Abstract
BACKGROUND: Although cross-sectional studies have identified lifestyle factors associated with high-density lipoprotein cholesterol (HDL-C), no studies have examined the association between changes in lifestyle factors and long-term changes in HDL-C. METHODS: We examined the association between changes in lifestyle factors and changes in HDL-C over a 14-year period in a cohort of 4,168 US male physicians, followed up between 1982 and 1997 and with HDL-C measured at both time points. Using linear regression, we examined the association between HDL-C change and categorized changes in alcohol consumption, physical activity, body mass index (BMI), and smoking, adjusting for age, baseline HDL-C, and other covariates. RESULTS: Stable BMI of <25 kg/m(2) or BMI reduction from ≥25 to <25 kg/m(2) were associated with increases in HDL-C of 3.1 to 4.7 mg/dL over 14 years. Alcohol consumption of ≥1 drink daily or increase in alcohol consumption from <1 to ≥1 drink daily was associated with increases in HDL-C of 2.4 to 3.3 mg/dL over 14 years. Adopting a sedentary lifestyle was associated with decreases in 14-year decreases in HDL-C. CONCLUSION: These findings suggest that reductions in BMI and increases in alcohol consumption are associated with 14-year increases in HDL-C, whereas decreases in physical activity are associated with 14-year decreases in HDL-C.