High blood cholesterol is typically considered a feature of wealthy western countries ^1,2 . However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world ³ and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health ^4,5 . However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.

Although dietary patterns have been linked to chronic diseases such as cardiovascular disease, sparse data are available for a relationship between dietary patterns and incident chronic kidney disease (CKD) in West Asian populations. The aim of this study was to evaluate the association of population-based dietary pattern with the risk of incident CKD after 6.1 years of follow-up. At baseline, habitual dietary intakes of 1630 participants of the Tehran Lipid and Glucose Study (TLGS) who were free of CKD was assessed by a valid and reliable food-frequency questionnaire. The following three major dietary patterns were identified using a principal components analysis: Lacto-vegetarian dietary pattern, traditional Iranian dietary pattern, and high fat, high sugar dietary pattern. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease (MDRD) Study equation and CKD was defined as eGFR < 60 mL/min/1.73m2. Odds ratio (OR) using multivariable logistic regression was calculated for the association of incident CKD with the extracted dietary patterns. After adjusting for age, sex, smoking, total energy intake, physical activity, body mass index, diabetes, and hypertension the OR for participants in the highest compared with those in the lowest tertile of the lacto-vegetarian dietary pattern was 0.57 (95% confidence interval [CI]: 0.41 to 0.80, P-trend = 0.002). In contrast, the high fat, high sugar dietary pattern was positively associated with the incidence of CKD (OR for the third tertile compared with first tertile: 1.46; 95% CI: 1.03–2.09; P-trend = 0.036). Traditional Iranian dietary pattern was not associated with incident CKD. The high fat, high sugar dietary pattern was associated with significantly increased (46%) odds of incident CKD, whereas a lacto-vegetarian dietary pattern may be protective against the occurrence of CKD by 43%.

The aim of this study was to investigate the associations between micronutrient intakes and the 3.6-year incidence of chronic kidney disease (CKD) in adults. This cohort study was conducted, within the framework of the Tehran Lipid and Glucose Study, on 1692 subjects, aged ≥30 years, without CKD at the baseline. Dietary intakes were collected using a valid and reliable food-frequency questionnaire. Anthropometrics and biochemical measurements were taken. Chronic kidney disease was defined as eGFR < 60 mL/min/1.73 m². The mean age of participants was 43.3 ± 11.4 years. In the fully adjusted model, individuals in the top quintile of folate (OR: 0.44, 95% CI: 0.24–0.80), cobalamin (OR: 0.57, 95% CI: 0.34–0.93), vitamin C (OR: 0.38, 95% CI: 0.21–0.69), vitamin E (OR: 0.45, 95% CI: 0.22–0.92), vitamin D (OR: 0.39, 95% CI: 0.21–0.70), potassium (OR: 0.47, 95% CI: 0.23–0.97) and magnesium (OR: 0.41, 95% CI: 0.22–0.76) had decreased risk of CKD, and in the top quintile of sodium (OR: 1.64, 95% CI: 1.03–2.61), subjects had increased risk of CKD, in comparison to the bottom quintile. No significant associations were found between the intakes of other micronutrients. High intake of several micronutrients including vitamins C, E, D, cobalamin, folate, magnesium, and potassium was associated with a decreased risk, while sodium was associated with an increased risk of incident CKD.

The purpose of this study was primarily to evaluate the association of total fibre intake with the risk of incident chronic kidney disease (CKD). We also evaluated the association of dietary fibre from fruits, vegetables, cereals and legumes with the incidence of CKD in a population-based prospective study. We followed up 1630 participants of the Tehran Lipid and Glucose Study for 6·1 years, who were initially free of CKD. Baseline diet was assessed by a valid and reliable FFQ. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease Study equation, and CKD was defined as eGFR <60 ml/min per 1·73 m². OR using multivariable logistic regression was reported for the association of incident CKD with tertiles of dietary fibre intake. After adjustment for age, sex, smoking, total energy intake, physical activity, diabetes and using angiotensin-converting-enzyme inhibitor, the OR for subjects in the highest compared with the lowest tertile of total fibre intake was 0·47 (95 % CI 0·27, 0·86). In addition, for every 5 g/d increase in total fibre intake, the risk of incident CKD decreased by 11 %. After adjusting for potential confounders, OR for participants in the highest compared with the lowest tertile of fibre from vegetables was 0·63 (95 % CI 0·43, 0·93) and from legumes it was 0·68 (95 % CI 0·47, 0·98). We observed inverse associations between total fibre intake and risk of incident CKD, which demonstrate that high fibre intake, mainly from legumes and vegetables, may reduce the occurrence of CKD.

The current study aimed to investigate the association between dietary amino acid patterns and incidence of hypertension, using principal components factor analyses. This study was conducted within the framework of Tehran Lipid and Glucose Study on 4288 adults, who were free of hypertension at baseline (2008–2011) and were followed for three years (2011–2014). Principal component factor analyses were conducted based on eight amino acid groups and three amino acid patterns were extracted. The first pattern was characterized by branched chain, aromatic, and alcoholic amino acids, and proline. Acidic amino acids and proline were highly loaded in the second pattern and the third was characterized by sulphuric and small amino acids. Adjusted odds ratio of the highest quartile of the first pattern was 1.83 (95%CI: 1.21–2.77, P for trend = 0.002) compared to the lowest one. The first pattern had high positive correlation with dietary intakes of animal protein and dairy, but was negatively correlated with plant protein, fruit, and vegetable. There was no significant association for the second and third patterns. Findings indicate that the dietary amino acid pattern, rich in branched chain, aromatic, and alcoholic amino acids, and proline could increase the risk of hypertension.