Association of Dietary Fiber Intake and Waist-to-Hip Ratio with Total Cholesterol Levels among Adult Outpatients at Johan Pahlawan Public Health Center, West Aceh
Abstract
Background: High total cholesterol is a major risk factor for cardiovascular disease and is influenced by diet and body fat distribution. Low dietary fiber intake and abdominal fat accumulation, assessed by the waist-to-hip ratio (WHR), may raise cholesterol levels, but evidence among middle-aged primary-care patients in West Aceh is limited. Objective: This study aimed to analyze the associations of dietary fiber intake and WHR with total cholesterol levels among adult outpatients at the Johan Pahlawan Public Health Center, West Aceh Regency. Methods: An analytical observational study with a cross-sectional design was conducted in May 2026 on 102 patients aged 40–60 years selected by consecutive sampling. Fiber intake was assessed with a semi-quantitative food frequency questionnaire (SQ-FFQ) and analyzed with Nutrisurvey; waist and hip circumferences were measured with a measuring tape; and total cholesterol was measured in capillary blood with an Easy Touch GCU meter. Data were analyzed with the Chi-square test (α = 0.05), and odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Abnormal total cholesterol (>200 mg/dL) was found in 57 respondents (55.9%); 50 (49.0%) had inadequate fiber intake (<25 g/day) and 52 (51.0%) had an at-risk WHR. Abnormal cholesterol was more frequent among respondents with inadequate than adequate fiber intake (68.0% vs. 44.2%; p = 0.027; OR = 2.68; 95% CI: 1.20–6.01) and among those with an at-risk than a not-at-risk WHR (75.0% vs. 36.0%; p < 0.001; OR = 5.33; 95% CI: 2.27–12.52). Conclusion: Dietary fiber intake and WHR are both significantly associated with total cholesterol levels in middle-aged adult outpatients. Increasing the consumption of fiber-rich foods and controlling central obesity should be promoted in primary care to prevent and manage hypercholesterolemia.
Keywords: dietary fiber intake; hypercholesterolemia; total cholesterol; waist-to-hip ratio; middle-aged adults
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DOI: https://doi.org/10.35308/j-kesmas.v1i2.16763
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