 42% of the participants no longer showed symptoms of MetS; the reduction rates differed significantly between the groups (p = 0.024), with those in the face-to-face and telephone group exhibiting similar rates (52% and 54%, respectively, vs. 21% in the usual care group). Between-group analysis revealed that the face-to-face group achieved the greatest improvement in metabolic parameters, while the telephone group had the greatest improvement in dietary adherence compared with the usual care group. CONCLUSIONS: Telephone counseling is an effective way to implement behavioral counseling to improve lifestyle habits in MetS patients.

Demosthenes B Panagiotakos1, Christos Pitsavos2, Yannis Skoumas2, Yannis Lentzas2, Christodoulos Stefanadis21Department of Nutrition Science-Dietetics, Harokopio University, Athens, Greece; 2First Cardiology Clinic, School of Medicine, University of Athens, Athens, GreeceObjective: We evaluated the 5-year incidence of diabetes in an adult population from Greece.Research design and methods: 3042 individuals (>18 years), free of cardiovascular disease, participated in the baseline examination (during 2001–2002). Of this sample, 1012 men and 1035 women were found alive at the time of follow-up, while 32 (2.1%) men and 22 (1.4%) women died during this period. The rest were lost to follow-up. Incidence of type 2 diabetes mellitus was evaluated in 1806 participants who did not have diabetes at baseline.Results: The age-adjusted 5-year incidence of diabetes was 5.5% (men, 5.8%; women, 5.2%). A linear trend was observed between diabetes incidence and age (5.6% increases in incidence per 1-year difference in age, p

We sought to evaluate factors that are associated with physical activity changes among adults within a 5-year period.From May 2001 to December 2002 we randomly enrolled 1514 men and 1528 women without any evidence of cardiovascular or any other chronic disease. The sampling was stratified by the age-gender distribution of the greater area of Athens. Weekly energy expenditure assessed by considering frequency, duration, and intensity of sports-related physical activity. During 2006, the 5-year follow-up was performed in 1955 participants, which included, among others, current physical activity status.A total of 587 (61%) men and 673 (68%) women were classified as physically inactive at baseline, whereas 661 (69%) men and 728 (73%) women were classified as physically inactive at follow-up; thus, a 13% increase in physical inactivity rate was observed in men and a 7% in women during the follow-up period (p0.01). Multivariate analysis revealed that male gender, being a nonsmoker, healthy eating, better self-reported quality-of-life, and lower prevalence of hypercholesterolemia and incidence of cardiovascular disease were the characteristics of people that remained physically active; advanced age, anxiety and depression, overweight, and low quality-of-life were the baseline predictors of physical inactivity among initially active participants, which also had a greater incidence of cardiovascular disease.Gender, aging, psychological disorders, body mass, smoking, dietary habits, perceived health status, and quality-of-life were the most important discriminating factors of physical activity changes.

AIM: To investigate the relationship between low-grade inflammation and several glycemic indices in a population-based sample of men and women. METHODS: The ATTICA study is a population-based cohort that randomly enrolled 1514 men and 1528 women (aged >18 years old), stratified by age and gender, from the Greater Athens area, during 2001-2002. Among several characteristics, inflammation markers (high sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, homocysteine and amyloid A) and glycemic control indices (fasting blood glucose, insulin, HOMA) were measured in the participants. RESULTS: The prevalence of diabetes was 7.8% in men and 6.0% in women. The prevalence of impaired fasting glucose (IFG) was 21% in men and 12% in women. Diabetic subjects had 57% higher mean levels of C-reactive protein (p < 0.001), 22% higher mean levels of interleukin-6 (p < 0.001) and 60% higher levels of tumor necrosis factor-alpha (p < 0.001) compared to non-diabetic subjects. Homocysteine and serum amyloid A levels did not show significant differences among groups. CONCLUSION: Our study supports a positive association between low-grade inflammation and diabetes in a population-based sample of men and women without any evidence of cardiovascular disease, which is independent of demographic, clinical and lifestyle characteristics, including physical activity and dietary factors.

OBJECTIVES The aim of this work was to investigate the association between fish consumption and levels of various inflammatory markers among adults without any evidence of cardiovascular disease. BACKGROUND Fish consumption has been associated with reduced risk of coronary heart disease, but the mechanisms have not been well understood or appreciated. METHODS The ATTICA study is a cross-sectional survey that enrolled 1,514 men (age 18 to 87 years) and 1,528 women (age 18 to 89 years) from the Attica region, Greece. Of them, 5% of men and 3% of women were excluded due to a history of cardiovascular disease. Among others, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, serum amyloid A (SAA), and white blood cells (WBC) were measured, and dietary habits (including fish consumption) were evaluated using a validated food frequency questionnaire. RESULTS A total of 88% of men and 91% of women reported fish consumption at least once a month. Compared to non-fish consumers, those who consumed >300 g of fish per week had on average 33% lower CRP, 33% lower IL-6, 21% lower TNF-alpha, 28% lower SAA levels, and 4% lower WBC counts (all p < 0.05). Significant results were also observed when lower quantities (150 to 300 g/week) of fish were consumed. All associations remained significant after various adjustments were made. CONCLUSIONS Fish consumption was independently associated with lower inflammatory markers levels, among healthy adults. The strength and consistency of this finding has implications for public health and should be explored further.

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and educational level seems to be an important determinant of the disease occurrence. The aim of this work was to investigate the association between education status and 10-year incidence of CVD, controlling for various socio-demographic lifestyle and clinical factors. From May 2001 to December 2002, 1514 men and 1528 women (18 years) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. Education status was measured in years of schooling. The 10-year incidence of CVD was 15.7% [95% confidence intervals (CI) 14.1%-17.4%], 19.7% in men and 11.7% in women (Pgender0.001). Age-and gender-adjusted analyses revealed that those with low education (9 years of schooling) were 1.52 times more likely (95% CI 1.03-2.23%) to have CVD compared with those with high education (12 years of schooling). People in the low education group had higher prevalence of hypertension, diabetes and dyslipidaemias, were more likely to be smokers and sedentary, had less healthy dietary habits, as compared with those in the high education group. When controlling for participants' medical history, smoking, dietary and lifestyle habits, low education was no longer significantly associated with CVD, illustrating the mediating effect of clinical and behavioural factors in the link between education and disease. It was of interest that low education status interacted with alcohol drinking, enhancing the adverse effect of low education on CVD risk (relative risk 1.44, 95% CI 0.94%-2.20%), after various adjustments made. In this study, it was concluded that low educational level was associated with increased CVD risk. This was mainly explained by the intermediate association of low education with unhealthy choices that consequently worsen clinical status.

The optimal performance of cardiovascular disease (CVD) risk models in various populations (such as the Framingham Heart Sheet or the ESC SCORE) is of major interest in risk prediction modeling nowadays. We evaluated whether the inclusion of socioeconomic status (SES) in the HellenicSCORE would increase the accuracy of prediction, irrespectively of dietary information and the classical CVD risk factors.Data from 1514 men and 1528 women (age18 years), who were free of known CVD on enrolment in 2001-02, were studied (the ATTICA study). Five years later a follow up was performed and the development of CVD was defined (WHO-ICD-10 criteria). As SES indicators, education status and mean annual income were recorded, and a special SES 3-class index was calculated (low, moderate and high). The MedDietScore, which incorporates the inherent characteristics of the Mediterranean diet, was used as a dietary assessment tool, while the HellenicSCORE, which reflects the level of CVD risk factors, was also calculated. Additive logistic regression models were used to test the additive effect of SES and dietary assessment on the predictive ability of the HellenicSCORE.SES assessment did not improve the predictive ability of the estimated risk model compared to the model that included the HellenicSCORE, physical activity status, waist-to-hip ratio, diabetes and family history of CVD. Additionally, SES did not improve the predictive ability of the estimated risk model even when dietary assessment was added to the above model.Socioeconomic status does not improve the predictive ability of a CVD risk model, even when dietary information is also taken into account.

ObjectiveThe aim of the present work was to calculate the current cost of the Mediterranean diet in Greece and to evaluate the role of diet cost in the development of cardiovascular events after a 5-year follow-up.DesignCross-sectional. Cost of diet was measured in €/week based on common Greek dietary choices, while baseline dietary habits were assessed through a semi-quantitative FFQ (Greek-EPIC). The Mediterranean Diet Score (MedDietScore) was applied to assess overall adherence to this pattern using scores of eleven food variables and alcohol, according to the principles of the Mediterranean diet.SettingFive-year follow-up of the ATTICA study, a nutrition and health survey of a representative, free-living sample of the Greek population resident in the province of Attica, where Athens is a major metropolis.SubjectsFrom 2001 to 2002, 1514 men and 1528 women (aged >18 years) without known CVD were enrolled. In 2006, the 5-year follow-up was performed.ResultsThe weekly cost of participants’ diets varied from 5·35 to 83·57 €/week in men (mean 25·45 (sd 6·80) €/week) and from 10·89 to 55·49 €/week in women (mean 25·63 (sd 6·30) €/week). Diet cost was correlated marginally to MedDietScore (r = 0·060, P = 0·05) as well as being associated with history of hypercholesterolaemia (mean (sd), yes v. no: 24·90 (5·73) v. 25·82 (6·95) €/week, P = 0·027), physical activity (mean (sd), yes v. no: 26·42 (6·90) v. 24·82 (6·20) €/week, P < 0·001) and current smoking (mean (sd), yes v. no: 24·99 (6·40) v. 25·98 (6·70) €/week, P = 0·017). No significant association was found between diet cost and 5-year incidence of CVD (hazard ratio = 1·021, 95 % CI 0·965, 1·081). However, adherence to the traditional Mediterranean diet was inversely associated with the development of CVD (relative risk per 1-unit increase in MedDietScore = 0·92, 95 % CI 0·89, 0·94) after adjustment for various potential confounders including diet cost.ConclusionsQuality but not cost of the diet is associated with the development of CVD.

BackgroundThe aims of the present work were to investigate whether dietary habits are associated with socio-economic status (SES), and if they modify the relationship between SES and CVD risk factors, in a sample of men and women free from known CVD.MethodsThis population-based study was carried out in the province of Attica, where Athens is a major metropolis. During 2001–2002, information from 1528 men (18–87 years old) and 1514 women (18–89 years old) was collected (75 % participation rate). Among several sociodemographic, clinical and biological factors, adherence to the Mediterranean diet was assessed by a special diet score (Mediterranean Diet Score, MDS) that incorporated the inherent characteristics of this traditional diet. CVD risk factors were examined across the participants’ educational level and annual income that defined their SES.ResultsLow SES groups exhibited higher prevalence of CVD risk factors, such as obesity, hypertension, diabetes mellitus and hypercholesterolaemia (allP< 0·001). Low SES groups also showed less adherence to the Mediterranean diet than high SES groups (MDS: 23·6 (sd8·1)v. 25·6 (sd5·6),P< 0·001). Higher SES index was associated with lower likelihood of having hypercholesterolaemia (OR = 0·91; 95 % CI 0·83, 1·00) and diabetes (OR = 0·83; 95 % CI 0·72, 0·95), after adjusting for various potential confounders. However, the previously mentioned inverse relationship observed between SES and prevalence of CVD risk factors was mainly explained by the dietary habits of the participants.ConclusionsLow SES groups showed less adherence to the Mediterranean diet compared with high SES groups. This finding may, in part, explain the higher CVD risk factors profile observed among low SES participants.

The aim of this work was to investigate whether clinical characteristics and dietary habits influence the association between education status and 5-year incidence of cardiovascular disease (CVD). From 2001 to 2002, 1,514 men and 1,528 women (>18 year) without known CVD were enrolled. In 2006, the 5-year follow-up was performed (31% participants were lost to follow-up). Development of fatal or non-fatal CVD (coronary heart disease, acute coronary syndromes, stroke, or other CVD) was defined according to WHO-ICD-10 criteria. Education status was measured in years of school, while baseline dietary habits were assessed through a semi-quantitative food-frequency questionnaire (EPIC-Greek). The Mediterranean-Diet-Score was applied to assess overall adherence to this pattern using scores of 11 food-variables and alcohol, according to the principles of the Mediterranean-diet. The 5-year incidence of CVD was 108 (11.0%) cases in men and 62 (6.1%) cases in women (P

Background: Individuals with the metabolic syndrome (MS) are at high risk for coronary heart disease. In this study, we evaluated the levels of inflammatory, lipidaemic and glycaemic control markers in subjects with and without MS, as given by different definitions. Methods: During 2001–2002, we randomly enrolled 1514 men (18–87 years old) and 1528 women (18–89 years old), without any clinical evidence of cardiovascular disease, from the Attica area, Greece. Among several variables, we also measured inflammatory markers, total antioxidant capacity, glucose and insulin levels and various lipids. MS was defined according to either the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) III criteria or the International Diabetes Federation (IDF) Epidemiology Task Force group. In all the analyses, subjects with diabetes were excluded. Results: The prevalence of the MS was 17.9% according to the NCEP definition and 48.9% according to the IDF definition (p

Marital status has been recognized as a significant health-influencing factor, including cardiovascular disease (CVD) risk. The aim of the present paper was to evaluate whether eating habits mediate the relationship between marital status and levels of CVD risk factors among apparently healthy men and women from the ATTICA Study. During 2001-2002, we randomly enrolled 1514 men (18-87 years old) and 1528 women (18-89 years old) from the Attica area, Greece; the sampling was stratified by the age-gender distribution of the region. Participants underwent clinical, anthropometric and psychological assessment. Food consumption was assessed through a semi-quantitative food frequency questionnaire. Participants were classified as never married, married, divorced and widowed. Discriminant analysis revealed that vegetable consumption, followed by red meat, potatoes, poultry, and soft drinks were the factors with the higher discriminating ability among the food groups studied. In particular, dietary patterns of never married participants were characterized by the consumption of potatoes and red meat, those of married participants by nuts, legumes and fish, those of divorced participants by fruits, cereals and soft drinks, whereas those of widowed participants by dairy, vegetables, sweets and poultry. In addition, never married and divorced participants reported eating fast-foods more frequently and drink less alcohol compared to married or widowed participants. After controlling for potential confounders (i.e., age, gender, physical activity, anxiety score and smoking habits), the reported marital status of the participants was associated only with body mass index and total serum cholesterol levels. When the analysis was repeated after taking into account the information on dietary habits by creating four "new" dietary-adjusted marital status groups, no significant association was revealed between marital status and body mass index and blood cholesterol levels. This finding implies that, in our population, eating patterns may explain the observed differences between marital status and selected CVD risk factors.

Background Dietary habits have been associated with the prevalence of the metabolic syndrome. Objective The associations between foods or food patterns and the characteristics of the metabolic syndrome were evaluated. Design Cross-sectional survey. Subjects During 2001 to 2002, 1,514 men (aged 18 to 87 years) and 1,528 women (aged 18 to 89 years) without any clinical evidence of cardiovascular disease were randomly enrolled, from the Attica region in Greece. Main outcome measures Dietary habits were evaluated using a semiquantitative, food frequency questionnaire. Characteristics of the metabolic syndrome (ie, blood pressure, waist circumference, glucose, triglycerides, and high-density lipoprotein cholesterol) were also measured. Statistical analysis Principal components analysis was applied to extract dietary patterns from 22 foods or food groups. Multivariate regression analysis evaluated the associations between the extracted dietary patterns and characteristics of the metabolic syndrome. Results Six components were derived explaining 56% of the total variation in intake. Component 1 was characterized by the consumption of cereals, fish, legumes, vegetables, and fruits (explained variation 19.7%); component 2 was characterized by the intake of potatoes and meat (explained variation 11.7%), component 6 was characterized by alcohol intake (explained variation 4.8%), whereas the other components were mainly characterized by consumption of dairy and sweets. After adjusting for various confounders, component 1 was inversely associated with waist circumference, systolic blood pressure, triglycerides, positively associated with high-density lipoprotein cholesterol levels, and inversely with the likelihood of the metabolic syndrome (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.79 to 0.97), whereas components 2 and 6 were positively correlated with the previous indexes, and the likelihood of having the metabolic syndrome (OR 1.13, 95% CI 1.05 to 1.21 and OR 1.26, 95% CI 1.21 to 1.33). Conclusions A dietary pattern that includes cereals, fish, legumes, vegetables, and fruits was independently associated with reduced levels of clinical and biological markers linked to the metabolic syndrome, whereas meat and alcohol intake showed the opposite results.

The aim of this work was to investigate the association between fish consumption and levels of various inflammatory markers among adults without any evidence of cardiovascular disease.Fish consumption has been associated with reduced risk of coronary heart disease, but the mechanisms have not been well understood or appreciated.The ATTICA study is a cross-sectional survey that enrolled 1,514 men (age 18 to 87 years) and 1,528 women (age 18 to 89 years) from the Attica region, Greece. Of them, 5% of men and 3% of women were excluded due to a history of cardiovascular disease. Among others, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, serum amyloid A (SAA), and white blood cells (WBC) were measured, and dietary habits (including fish consumption) were evaluated using a validated food frequency questionnaire.A total of 88% of men and 91% of women reported fish consumption at least once a month. Compared to non-fish consumers, those who consumed300 g of fish per week had on average 33% lower CRP, 33% lower IL-6, 21% lower TNF-alpha, 28% lower SAA levels, and 4% lower WBC counts (all p0.05). Significant results were also observed when lower quantities (150 to 300 g/week) of fish were consumed. All associations remained significant after various adjustments were made.Fish consumption was independently associated with lower inflammatory markers levels, among healthy adults. The strength and consistency of this finding has implications for public health and should be explored further.

Results from population-based studies on the effects of food groups on glycemic control seem conflicting (1–10). In this report, we sought to evaluate the association of various food groups with indexes of glycemic control in adults with or without type 2 diabetes without any evidence of cardiovascular disease and randomly selected from the general population. During 2001–2002, we randomly enrolled 1,514 men (18–87 years old) and 1,528 women (18–89 years old) from the Attica region of Greece (of them, 5% of men and 3% of women were excluded because of history of cardiovascular diseases). Diabetes was defined according to the established criteria of the American Diabetes Association (11). Only subjects with type 2 diabetes were included in the analysis due to the small sample size of people with type 1 diabetes. Details about the aims and methods of the ATTICA study have been presented elsewhere (12). ### Anthropometrical, clinical, and biochemical characteristics Standing height and weight were recorded, and BMI was calculated (weight [in kilograms] divided by the square of height [in meters]). Arterial blood pressure and lipids were measured as previously described (11). Blood glucose levels were measured immediately with a Beckman Glucose Analyzer (Beckman Instruments, Fullerton, …

Objective In this work we evaluated the 5-year incidence of hypercholesterolemia, in a sample of cardiovascular disease free adult men and women from Greece. We also evaluated the association of several socio-demographic, dietary and lifestyle habits on the incidence of this disorder. Methods 1514 men and 1528 women (>18 y) without any clinical evidence of cardiovascular disease, living in Attica area, Greece, were enrolled in the ATTICA study from May 2001 to December 2002. The sampling was random, multi-stage, and included information about various socio-demographic, lifestyle (diet, exercise, smoking etc), biological (lipids, and inflammatory markers), and clinical characteristics of the participants. In 2006, a group of experts performed the 5-year follow-up through telephone calls or personal visits (941 of the 3042 (31%) participants were lost to follow-up). Hypercholesterolemia, among people who had normal blood lipids at initial examination, was defined as fasting total cholesterol levels > 200 mg/dl or use of lipids lowering agents (NCEP ATPIII). Results The 5-year incidence of hypercholesterolemia was 23.7% (n = 127) in men and 17.7% (n = 110) in women (p for gender differences < 0.001). Multi-adjusted logistic regression analysis which revealed that increased age (odds ratio = 1.05, p < 0.001), waist circumference (odds ratio = 1.02, p = 0.03), fasting blood glucose (odds ratio = 1.01, p = 0.08) and apolipoprotein B (odds ratio = 1.02, p = 0.001) levels, were the most significant baseline predictors of developing hypercholesterolemia within a 5-year period. Conclusion Incidence of hypercholesterolemia was high in both genders, emphasizing the burden of this disorder at population level. Aging, increased waist circumference, fasting blood glucose and apolipoprotein B levels were the most significant baseline predictors of hypercholesterolemia.