Lifestyle therapy changes and hypercholesterolemia: Identifying risk groups in a community sample of blacks and whites

Objective: To examine diet and exercise lifestyle therapy change (LTC), behaviors and their relation to hypercholesterolemia in a community sample of Blacks and Whites. Design: Latent class analysis (LCA) was employed to identify homogeneous subgroups of community dwelling Blacks and Whites related to LTC for hypercholesterolemia. LCA is a statistical technique used to identify subgroups of individuals who share a similar pattern of responses to a set of observations. The relation between hypercholesterolemia and latent class membership was assessed. Participants: Adults age 18 and over who participated in a county-level adaptation of the Behavioral Risk Factor Surveillance System. Main Outcome Measure: Hypercholesterolemia (absence or presence). Results: Eleven unique latent classes of LTC behavior emerged from LCA models. Exercisers and Fat Reducers represented between 19% and 29% of each race-sex group. Latent class membership probabilities varied substantially across race and sex. Only Black women had a class of Contemplators (21.5%). Overall, men and Blacks with self reported hypercholesterolemia were more likely to engage only in fat reduction but not increase in vegetable consumption, reduction of fat or regular exercise (odds ratios range from 1.8-3.5). Conclusions: The distribution of diet and exercise related LTC behaviors in relation to self-reported hypercholesterolemia can help to identify, understand and tailor culturally and sex specific interventions based on the proportions of men and women in different latent classes.