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Li H, Zeng Y, Zi J, Hu Y, Ma G, Wang X, Shan S, Cheng G, Xiong J. Dietary Flavonoids Consumption and Health: An Umbrella Review. Mol Nutr Food Res 2024; 68:e2300727. [PMID: 38813726 DOI: 10.1002/mnfr.202300727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 05/07/2024] [Indexed: 05/31/2024]
Abstract
SCOPE The current evidence between dietary flavonoids consumption and multiple health outcomes is inadequate and inconclusive. To summarize and evaluate the evidence for dietary flavonoids consumption and multiple health outcomes, an umbrella review of meta-analyses and systematic reviews is conducted. METHODS AND RESULTS PubMed, Ovid-EMBASE, and the Cochrane Database of Systematic Reviews are searched up to January 2024. The study includes a total of 32 articles containing 24 unique health outcomes in this umbrella review. Meta-analyses are recalculated by using a random effects model. Separate analyses are performed based on the kind of different flavonoid subclasses. The study finds some unique associations such as flavonol and gastric cancer, isoflavone and uterine fibroids and endometrial cancer, total flavonoids consumption and lung cancer, ovarian cancer, and prostate cancer. Overall, the study confirms the negative associations between dietary flavonoids consumption and type 2 diabetes mellitus, cardiovascular diseases, breast cancer, colorectal cancer, lung cancer, and mortality, while positive associations are observed for prostate cancer and uterine fibroids. CONCLUSION Although dietary flavonoids are significantly associated with many outcomes, firm generalizable conclusions about their beneficial or harmful effects cannot be drawn because of the low certainty of evidence for most of outcomes. More well-designed primary studies are needed.
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Affiliation(s)
- Haoqi Li
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Yaxian Zeng
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Jing Zi
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Yifan Hu
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Guochen Ma
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaoyu Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Shufang Shan
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Guo Cheng
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
- Food Safety Monitoring and Risk Assessment Key Laboratory of Sichuan Province, Chengdu, 610041, China
| | - Jingyuan Xiong
- Healthy Food Evaluation Research Center, Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
- Food Safety Monitoring and Risk Assessment Key Laboratory of Sichuan Province, Chengdu, 610041, China
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Sato T, Yagi A, Yamauchi M, Kumondai M, Sato Y, Kikuchi M, Maekawa M, Yamaguchi H, Abe T, Mano N. The Use of an Antioxidant Enables Accurate Evaluation of the Interaction of Curcumin on Organic Anion-Transporting Polypeptides 4C1 by Preventing Auto-Oxidation. Int J Mol Sci 2024; 25:991. [PMID: 38256064 PMCID: PMC10815578 DOI: 10.3390/ijms25020991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Flavonoids have garnered attention because of their beneficial bioactivities. However, some flavonoids reportedly interact with drugs via transporters and may induce adverse drug reactions. This study investigated the effects of food ingredients on organic anion-transporting polypeptide (OATP) 4C1, which handles uremic toxins and some drugs, to understand the safety profile of food ingredients in renal drug excretion. Twenty-eight food ingredients, including flavonoids, were screened. We used ascorbic acid (AA) to prevent curcumin oxidative degradation in our method. Twelve compounds, including apigenin, daidzein, fisetin, genistein, isorhamnetin, kaempferol, luteolin, morin, quercetin, curcumin, resveratrol, and ellagic acid, altered OATP4C1-mediated transport. Kaempferol and curcumin strongly inhibited OATP4C1, and the Ki values of kaempferol (AA(-)), curcumin (AA(-)), and curcumin (AA(+)) were 25.1, 52.2, and 23.5 µM, respectively. The kinetic analysis revealed that these compounds affected OATP4C1 transport in a competitive manner. Antioxidant supplementation was determined to benefit transporter interaction studies investigating the effects of curcumin because the concentration-dependent curve evidently shifted in the presence of AA. In this study, we elucidated the food-drug interaction via OATP4C1 and indicated the utility of antioxidant usage. Our findings will provide essential information regarding food-drug interactions for both clinical practice and the commercial development of supplements.
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Affiliation(s)
- Toshihiro Sato
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai 980-8574, Japan; (M.K.); (Y.S.); (M.K.); (M.M.); (N.M.)
| | - Ayaka Yagi
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Minami Yamauchi
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Masaki Kumondai
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai 980-8574, Japan; (M.K.); (Y.S.); (M.K.); (M.M.); (N.M.)
| | - Yu Sato
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai 980-8574, Japan; (M.K.); (Y.S.); (M.K.); (M.M.); (N.M.)
| | - Masafumi Kikuchi
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai 980-8574, Japan; (M.K.); (Y.S.); (M.K.); (M.M.); (N.M.)
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Masamitsu Maekawa
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai 980-8574, Japan; (M.K.); (Y.S.); (M.K.); (M.M.); (N.M.)
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Hiroaki Yamaguchi
- Department of Pharmacy, Yamagata University Hospital, Yamagata 990-9585, Japan;
- Graduate School of Medical Science, Yamagata University, Yamagata 990-9585, Japan
| | - Takaaki Abe
- Division of Nephrology, Endocrinology, and Vascular Medicine, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan;
- Division of Medical Science, Graduate School of Biomedical Engineering, Tohoku University, Sendai 980-8579, Japan
- Department of Clinical Biology and Hormonal Regulation, Graduate School of Medicine, Tohoku University, Sendai 980-8575, Japan
| | - Nariyasu Mano
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai 980-8574, Japan; (M.K.); (Y.S.); (M.K.); (M.M.); (N.M.)
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai 980-8578, Japan
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3
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Li T, Zhao Y, Yuan L, Zhang D, Feng Y, Hu H, Hu D, Liu J. Total dietary flavonoid intake and risk of cardiometabolic diseases: A dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr 2022; 64:2760-2772. [PMID: 36148848 DOI: 10.1080/10408398.2022.2126427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Several epidemiological studies have suggested that flavonoid intake is associated with a decreased risk of cardiometabolic disease. However, the results remained inconsistent and there is no dose-response meta-analysis for specific outcomes. We conducted a meta-analysis to synthesize the knowledge about their associations and to explore their dose-response relationships. We comprehensively searched the PubMed, Embase, and Web of Science databases for prospective cohort studies published up to December 1, 2021. Summary relative risks (RR) and 95% confidence intervals (CI) were pooled for the association between flavonoid intake and cardiometabolic disease. Evaluations of linear or nonlinear dose-response were presented by restricted cubic splines. We identified 47 articles, including 1,346 676 participants and 127,507 cases in this meta-analysis. The summary of RR per 500 mg/d increase in flavonoid intake was 0.93 (95% CI 0.88-0.98) for cardiovascular disease, 0.89 (95% CI 0.84-0.94) for diabetes, and 0.97 (95% CI 0.94-0.99) for hypertension, respectively. We also found a linearity dose-response association between total flavonoid intake and cardiovascular disease (p nonlinearity = 0.541), and diabetes (p nonlinearity = 0.077). Our finding based on quantitative data suggested that a higher level of flavonoid intake is beneficial for the prevention of cardiometabolic diseases.
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Affiliation(s)
- Tianze Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Lijun Yuan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongdong Zhang
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Huifang Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jiaye Liu
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, China
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Abstract
Epidemiological studies have shown that higher intake of flavonoid is inversely associated with CHD risk. However, which flavonoid subclass could reduce CHD risk has remained controversial. The present meta-analysis of prospective cohort studies aimed to quantitatively assess the associations between flavonoid subclasses and CHD risk. A systematic literature search was implemented from PubMed and Web of Science databases up to March 2021, and eligible studies were identified. Multivariate-adjust relative risks (RR) with corresponding 95 % CI were pooled by using a random-effects model. A restricted cubic spline regression model was performed for non-linear dose-response analysis. A total of 19 independent prospective cohort studies with 894 471 participants and 34 707 events were included. The results showed that dietary intakes of anthocyanins (RR = 0·90; 95 % CI: 0·83, 0·98), proanthocyanidins (RR = 0·78; 95 % CI: 0·65, 0·94), flavonols (RR = 0·88; 95 % CI: 0·79, 0·98), flavones (RR = 0·94; 95 % CI: 0·89, 0·99) and isoflavones (RR = 0·90; 95 % CI: 0·83, 0·98) were negatively associated with CHD risk. Dose-response analysis showed that increment of 50 mg/d anthocyanins, 100 mg/d proanthocyanidins, 25 mg/d flavonols, 5 mg/d flavones and 0·5 mg/d isoflavones were associated with 5 % reduction in CHD risk, respectively. Sensitivity and subgroup analyses were used to further support these associations. The present results indicate that dietary intakes of fruits and vegetables abundant five flavonoid subclasses, namely anthocyanins, proanthocyanidins, flavonols, flavones and isoflavones, are associated with a lower risk of CHD.
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Zurbau A, Au‐Yeung F, Blanco Mejia S, Khan TA, Vuksan V, Jovanovski E, Leiter LA, Kendall CWC, Jenkins DJA, Sievenpiper JL. Relation of Different Fruit and Vegetable Sources With Incident Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. J Am Heart Assoc 2020; 9:e017728. [PMID: 33000670 PMCID: PMC7792377 DOI: 10.1161/jaha.120.017728] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
Abstract
Background Public health policies reflect concerns that certain fruit sources may not have the intended benefits and that vegetables should be preferred to fruit. We assessed the relation of fruit and vegetable sources with cardiovascular outcomes using a systematic review and meta-analysis of prospective cohort studies. Methods and Results MEDLINE, EMBASE, and Cochrane were searched through June 3, 2019. Two independent reviewers extracted data and assessed study quality (Newcastle-Ottawa Scale). Data were pooled (fixed effects), and heterogeneity (Cochrane-Q and I2) and certainty of the evidence (Grading of Recommendations Assessment, Development, and Evaluation) were assessed. Eighty-one cohorts involving 4 031 896 individuals and 125 112 cardiovascular events were included. Total fruit and vegetables, fruit, and vegetables were associated with decreased cardiovascular disease (risk ratio, 0.93 [95% CI, 0.89-0.96]; 0.91 [0.88-0.95]; and 0.94 [0.90-0.97], respectively), coronary heart disease (0.88 [0.83-0.92]; 0.88 [0.84-0.92]; and 0.92 [0.87-0.96], respectively), and stroke (0.82 [0.77-0.88], 0.82 [0.79-0.85]; and 0.88 [0.83-0.93], respectively) incidence. Total fruit and vegetables, fruit, and vegetables were associated with decreased cardiovascular disease (0.89 [0.85-0.93]; 0.88 [0.86-0.91]; and 0.87 [0.85-0.90], respectively), coronary heart disease (0.81 [0.72-0.92]; 0.86 [0.82-0.90]; and 0.86 [0.83-0.89], respectively), and stroke (0.73 [0.65-0.81]; 0.87 [0.84-0.91]; and 0.94 [0.90-0.99], respectively) mortality. There were greater benefits for citrus, 100% fruit juice, and pommes among fruit sources and allium, carrots, cruciferous, and green leafy among vegetable sources. No sources showed an adverse association. The certainty of the evidence was "very low" to "moderate," with the highest for total fruit and/or vegetables, pommes fruit, and green leafy vegetables. Conclusions Fruits and vegetables are associated with cardiovascular benefit, with some sources associated with greater benefit and none showing an adverse association. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03394339.
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Affiliation(s)
- Andreea Zurbau
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
| | - Fei Au‐Yeung
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
| | - Sonia Blanco Mejia
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
| | - Tauseef A. Khan
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
| | - Vladimir Vuksan
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoOntarioCanada
- Division of Endocrinology and MetabolismSt. Michael’s HospitalTorontoOntarioCanada
| | - Elena Jovanovski
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
| | - Lawrence A. Leiter
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
- Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoOntarioCanada
- Division of Endocrinology and MetabolismSt. Michael’s HospitalTorontoOntarioCanada
- Department of Medicine, Faculty of MedicineUniversity of TorontoOntarioCanada
| | - Cyril W. C. Kendall
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
- College of Pharmacy and NutritionUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - David J. A. Jenkins
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
- Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoOntarioCanada
- Division of Endocrinology and MetabolismSt. Michael’s HospitalTorontoOntarioCanada
| | - John L. Sievenpiper
- Department of Nutritional SciencesFaculty of MedicineUniversity of TorontoOntarioCanada
- Clinical Nutrition and Risk Factor Modification CenterSt. Michael’s HospitalTorontoOntarioCanada
- Toronto 3D Knowledge Synthesis and Clinical Trial UnitTorontoOntarioCanada
- Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoOntarioCanada
- Division of Endocrinology and MetabolismSt. Michael’s HospitalTorontoOntarioCanada
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Hejazi J, Ghanavati M, Hejazi E, Poustchi H, Sepanlou SG, Khoshnia M, Gharavi A, Sohrabpour AA, Sotoudeh M, Dawsey SM, Boffetta P, Abnet CC, Kamangar F, Etemadi A, Pourshams A, FazeltabarMalekshah A, Brennan P, Malekzadeh R, Hekmatdoost A. Habitual dietary intake of flavonoids and all-cause and cause-specific mortality: Golestan cohort study. Nutr J 2020; 19:108. [PMID: 32988395 PMCID: PMC7523365 DOI: 10.1186/s12937-020-00627-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/17/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Flavonoids are the most important group of polyphenols with well-known beneficial effects on health. However; the association of intake of total flavonoid or their subclasses with all-cause or cause-specific mortality is not fully understood. The present study aims to evaluate the association between intake of total flavonoid, flavonoid subclasses, and total and cause-specific mortality in a developing country. METHODS A total number of 49,173 participants from the Golestan cohort study, who completed a validated food frequency questionnaire at recruitment, were followed from 2004 till 2018. Phenol-Explorer database was applied to estimate dietary intakes of total flavonoid and different flavonoid subclasses. Associations were examined using adjusted Cox proportional hazards models. RESULTS During a mean follow-up of 10.63 years, 5104 deaths were reported. After adjusting for several potential confounders, the hazard ratios (HRs) of all-cause mortality for the highest versus the lowest quintile of dietary flavanones, flavones, isoflavonoids, and dihydrochalcones were 0.81 (95% confidence interval = 0.73-0.89), 0.83(0.76-0.92), 0.88(0.80-0.96) and 0.83(0.77-0.90), respectively. However, there was no association between total flavonoid intake or other flavonoid subclasses with all-cause mortality. In cause-specific mortality analyses, flavanones and flavones intakes were inversely associated with CVD mortality [HRs: 0.86(0.73-1.00) and 0.85(0.72-1.00)] and isoflavonoids and dihydrochalcones were the only flavonoid subclasses that showed a protective association against cancer mortality [HR: 0.82(0.68-0.98)]. CONCLUSION The results of our study suggest that certain subclasses of flavonoids can reduce all-cause mortality and mortality rate from CVD and cancer.
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Affiliation(s)
- Jalal Hejazi
- Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Matin Ghanavati
- Departments of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Hejazi
- Departments of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hossein Poustchi
- Liver and Pancreaticobiliary Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf G Sepanlou
- Liver and Pancreaticobiliary Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khoshnia
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolsamad Gharavi
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
| | - Amir Ali Sohrabpour
- Liver and Pancreaticobiliary Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Sotoudeh
- Digestive Disease Research Center, Digestive Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Paolo Boffetta
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar FazeltabarMalekshah
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer (IARC / WHO), Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Azita Hekmatdoost
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Departments of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Parmenter BH, Croft KD, Hodgson JM, Dalgaard F, Bondonno CP, Lewis JR, Cassidy A, Scalbert A, Bondonno NP. An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk. Food Funct 2020; 11:6777-6806. [PMID: 32725042 DOI: 10.1039/d0fo01118e] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is an accumulating body of literature reporting on dietary flavonoid intake and the risk of cardiovascular disease (CVD) in prospective cohort studies. This makes apparent the need for an overview and update on the current state of the science. To date, at least 27 prospective cohorts (in 44 publications) have evaluated the association between estimated habitual flavonoid intake and CVD risk. At this time, the totality of evidence suggests long-term consumption of flavonoid-rich foods may be associated with a lower risk of fatal and non-fatal ischemic heart disease (IHD), cerebrovascular disease, and total CVD; disease outcomes which are principally, though not exclusively, composed of cases of atherosclerotic CVD (ASCVD). To date, few studies have investigated outcome specific ASCVD, such as peripheral artery disease (PAD) or ischemic stroke. Of the flavonoid subclasses investigated, evidence more often implicates diets rich in anthocyanins, flavan-3-ols, and flavonols in lowering the risk of CVD. Although inferences are restricted by confounding and other inherent limitations of observational studies, causality appears possible based on biological plausibility, temporality, and the relative consistency of the reported associations. However, whether the associations observed represent a benefit of the isolated bioactives per se, or are a signal of the bioactives acting in concert with the co-occurring nutrient matrix within flavonoid-bearing foods, are issues of consideration. Thus, the simple interpretation, and the one most relevant for dietary advice, is that consumption of flavonoid-rich foods or diets higher in flavonoids, appear nutritionally beneficial in the prevention of CVD.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Kevin D Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Frederik Dalgaard
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia and Centre for Kidney Research, School of Public Health, The University of Sydney, Sydney, Australia
| | - Aedín Cassidy
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Augustin Scalbert
- Biomarkers Group, International Agency for Research on Cancer, Lyon, France
| | - Nicola P Bondonno
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia. and School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
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8
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Yamagata K. Polyphenols Regulate Endothelial Functions and Reduce the Risk of Cardiovascular Disease. Curr Pharm Des 2020; 25:2443-2458. [PMID: 31333108 DOI: 10.2174/1381612825666190722100504] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/20/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Previous studies have shown that intake of polyphenols through the consumption of vegetables and fruits reduces the risk of Cardiovascular Disease (CVD) by potentially influencing endothelial cell function. OBJECTIVE In this review, the effects and molecular mechanisms of plant polyphenols, particularly resveratrol, epigallocatechin gallate (EGCG), and quercetin, on endothelial functions, and their putative protective effects against CVD are described. METHODS Epidemiologic studies examined the effect of the CVD risk of vegetables and the fruit. Furthermore, studies within vitro models investigated the underlying molecular mechanisms of the action of the flavonoid class of polyphenols. These findings help elucidate the effect of polyphenols on endothelial function and CVD risk reduction. RESULTS Epidemiologic and in vitro studies have demonstrated that the consumption of vegetables and fruits decreases the incidence of CVDs. Furthermore, it has also been indicated that dietary polyphenols are inversely related to the risk of CVD. Resveratrol, EGCG, and quercetin prevent oxidative stress by regulating the expression of oxidase and the antioxidant enzyme genes, contributing to the prevention of stroke, hypertension, heart failure, and ischemic heart disease. CONCLUSION High intake of dietary polyphenols may help prevent CVD. Polyphenols inhibit endothelial dysfunction and induce vascular endothelium-dependent vascular relaxation viz. redox regulation and nitric oxide production. The polyphenol-induced healthy endothelial cell function may be related to CVD prevention.
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Affiliation(s)
- Kazuo Yamagata
- Laboratory of Molecular Health Science of Food, Department of Food Science & Technology, Nihon University (NUBS), 1866 Kameino, Fujisawa, Kanagawa, 252-8510, Japan
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9
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Del Bo' C, Bernardi S, Marino M, Porrini M, Tucci M, Guglielmetti S, Cherubini A, Carrieri B, Kirkup B, Kroon P, Zamora-Ros R, Liberona NH, Andres-Lacueva C, Riso P. Systematic Review on Polyphenol Intake and Health Outcomes: Is there Sufficient Evidence to Define a Health-Promoting Polyphenol-Rich Dietary Pattern? Nutrients 2019; 11:E1355. [PMID: 31208133 PMCID: PMC6627994 DOI: 10.3390/nu11061355] [Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 12/21/2022] Open
Abstract
Growing evidence support association between polyphenol intake and reduced risk for chronic diseases, even if there is a broad debate about the effective amount of polyphenols able to exert such protective effect. The present systematic review provides an overview of the last 10-year literature on the evaluation of polyphenol intake and its association with specific disease markers and/or endpoints. An estimation of the mean total polyphenol intake has been performed despite the large heterogeneity of data reviewed. In addition, the contribution of dietary sources was considered, suggesting tea, coffee, red wine, fruit and vegetables as the main products providing polyphenols. Total flavonoids and specific subclasses, but not total polyphenols, have been apparently associated with a low risk of diabetes, cardiovascular events and all-cause mortality. However, large variability in terms of methods for the evaluation and quantification of polyphenol intake, markers and endpoints considered, makes it still difficult to establish an evidence-based reference intake for the whole class and subclass of compounds. Nevertheless, the critical mass of data available seem to strongly suggest the protective effect of a polyphenol-rich dietary pattern even if further well targeted and methodologically sound research should be encouraged in order to define specific recommendations.
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Affiliation(s)
- Cristian Del Bo'
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Stefano Bernardi
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Mirko Marino
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Marisa Porrini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Massimiliano Tucci
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Simone Guglielmetti
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, 60127 Ancona, Italy.
| | - Barbara Carrieri
- Geriatria, Accettazione Geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, 60127 Ancona, Italy.
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, 60131 Ancona, Italy.
| | - Benjamin Kirkup
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UG, UK.
| | - Paul Kroon
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UG, UK.
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain.
| | - Nicole Hidalgo Liberona
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain.
- CIBER Fragilidad y Envejecimiento Saludable (CIBERfes), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Cristina Andres-Lacueva
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain.
- CIBER Fragilidad y Envejecimiento Saludable (CIBERfes), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy.
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10
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Xie X, Zu X, Liu F, Wang T, Wang X, Chen H, Liu K, Wang P, Liu F, Zheng Y, Bode AM, Dong Z, Kim DJ. Purpurogallin is a novel mitogen-activated protein kinase kinase 1/2 inhibitor that suppresses esophageal squamous cell carcinoma growth in vitro and in vivo. Mol Carcinog 2019; 58:1248-1259. [PMID: 31100197 DOI: 10.1002/mc.23007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 03/05/2019] [Accepted: 03/08/2019] [Indexed: 12/28/2022]
Abstract
Purpurogallin is a natural compound that is extracted from nutgalls and oak bark and it possesses antioxidant, anticancer, and anti-inflammatory properties. However, the anticancer capacity of purpurogallin and its molecular target have not been investigated in esophageal squamous cell carcinoma (ESCC). Herein, we report that purpurogallin suppresses ESCC cell growth by directly targeting the mitogen-activated protein kinase kinase 1/2 (MEK1/2) signaling pathway. We found that purpurogallin inhibits anchorage-dependent and -independent ESCC growth. The results of in vitro kinase assays and cell-based assays indicated that purpurogallin also strongly attenuates the extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway and also directly binds to and inhibits MEK1 and MEK2 activity. Furthermore, purpurogallin contributed to S and G2 phase cell cycle arrest by reducing cyclin A2 and cyclin B1 expression and also induced apoptosis by activating poly (ADP ribose) polymerase (PARP). Notably, purpurogallin suppressed patient-derived ESCC tumor growth in an in vivo mouse model. These findings indicated that purpurogallin is a novel MEK1/2 inhibitor that could be useful for treating ESCC.
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Affiliation(s)
- Xiaomeng Xie
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China
| | - Xueyin Zu
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China.,Department of Pathophysiology, The School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Feifei Liu
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China
| | - Ting Wang
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China.,Department of Pathophysiology, The School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiangyu Wang
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China
| | - Hanyong Chen
- The Hormel Institute, University of Minnesota, Austin, Minnesota
| | - Kangdong Liu
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China.,Department of Pathophysiology, The School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China.,The Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, Henan, China.,The Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, Henan, China
| | - Penglei Wang
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China.,Department of Pathophysiology, The School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Fangfang Liu
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China.,Department of Pathophysiology, The School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yan Zheng
- The Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Ann M Bode
- The Hormel Institute, University of Minnesota, Austin, Minnesota
| | - Zigang Dong
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China.,Department of Pathophysiology, The School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China.,The Hormel Institute, University of Minnesota, Austin, Minnesota.,The Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, Henan, China.,International Joint Research Center of Cancer Chemoprevention, Zhengzhou, China
| | - Dong Joon Kim
- Department of Molecular and Cellular Biology, China-US (Henan) Hormel Cancer Institute, Zhengzhou, Henan, China.,Department of Pathophysiology, The School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
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11
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Effects of domestic cooking on flavonoids in broccoli and calculation of retention factors. Heliyon 2019; 5:e01310. [PMID: 30899833 PMCID: PMC6407093 DOI: 10.1016/j.heliyon.2019.e01310] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/04/2019] [Accepted: 02/26/2019] [Indexed: 01/27/2023] Open
Abstract
The flavonoid contents in vegetables are strongly influenced by domestic cooking. The objective of this study was to evaluate the effects of domestic cooking on the structurally complex flavonoids in broccoli. Raw broccoli was cooked by boiling, steaming and microwaving. Seven kaempferol (Km) glycosides and one quercetin (Qn) glycoside were identified and quantified in raw and cooked broccoli by HPLC-MS. Boiling resulted in significant loss of all flavonoids, while steaming and microwaving led to minor loses or even increases of the flavonoids. Apparent retention factors (AR) and true retention factors (TR) were calculated for individual flavonoids. AR ranged from 35.6% to 147.5% and TR ranged from 30.4% to 174.1%, respectively, depending on the cooking method and chemical structures of flavonoids. Two different ways to calculate total retention factors, "Retention Factor by Glycoside" and "Retention Factor by Aglycone", were also calculated. In conclusion, domestic cooking significantly altered the flavonoid contents in broccoli, with cooking method and chemical nature being key influential factors. Acylated Km tri- or tetra-glycosides appeared to be more resistant to domestic cooking.
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12
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Metabolic Syndrome: Preventive Effects of Dietary Flavonoids. STUDIES IN NATURAL PRODUCTS CHEMISTRY 2019. [DOI: 10.1016/b978-0-444-64181-6.00001-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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13
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Kimble R, Keane KM, Lodge JK, Howatson G. Dietary intake of anthocyanins and risk of cardiovascular disease: A systematic review and meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr 2018; 59:3032-3043. [PMID: 30277799 DOI: 10.1080/10408398.2018.1509835] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Accumulating evidence suggests flavonoid intake is associated with reduced risk of non-communicable diseases. We aimed to systematically determine and quantify the potential association between dietary anthocyanin intake and risk of cardiovascular diseases (CVD). A systematic literature search of studies reporting anthocyanin intake and risk of fatal or nonfatal CVD was performed using SCOPUS, MEDLINE, CINAHL and Cochrane Library. The relative risk (RR) or hazard ratio (HR) of highest category of anthocyanin foods were pooled in a random-effects meta-analysis. Subgroup analysis were conducted to determine possible sources of heterogeneity. The meta-analysis suggested intake of dietary anthocyanins and reduced risk of CHD (RR = 0.91, 95% CI: 0.83, 0.99; I2 = 12.0, Ph = 0.337) and CVD mortality (RR = 0.92, 95% CI: 0.87, 0.97; I2 = 0.0, Ph = 0.584). However, there was no relationship between the intake of these compounds and reduced risk of MI, stroke or total CVD. Subgroup analysis determined reduced risk of CHD and CVD mortality was more prominent for anthocyanidin intake, as opposed to anthocyanin or berries. Our systematic review and meta-analysis provides evidence that anthocyanins, specifically anthocyanidins, reduce the risk of CHD and CVD mortality. Further randomized controlled trials on anthocyanin intake and CVD risk factors are needed to support these findings.
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Affiliation(s)
- Rachel Kimble
- Department of Sport Exercise and Rehabilitation Faculty of Health and Life Sciences, Northumbria University , Newcastle-upon-Tyne , UK
| | - Karen M Keane
- Department of Sport Exercise and Rehabilitation Faculty of Health and Life Sciences, Northumbria University , Newcastle-upon-Tyne , UK
| | - John K Lodge
- Department of Applied Sciences Faculty of Health and Life Sciences, Northumbria University , Newcastle-upon-Tyne , UK
| | - Glyn Howatson
- Department of Sport Exercise and Rehabilitation Faculty of Health and Life Sciences, Northumbria University , Newcastle-upon-Tyne , UK.,Water Research Group, School of Environmental Sciences and Development, Northwest University , Potchefstroom , South Africa
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14
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Treggiari D, Dalbeni A, Meneguzzi A, Delva P, Fava C, Molesini B, Pandolfini T, Minuz P. Lycopene inhibits endothelial cells migration induced by vascular endothelial growth factor A increasing nitric oxide bioavailability. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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15
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Kuhnle GGC. Nutrition epidemiology of flavan-3-ols: The known unknowns. Mol Aspects Med 2017; 61:2-11. [PMID: 29146101 DOI: 10.1016/j.mam.2017.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 10/19/2017] [Accepted: 10/24/2017] [Indexed: 01/17/2023]
Abstract
Nutritional epidemiology has an important role, as it can provide long-term data from large populations and does not rely on surrogate markers for morbidity/mortality. Meaningful interpretation and applications of outcomes from epidemiological studies depend on the accurate assessment of dietary intake, which is currently mainly based on a combination of self-reporting and food composition data. Flavan-3-ols are a group of bioactives (non-essential dietary components with significant impact on health) that is a possible candidate for the development of dietary recommendations. The breadth of data available on their effect on health also provides the basis for investigating the suitability of the methods currently used in nutritional epidemiology to assess the health effects of bioactives. The outcomes of this assessment demonstrate that the limitations of currently used methods make it virtually impossible to estimate intake accurately from self-reported dietary data. This is due to the limitations of self-reporting, especially from food-frequency questionnaires, and the inability of currently used methods to deal with the high variability of food composition. Indeed, the estimated intake of flavan-3-ols, can only be interpreted as a marker of specific dietary patterns, but not as the actual intake amount. The interpretation of results from such studies are fraught with serious limitations, especially for establishing associations between intake and health and the development of dietary recommendations. Alternative assessment not affected by these limitations, such as biomarkers, are required to overcome these limitations. The development of nutritional biomarkers is therefore crucial to investigate the health effect of bioactives.
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Affiliation(s)
- Gunter G C Kuhnle
- Department of Food & Nutritional Sciences, Harry Nursten Building, University of Reading, Reading RG6 6UR, United Kingdom.
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16
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Dwyer JT. The Best of Times. Annu Rev Nutr 2017; 37:33-49. [PMID: 28574804 DOI: 10.1146/annurev-nutr-071816-064932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
I came of age as a nutrition scientist during the best of times-years that spanned a rapidly changing world of food and nutrition science, politics, and policy that greatly broadened the specialty and its influence on public affairs. I followed the conventional route in academe, working my way up the academic ladder in Boston from a base first in a school of public health and later in a teaching hospital and medical school, interspersed with stints in Washington, DC. Thus I tell a tale of two cities. Those were the best of times because nutrition science and policy converged and led to important policies and programs that shaped the field for the next 50 years.
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Affiliation(s)
- Johanna T Dwyer
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland 20892; .,Schools of Medicine, Friedman School of Nutrition Science and Policy, and the Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts 02111
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17
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Kumar M, Nayak PK. Natural phytochemicals: A promising approach in the management of myocardial infarction. Biomed Pharmacother 2017; 92:1138-1139. [DOI: 10.1016/j.biopha.2016.12.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/30/2016] [Accepted: 12/31/2016] [Indexed: 11/25/2022] Open
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18
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Feresin RG, Pourafshar S, Huang J, Zhao Y, Arjmandi BH, Salazar G. Extraction and Purification of Polyphenols from Freeze-dried Berry Powder for the Treatment of Vascular Smooth Muscle Cells In Vitro. J Vis Exp 2017. [PMID: 28715389 DOI: 10.3791/55605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Epidemiological studies indicate that increased flavonoid intake correlates with decreased mortality due to cardiovascular diseases (CVD) in the United States (US) and Europe. Berries are widely consumed in the US and have a high polyphenolic content. Polyphenols have been shown to interact with many molecular targets and to exert numerous positive biological functions, including antioxidant, anti-inflammatory, and cardioprotective effects. Polyphenols isolated from blackberry (BL), raspberry (RB), and black raspberry (BRB) reduce oxidative stress and cellular senescence in response to angiotensin II (Ang II). This work provides a detailed description of the protocol used to prepare the polyphenol extracts from freeze-dried berries. Polyphenol extractions from freeze-dried berry powder were performed using 80% aqueous ethanol and an ultrasonic-assisted extraction method. The crude extract was further purified and fractionated using chloroform and ethyl acetate, respectively. The effects of both crude and purified extracts were tested on Vascular Smooth Muscle Cells (VSMCs) in culture.
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Affiliation(s)
- Rafaela G Feresin
- Department of Dietetics and Nutrition, University of Arkansas for Medical Sciences
| | - Shirin Pourafshar
- Department of Nutrition, Food and Exercise Sciences, Florida State University; Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University
| | - Jingwen Huang
- Department of Nutrition, Food and Exercise Sciences, Florida State University
| | - Yitong Zhao
- Department of Nutrition, Food and Exercise Sciences, Florida State University
| | - Bahram H Arjmandi
- Department of Nutrition, Food and Exercise Sciences, Florida State University; Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University
| | - Gloria Salazar
- Department of Nutrition, Food and Exercise Sciences, Florida State University; Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University;
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19
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Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, Greenwood DC, Riboli E, Vatten LJ, Tonstad S. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol 2017; 46:1029-1056. [PMID: 28338764 PMCID: PMC5837313 DOI: 10.1093/ije/dyw319] [Citation(s) in RCA: 1150] [Impact Index Per Article: 164.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 12/23/2022] Open
Abstract
Background Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations. Methods PubMed and Embase were searched up to 29 September 2016. Prospective studies of fruit and vegetable intake and cardiovascular disease, total cancer and all-cause mortality were included. Summary relative risks (RRs) were calculated using a random effects model, and the mortality burden globally was estimated; 95 studies (142 publications) were included. Results For fruits and vegetables combined, the summary RR per 200 g/day was 0.92 [95% confidence interval (CI): 0.90-0.94, I 2 = 0%, n = 15] for coronary heart disease, 0.84 (95% CI: 0.76-0.92, I 2 = 73%, n = 10) for stroke, 0.92 (95% CI: 0.90-0.95, I 2 = 31%, n = 13) for cardiovascular disease, 0.97 (95% CI: 0.95-0.99, I 2 = 49%, n = 12) for total cancer and 0.90 (95% CI: 0.87-0.93, I 2 = 83%, n = 15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600 g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal. Conclusions Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.
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Affiliation(s)
- Dagfinn Aune
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Bjørknes University College, Oslo, Norway
| | - Edward Giovannucci
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology
- Department of Nutrition, Harvard T. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lars T Fadnes
- Department of Global Public Health and Primary Care & Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - NaNa Keum
- Department of Epidemiology
- Department of Nutrition, Harvard T. Chan School of Public Health, Boston, MA, USA
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | | | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Lars J Vatten
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Serena Tonstad
- Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
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20
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Kent K, Charlton K. Relative Validity and Reproducibility of an Interviewer Administered 14-Item FFQ to Estimate Flavonoid Intake Among Older Adults with Mild-Moderate Dementia. J Nutr Gerontol Geriatr 2017; 36:134-147. [PMID: 28535111 DOI: 10.1080/21551197.2017.1321080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
There is a large burden on researchers and participants when attempting to accurately measure dietary flavonoid intake using dietary assessment. Minimizing participant and researcher burden when collecting dietary data may improve the validity of the results, especially in older adults with cognitive impairment. A short 14-item food frequency questionnaire (FFQ) to measure flavonoid intake, and flavonoid subclasses (anthocyanins, flavan-3-ols, flavones, flavonols, and flavanones) was developed and assessed for validity and reproducibility against a 24-hour recall. Older adults with mild-moderate dementia (n = 49) attended two interviews 12 weeks apart. With the assistance of a family carer, a 24-h recall was collected at the first interview, and the flavonoid FFQ was interviewer-administered at both time-points. Validity and reproducibility was assessed using the Wilcoxon signed-rank sum test, Spearman's correlation coefficient, Bland-Altman Plots, and Cohen's kappa. Mean flavonoid intake was determined (FFQ1 = 795 ± 492.7 mg/day, 24-h recall = 515.6 ± 384.3 mg/day). Tests of validity indicated the FFQ was better at estimating total flavonoid intake than individual flavonoid subclasses compared with the 24-h recall. There was a significant difference in total flavonoid intake estimates between the FFQ and the 24-h recall (Wilcoxon signed-rank sum p < 0.001; Bland-Altman plots indicated large bias and wide limits of agreement), but they were well correlated (Spearman's correlation coefficient r = 0.74, p < 0.001; Cohen's kappa κ = 0.292, p < 0.001). The FFQ showed good reproducibility, with a small mean percentage difference (12.6%). The Wilcoxon signed-rank sum test showed no significant difference, Spearman's correlation coefficient indicated excellent reliability (r = 0.75, p < 0.001), Bland-Altman plots visually showed small, nonsignificant bias and wide limits of agreement, and Cohen's kappa indicated fair agreement (κ = 0.429, p < 0.001). A 14-item FFQ developed to easily measure flavonoid intake in older adults with dementia demonstrates fair validity against a 24-h recall and good reproducibility.
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Affiliation(s)
- Katherine Kent
- a Faculty of Health , University of Tasmania , Tasmania , Australia
| | - Karen Charlton
- b Faculty of Science, Medicine and Health , University of Wollongong , Wollongong , Australia.,c Illawarra Health and Medical Research Institute , Wollongong , NSW , Australia
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21
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Cassidy A. Berry anthocyanin intake and cardiovascular health. Mol Aspects Med 2017; 61:76-82. [PMID: 28483533 DOI: 10.1016/j.mam.2017.05.002] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 05/04/2017] [Indexed: 01/01/2023]
Abstract
Over half of all cardiovascular (CV) events could be prevented by improved diet. This is reflected in government targets for fruit/vegetable intake, yet these are variable across the world (UK: 5-a-day; USA: 9-a-day), do not identify specific fruits/vegetables, and prove hard to achieve. Mounting evidence from prospective studies, supported by recent randomised controlled trials suggest that the benefits of fruits/vegetables may be due to bioactive substances called flavonoids. Specifically one sub-class of flavonoids, the anthocyanins, responsible for the red/blue hue, are receiving growing attention. Although promising data is emerging from cohort studies, and cell/animal studies, proof of efficacy from longer-term randomised controlled trials, and an understanding of the importance of differential metabolism in relation to clinical efficacy are distinctly lacking. Diet related ill-health are among the leading priorities of our time and simple dietary change, including incorporating a few portions of anthocyanin-rich fruit into our diet could have a significant impact at a public health level.
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Affiliation(s)
- Aedín Cassidy
- Department of Nutrition & Preventive Medicine, Norwich Medical School, University of East Anglia, James Watson Road, Norwich, NR4 7UQ, United Kingdom.
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22
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Association of Polyphenol Biomarkers with Cardiovascular Disease and Mortality Risk: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2017; 9:nu9040415. [PMID: 28441720 PMCID: PMC5409754 DOI: 10.3390/nu9040415] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/12/2017] [Accepted: 04/19/2017] [Indexed: 11/17/2022] Open
Abstract
Epidemiologic studies have suggested an inverse association between flavonoids and cardiovascular disease (CVD). However, the results might have been influenced by the use of dietary assessment methods, which are error prone. The aim of this paper was to systematically review and analyse the literature for evidence of associations between polyphenol biomarkers and CVD and mortality risk in observational studies. Eligible studies were identified through PubMed, Web of Science, and reference lists. Multivariable adjusted associations were extracted. Data were log-transformed and pooled using the random effects model. In total, eight studies were included, investigating 16 different polyphenol biomarkers in association with CVD and mortality. Blood and urine were used as biospecimens, and enterolactone, a lignan metabolite, was most often investigated. Three meta-analyses were conducted investigating the association between enterolactone, and all-cause and CVD mortality, and non-fatal myocardial infarction. A 30% and 45% reduced all-cause and CVD mortality risk were revealed at higher enterolactone concentrations. Furthermore, inverse associations were observed between polyphenol biomarkers and all-cause mortality, kaempferol, and acute coronary syndrome. There is evidence to suggest that enterolactone is associated with a lower CVD mortality risk. This emphasises the importance of the role of the microbiota in disease prevention. To strengthen the evidence, more studies are warranted.
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Redan BW, Albaugh GP, Charron CS, Novotny JA, Ferruzzi MG. Adaptation in Caco-2 Human Intestinal Cell Differentiation and Phenolic Transport with Chronic Exposure to Blackberry (Rubus sp.) Extract. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2017; 65:2694-2701. [PMID: 28287259 DOI: 10.1021/acs.jafc.7b00027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
As evidence mounts for a health-protective role of dietary phenolics, the importance of understanding factors influencing bioavailability increases. Recent evidence has suggested chronic exposure to phenolics may impact their absorption and metabolism. To explore alterations occurring from chronic dietary exposure to phenolics, Caco-2 cell monolayers were differentiated on Transwell inserts with 0-10 μM blackberry (Rubus sp.) total phenolics extracts rich in anthocyanins, flavonols, and phenolic acids. Following differentiation, apical to basolateral transport of phenolics was assessed from an acute treatment of 100 μM blackberry phenolics from 0 to 4 h. Additionally, differences in gene expression of transport and phase II metabolizing systems including ABC transporters, organic anion transporters (OATs), and uridine 5'-diphospho (UDP) glucuronosyltransferases (UGTs) were probed. After 4 h, 1 μM pretreated monolayers showed a significant (P < 0.05) decrease in the percentage of cumulative transport including less epicatechin (42.1 ± 0.53), kaempferol glucoside (23.5 ± 0.29), and dicaffeoylquinic acid (31.9 ± 0.20) compared to control. Finally, significant (P < 0.05) alterations in mRNA expression of key phase II metabolizing enzymes and transport proteins were observed with treatment. Therefore, adaptation to blackberry extract exposure may impact intestinal transport and metabolism of phenolics.
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Affiliation(s)
- Benjamin W Redan
- Department of Nutrition Science, Purdue University , 700 W. State Street, West Lafayette, Indiana 47907, United States
| | - George P Albaugh
- Food Components and Health Laboratory, USDA-ARS , 10300 Baltimore Avenue, BLDG 307-B BARC-EAST, Beltsville, Maryland 20705, United States
| | - Craig S Charron
- Food Components and Health Laboratory, USDA-ARS , 10300 Baltimore Avenue, BLDG 307-B BARC-EAST, Beltsville, Maryland 20705, United States
| | - Janet A Novotny
- Food Components and Health Laboratory, USDA-ARS , 10300 Baltimore Avenue, BLDG 307-B BARC-EAST, Beltsville, Maryland 20705, United States
| | - Mario G Ferruzzi
- Department of Nutrition Science, Purdue University , 700 W. State Street, West Lafayette, Indiana 47907, United States
- Department of Food Science, Purdue University , 745 Agriculture Mall Drive, West Lafayette, Indiana 47907, United States
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Dairy products consumption and incident metabolic syndrome. Br J Nutr 2017; 117:621. [DOI: 10.1017/s0007114517000526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Goetz ME, Judd SE, Hartman TJ, McClellan W, Anderson A, Vaccarino V. Flavanone Intake Is Inversely Associated with Risk of Incident Ischemic Stroke in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. J Nutr 2016; 146:2233-2243. [PMID: 27655760 PMCID: PMC5086785 DOI: 10.3945/jn.116.230185] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 08/26/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Flavonoids may have beneficial cerebrovascular effects, but evidence from racially and geographically representative cohorts in comprehensive flavonoid databases is lacking. Given racial and geographic disparities in stroke incidence, representative cohort studies are needed. OBJECTIVES We evaluated the association between flavonoid intake and incident ischemic stroke in a biracial, national cohort using updated flavonoid composition tables and assessed differences in flavonoid intake by sex, race, and region of residence. METHODS We evaluated 20,024 participants in the REGARDS (REasons for Geographic and Racial Differences in Stroke) study, a biracial prospective study. Participants with stroke history or missing dietary data were excluded. Flavonoid intake was estimated by using a Block98 food frequency questionnaire and the USDA's Provisional Flavonoid Addendum and Proanthocyanidin Database. Associations between quintiles of flavonoid intake and incident ischemic stroke were evaluated by using Cox proportional hazards models, adjusting for confounders. RESULTS Over 6.5 y, 524 acute ischemic strokes occurred. Flavanone intake was lower in the Southeastern United States but higher in blacks than in whites. After multivariable adjustment, flavanone intake was inversely associated with incident ischemic stroke (HR: 0.72; 95% CI: 0.55, 0.95; P-trend = 0.03). Consumption of citrus fruits and juices was inversely associated with incident ischemic stroke (HR: 0.69; 95% CI: 0.53, 0.91; P-trend = 0.02). Total flavonoids and other flavonoid subclasses were not associated with incident ischemic stroke. There was no statistical interaction with sex, race, or region for any flavonoid measure. CONCLUSIONS Greater consumption of flavanones, but not total or other flavonoid subclasses, was inversely associated with incident ischemic stroke. Associations did not differ by sex, race, or region for the association; however, regional differences in flavanone intake may contribute to regional disparities in ischemic stroke incidence. Higher flavanone intake in blacks suggests that flavanone intake is not implicated in racial disparities in ischemic stroke incidence.
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Affiliation(s)
| | - Suzanne E Judd
- Department of Epidemiology, Rollins School of Public Health,,Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL; and
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health,,Winship Cancer Institute, Emory University, Atlanta, GA
| | - William McClellan
- Department of Epidemiology, Rollins School of Public Health,,Renal Division and
| | - Aaron Anderson
- Department of Neurology, Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health,,Division of Cardiology, Department of Medicine, and
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Goetz ME, Judd SE, Safford MM, Hartman TJ, McClellan WM, Vaccarino V. Dietary flavonoid intake and incident coronary heart disease: the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Am J Clin Nutr 2016; 104:1236-1244. [PMID: 27655439 PMCID: PMC5081714 DOI: 10.3945/ajcn.115.129452] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 08/25/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Flavonoids are dietary polyphenolic compounds with a variety of proposed beneficial cardiovascular effects, but rigorous prospective studies that examine the association between flavonoid intake and incident coronary heart disease (CHD) in geographically and racially diverse US samples are limited. OBJECTIVE With the use of the new, expanded USDA flavonoid database, we assessed the association between total flavonoid and flavonoid subclass intakes with incident CHD in a biracial and geographically diverse cohort, as well as effect modification by age, sex, race, and region of residence. DESIGN Participants were 16,678 black and white men and women enrolled in the REGARDS (REasons for Geographic and Racial Differences in Stroke) study, a national prospective cohort study. All participants were without CHD at baseline, and all completed a Block98 food-frequency questionnaire. Flavonoid intakes were estimated from USDA flavonoid databases, which were recently improved to address missing values for cooked foods and to adjust for flavonoid losses due to processing. Incident CHD events were participant reported and adjudicated by experts. Quintiles of flavonoid intake were examined as predictors of incident CHD by using Cox proportional hazards regression to obtain HRs. Tests for trend used the quintile medians. RESULTS Over a mean ± SD follow-up of 6.0 ± 1.9 y, 589 CHD events occurred. High flavonoid intake was associated with self-identified white race, exercise, not smoking, more education, and higher income. In models that adjusted for sociodemographic, health behavior, and dietary factors, there was an inverse association between anthocyanidin and proanthocyanidin intakes and incident CHD (HRs for quintile 5 compared with quintile 1-anthocyanidins: 0.71; 95% CI: 0.52, 0.98; P-trend = 0.04; proanthocyanidins: 0.63; 95% CI: 0.47, 0.84; P-trend = 0.02). There was no association between total flavonoid or other flavonoid subclass intakes and incident CHD. CONCLUSIONS Reported anthocyanidin and proanthocyanidin intakes were inversely associated with incident CHD. There was no significant effect modification by age, sex, race, or region of residence.
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Affiliation(s)
| | - Suzanne E Judd
- Department of Epidemiology, Rollins School of Public Health
- Department of Biostatistics, School of Public Health, and
| | - Monika M Safford
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health
- Winship Cancer Institute; and
| | - William M McClellan
- Department of Epidemiology, Rollins School of Public Health
- Renal Division and
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Emory University, Atlanta, GA; and
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Cassidy A, Bertoia M, Chiuve S, Flint A, Forman J, Rimm EB. Habitual intake of anthocyanins and flavanones and risk of cardiovascular disease in men. Am J Clin Nutr 2016; 104:587-94. [PMID: 27488237 PMCID: PMC4997299 DOI: 10.3945/ajcn.116.133132] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/23/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although increased fruit intake reduces cardiovascular disease (CVD) risk, which fruits are most beneficial and what key constituents are responsible are unclear. Habitual intakes of flavonoids, specifically anthocyanins and flavanones, in which >90% of habitual intake is derived from fruit, are associated with decreased CVD risk in women, but associations in men are largely unknown. OBJECTIVE We examined the relation between habitual anthocyanin and flavanone intake and coronary artery disease and stroke in the Health Professionals Follow-Up Study. DESIGN We followed 43,880 healthy men who had no prior diagnosed CVD or cancer. Flavonoid intake was calculated with the use of validated food-frequency questionnaires. RESULTS During 24 y of follow-up, 4046 myocardial infarction (MI) and 1572 stroke cases were confirmed by medical records. Although higher anthocyanin intake was not associated with total or fatal MI risk, after multivariate adjustment an inverse association with nonfatal MI was observed (HR: 0.87; 95% CI: 0.75, 1.00; P = 0.04; P-trend = 0.098); this association was stronger in normotensive participants (HR: 0.81; 95% CI: 0.69, 0.96; P-interaction = 0.03). Anthocyanin intake was not associated with stroke risk. Although flavanone intake was not associated with MI or total stroke risk, higher intake was associated with a lower risk of ischemic stroke (HR: 0.78; 95% CI: 0.62, 0.97; P = 0.03, P-trend = 0.059), with the greatest magnitude in participants aged ≥65 y (P-interaction = 0.04). CONCLUSIONS Higher intakes of fruit-based flavonoids were associated with a lower risk of nonfatal MI and ischemic stroke in men. Mechanistic studies and clinical trials are needed to unravel the differential benefits of anthocyanin- and flavanone-rich foods on cardiovascular health.
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Affiliation(s)
- Aedín Cassidy
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Monica Bertoia
- Departments of Nutrition and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Stephanie Chiuve
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | | | - John Forman
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Eric B Rimm
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
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