Dietary and lifestyle characteristics of women of reproductive age in Serbia with known hypercholesterolemia

Introduction: Hypercholesterolemia during reproductive age increases long-term cardiovascular risk and may affect hormonal balance, fertility, and pregnancy outcomes. Despite its importance, it remains frequently underdiagnosed and undertreated in women. Modifiable lifestyle factors, including diet, physical activity, and smoking, influence lipid profiles, making their association with hypercholesterolemia important for prevention strategies. This study aims to assess the prevalence of hypercholesterolemia and its association with dietary and lifestyle characteristics among women of reproductive age in Serbia. Methods: This secondary analysis used data from the cross-sectional Serbian National Health Survey 2019, which included non-institutionalized Serbian residents aged ≥15 years. The Serbian National Health Survey used the European Health Interview Survey (EHIS). Dietary intake was assessed using a Food Frequency Questionnaire (FFQ), and physical activity was assessed using the European Health Interview Survey Physical Activity Questionnaire (EHIS-PAQ). Results: The prevalence of self-reported hypercholesterolemia among women of reproductive age in Serbia was 3.4%. Smokers had approximately twofold higher odds, and obese women had ninefold higher odds of hypercholesterolemia than non-smokers and non-obese women, respectively. Consumption of non-alcoholic beverages and juices was associated with lower odds of hypercholesterolemia. Conclusion: Hypercholesterolemia among women of reproductive age in Serbia is associated with modifiable lifestyle factors, highlighting the need for interventions promoting healthy weight management, smoking cessation, and sustainable lifestyle changes.