title: Lifestyle change and high-density lipoprotein change: the US Department of Veterans Affairs Normative Aging Study.
abstract: BACKGROUND
  We sought to determine whether lifestyle modifications are associated with high-density lipoprotein cholesterol (HDL-C) change in a cohort with long-term follow-up.
  
  
  OBJECTIVE
  Changes in alcohol consumption, smoking, or body mass index (BMI) are associated with within-individual changes in HDL-C.
  
  
  METHODS
  We selected 1420 men with ≥2 HDL-C measurements from the US Department of Veterans Affairs Normative Aging Study (NAS). Changes in HDL-C (in milligrams/deciliter) over a 3-year period were calculated for each pair of exams. For each interval of HDL-C change, lifestyle exposures were categorized: participants maintained a stable BMI >25 kg/m(2) (reference) or ≤25 kg/m(2) since the previous exam, or increased or decreased BMI; participants were actively smoking at both exams (reference), nonsmokers at both exams, quit, or initiated smoking between exams; and participants maintained alcohol intake of <2 (reference) or ≥2 drinks daily since the previous exam, or increased or decreased alcohol intake. Longitudinal analysis was used to examine the relationship between the lifestyle change categories and 3-year change in HDL-C for each interval, adjusting for comorbidities, lipids, and cholesterol medication.
  
  
  RESULTS
  Participants were followed for approximately 14.3 years. Increases in HDL-C were associated with maintaining alcohol intake of ≥2 drinks daily (mean HDL-C increase, 0.86; P = 0.02), increasing alcohol intake from <2 to ≥2 drinks daily (mean, 2.53; P = 0.0003), and with maintaining a BMI of ≤25 kg/m(2) (mean, 0.71; P = 0.04).
  
  
  CONCLUSIONS
  Increases in alcohol consumption, maintaining moderate alcohol intake, and maintaining BMI ≤25 kg/m(2) were associated with significant 3-year increases in HDL-C.
authors.affiliation: Massachusetts Veterans Epidemiology and Research Information Center, Boston VA Healthcare System, USA. crahilly-tierney@partners.org
authors.forename: Catherine
authors.initials: C
authors.lastname: Rahilly-Tierney
authors.forename: Pantel
authors.initials: P
authors.lastname: Vokonas
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.forename: Avron
authors.initials: A
authors.lastname: Spiro
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D000428:Alcohol Drinking / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL