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Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults.
Am J Clin Nutr 2012; 95(2):454-64AJ

Abstract

BACKGROUND

Flavonoids are plant-based phytochemicals with cardiovascular protective properties. Few studies have comprehensively examined flavonoid classes in relation to cardiovascular disease mortality.

OBJECTIVE

We examined the association between flavonoid intake and cardiovascular disease (CVD) mortality among participants in a large, prospective US cohort.

DESIGN

In 1999, a total of 38,180 men and 60,289 women in the Cancer Prevention Study II Nutrition Cohort with a mean age of 70 and 69 y, respectively, completed questionnaires on medical history and lifestyle behaviors, including a 152-item food-frequency questionnaire. Cox proportional hazards modeling was used to calculate multivariate-adjusted hazard RRs and 95% CIs for associations between total flavonoids, 7 flavonoid classes, and CVD mortality.

RESULTS

During 7 y of follow-up, 1589 CVD deaths in men and 1182 CVD deaths in women occurred. Men and women with total flavonoid intakes in the top (compared with the bottom) quintile had a lower risk of fatal CVD (RR: 0.82; 95% CI: 0.73, 0.92; P-trend = 0.01). Five flavonoid classes-anthocyanidins, flavan-3-ols, flavones, flavonols, and proanthocyanidins-were individually associated with lower risk of fatal CVD (all P-trend < 0.05). In men, total flavonoid intakes were more strongly associated with stroke mortality (RR: 0.63; 95% CI: 0.44, 0.89; P-trend = 0.04) than with ischemic heart disease (RR: 0.90; 95% CI: 0.72, 1.13). Many associations appeared to be nonlinear, with lower risk at intakes above the referent category.

CONCLUSIONS

Flavonoid consumption was associated with lower risk of death from CVD. Most inverse associations appeared with intermediate intakes, suggesting that even relatively small amounts of flavonoid-rich foods may be beneficial.

Authors+Show Affiliations

Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA. marjimccullough@cancer.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

22218162

Citation

McCullough, Marjorie L., et al. "Flavonoid Intake and Cardiovascular Disease Mortality in a Prospective Cohort of US Adults." The American Journal of Clinical Nutrition, vol. 95, no. 2, 2012, pp. 454-64.
McCullough ML, Peterson JJ, Patel R, et al. Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults. Am J Clin Nutr. 2012;95(2):454-64.
McCullough, M. L., Peterson, J. J., Patel, R., Jacques, P. F., Shah, R., & Dwyer, J. T. (2012). Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults. The American Journal of Clinical Nutrition, 95(2), pp. 454-64. doi:10.3945/ajcn.111.016634.
McCullough ML, et al. Flavonoid Intake and Cardiovascular Disease Mortality in a Prospective Cohort of US Adults. Am J Clin Nutr. 2012;95(2):454-64. PubMed PMID: 22218162.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults. AU - McCullough,Marjorie L, AU - Peterson,Julia J, AU - Patel,Roshni, AU - Jacques,Paul F, AU - Shah,Roma, AU - Dwyer,Johanna T, Y1 - 2012/01/04/ PY - 2012/1/6/entrez PY - 2012/1/6/pubmed PY - 2012/3/7/medline SP - 454 EP - 64 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 95 IS - 2 N2 - BACKGROUND: Flavonoids are plant-based phytochemicals with cardiovascular protective properties. Few studies have comprehensively examined flavonoid classes in relation to cardiovascular disease mortality. OBJECTIVE: We examined the association between flavonoid intake and cardiovascular disease (CVD) mortality among participants in a large, prospective US cohort. DESIGN: In 1999, a total of 38,180 men and 60,289 women in the Cancer Prevention Study II Nutrition Cohort with a mean age of 70 and 69 y, respectively, completed questionnaires on medical history and lifestyle behaviors, including a 152-item food-frequency questionnaire. Cox proportional hazards modeling was used to calculate multivariate-adjusted hazard RRs and 95% CIs for associations between total flavonoids, 7 flavonoid classes, and CVD mortality. RESULTS: During 7 y of follow-up, 1589 CVD deaths in men and 1182 CVD deaths in women occurred. Men and women with total flavonoid intakes in the top (compared with the bottom) quintile had a lower risk of fatal CVD (RR: 0.82; 95% CI: 0.73, 0.92; P-trend = 0.01). Five flavonoid classes-anthocyanidins, flavan-3-ols, flavones, flavonols, and proanthocyanidins-were individually associated with lower risk of fatal CVD (all P-trend < 0.05). In men, total flavonoid intakes were more strongly associated with stroke mortality (RR: 0.63; 95% CI: 0.44, 0.89; P-trend = 0.04) than with ischemic heart disease (RR: 0.90; 95% CI: 0.72, 1.13). Many associations appeared to be nonlinear, with lower risk at intakes above the referent category. CONCLUSIONS: Flavonoid consumption was associated with lower risk of death from CVD. Most inverse associations appeared with intermediate intakes, suggesting that even relatively small amounts of flavonoid-rich foods may be beneficial. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/22218162/Flavonoid_intake_and_cardiovascular_disease_mortality_in_a_prospective_cohort_of_US_adults_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.111.016634 DB - PRIME DP - Unbound Medicine ER -