Association between statin use and serum cholesterol concentrations is modified by whole-grain consumption: NHANES 2003-2006

Am J Clin Nutr. 2014 Oct;100(4):1149-57. doi: 10.3945/ajcn.113.074344. Epub 2014 Aug 13.


Background: Statins are used to lower cardiovascular disease risk in part because of their effects on plasma lipid profiles. Dietary whole grains have been reported to improve plasma lipid profiles. Little is known about potential interactions between statins and whole grains.

Objective: We aimed to assess the interaction between statin use and whole-grain intake in relation to serum lipid concentrations in adults.

Design: In this cross-sectional study, we used data from 4284 adults aged ≥45 y with reliable and complete dietary data who were participating in the NHANES 2003-2006. Usual whole-grain intake was estimated from two 24-h diet recalls by using the MyPyramid Equivalents Database. Participants self-reported statin use. Total cholesterol and HDL-cholesterol concentrations were measured in all adult participants. The non-HDL-cholesterol concentration and total cholesterol:HDL-cholesterol ratio were calculated. Multiple linear and logistic regression models were used for analyses.

Results: Statin usage was 24.9% in all participants (n = 1065), and 31.0% of participants (n = 1327) consumed ≥16 g whole grains/d. After adjustment for demographic and lifestyle factors, the non-HDL-cholesterol concentration was significantly lower in statin users than in nonusers. This difference was greater in participants who consumed ≥16 g whole grains/d (difference: 31 mg/dL; P < 0.001) than in those who consumed <16 g whole grains/d (difference = 20 mg/d; P < 0.001) (P-interaction = 0.03). Significant interactions were also observed between whole-grain intake and statin use in relation to the total cholesterol:HDL-cholesterol ratio (P-interaction = 0.04) and elevated total cholesterol concentration (P-interaction = 0.02).

Conclusion: In adults aged ≥45 y, the use of statins was associated with healthier lipoprotein profiles when combined with higher whole-grain intake relative to low whole-grain intake.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / drug therapy
  • Cholesterol / blood*
  • Cross-Sectional Studies
  • Dietary Fiber / administration & dosage*
  • Edible Grain*
  • Energy Intake
  • Feeding Behavior*
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Nutrition Assessment
  • Nutrition Surveys


  • Dietary Fiber
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol