Association of flavonoid-rich foods and flavonoids with risk of all-cause mortality

Kerry L. Ivey, Majken K. Jensen, Jonathan M. Hodgson, A. Heather Eliassen, Aedín Cassidy, Eric B. Rimm

    Research output: Contribution to journalArticle

    19 Citations (Scopus)

    Abstract

    Flavonoids are bioactive compounds found in foods such as tea, red wine, fruits and vegetables. Higher intakes of specific flavonoids, and flavonoid-rich foods, have been linked to reduced mortality from specific vascular diseases and cancers. However, the importance of flavonoid-rich foods, and flavonoids, in preventing all-cause mortality remains uncertain. As such, we examined the association of intake of flavonoid-rich foods and flavonoids with subsequent mortality among 93 145 young and middle-aged women in the Nurses’ Health Study II. During 1 838 946 person-years of follow-up, 1808 participants died. When compared with non-consumers, frequent consumers of red wine, tea, peppers, blueberries and strawberries were at reduced risk of all-cause mortality (P<0·05), with the strongest associations observed for red wine and tea; multivariable-adjusted hazard ratios 0·60 (95 % CI 0·49, 0·74) and 0·73 (95 % CI 0·65, 0·83), respectively. Conversely, frequent grapefruit consumers were at increased risk of all-cause mortality, compared with their non-grapefruit consuming counterparts (P<0·05). When compared with those in the lowest consumption quintile, participants in the highest quintile of total-flavonoid intake were at reduced risk of all-cause mortality in the age-adjusted model; 0·81 (95 % CI 0·71, 0·93). However, this association was attenuated following multivariable adjustment; 0·92 (95 % CI 0·80, 1·06). Similar results were observed for consumption of flavan-3-ols, proanthocyanidins and anthocyanins. Flavonols, flavanones and flavones were not associated with all-cause mortality in any model. Despite null associations at the compound level and select foods, higher consumption of red wine, tea, peppers, blueberries and strawberries, was associated with reduced risk of total and cause-specific mortality. These findings support the rationale for making food-based dietary recommendations.

    Original languageEnglish
    Pages (from-to)1470-1477
    Number of pages8
    JournalBritish Journal of Nutrition
    Volume117
    Issue number10
    DOIs
    Publication statusPublished - 28 May 2017

    Fingerprint

    Flavonoids
    Food
    Mortality
    Tea
    Wine
    Blueberry Plants
    Fragaria
    Flavanones
    Citrus paradisi
    Flavones
    Proanthocyanidins
    Flavonols
    Anthocyanins
    Vascular Diseases
    Vegetables
    Fruit
    Nurses
    Health
    Neoplasms

    Cite this

    Ivey, Kerry L. ; Jensen, Majken K. ; Hodgson, Jonathan M. ; Eliassen, A. Heather ; Cassidy, Aedín ; Rimm, Eric B. / Association of flavonoid-rich foods and flavonoids with risk of all-cause mortality. In: British Journal of Nutrition. 2017 ; Vol. 117, No. 10. pp. 1470-1477.
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    abstract = "Flavonoids are bioactive compounds found in foods such as tea, red wine, fruits and vegetables. Higher intakes of specific flavonoids, and flavonoid-rich foods, have been linked to reduced mortality from specific vascular diseases and cancers. However, the importance of flavonoid-rich foods, and flavonoids, in preventing all-cause mortality remains uncertain. As such, we examined the association of intake of flavonoid-rich foods and flavonoids with subsequent mortality among 93 145 young and middle-aged women in the Nurses’ Health Study II. During 1 838 946 person-years of follow-up, 1808 participants died. When compared with non-consumers, frequent consumers of red wine, tea, peppers, blueberries and strawberries were at reduced risk of all-cause mortality (P<0·05), with the strongest associations observed for red wine and tea; multivariable-adjusted hazard ratios 0·60 (95 {\%} CI 0·49, 0·74) and 0·73 (95 {\%} CI 0·65, 0·83), respectively. Conversely, frequent grapefruit consumers were at increased risk of all-cause mortality, compared with their non-grapefruit consuming counterparts (P<0·05). When compared with those in the lowest consumption quintile, participants in the highest quintile of total-flavonoid intake were at reduced risk of all-cause mortality in the age-adjusted model; 0·81 (95 {\%} CI 0·71, 0·93). However, this association was attenuated following multivariable adjustment; 0·92 (95 {\%} CI 0·80, 1·06). Similar results were observed for consumption of flavan-3-ols, proanthocyanidins and anthocyanins. Flavonols, flavanones and flavones were not associated with all-cause mortality in any model. Despite null associations at the compound level and select foods, higher consumption of red wine, tea, peppers, blueberries and strawberries, was associated with reduced risk of total and cause-specific mortality. These findings support the rationale for making food-based dietary recommendations.",
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    Association of flavonoid-rich foods and flavonoids with risk of all-cause mortality. / Ivey, Kerry L.; Jensen, Majken K.; Hodgson, Jonathan M.; Eliassen, A. Heather; Cassidy, Aedín; Rimm, Eric B.

    In: British Journal of Nutrition, Vol. 117, No. 10, 28.05.2017, p. 1470-1477.

    Research output: Contribution to journalArticle

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    T1 - Association of flavonoid-rich foods and flavonoids with risk of all-cause mortality

    AU - Ivey, Kerry L.

    AU - Jensen, Majken K.

    AU - Hodgson, Jonathan M.

    AU - Eliassen, A. Heather

    AU - Cassidy, Aedín

    AU - Rimm, Eric B.

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    AB - Flavonoids are bioactive compounds found in foods such as tea, red wine, fruits and vegetables. Higher intakes of specific flavonoids, and flavonoid-rich foods, have been linked to reduced mortality from specific vascular diseases and cancers. However, the importance of flavonoid-rich foods, and flavonoids, in preventing all-cause mortality remains uncertain. As such, we examined the association of intake of flavonoid-rich foods and flavonoids with subsequent mortality among 93 145 young and middle-aged women in the Nurses’ Health Study II. During 1 838 946 person-years of follow-up, 1808 participants died. When compared with non-consumers, frequent consumers of red wine, tea, peppers, blueberries and strawberries were at reduced risk of all-cause mortality (P<0·05), with the strongest associations observed for red wine and tea; multivariable-adjusted hazard ratios 0·60 (95 % CI 0·49, 0·74) and 0·73 (95 % CI 0·65, 0·83), respectively. Conversely, frequent grapefruit consumers were at increased risk of all-cause mortality, compared with their non-grapefruit consuming counterparts (P<0·05). When compared with those in the lowest consumption quintile, participants in the highest quintile of total-flavonoid intake were at reduced risk of all-cause mortality in the age-adjusted model; 0·81 (95 % CI 0·71, 0·93). However, this association was attenuated following multivariable adjustment; 0·92 (95 % CI 0·80, 1·06). Similar results were observed for consumption of flavan-3-ols, proanthocyanidins and anthocyanins. Flavonols, flavanones and flavones were not associated with all-cause mortality in any model. Despite null associations at the compound level and select foods, higher consumption of red wine, tea, peppers, blueberries and strawberries, was associated with reduced risk of total and cause-specific mortality. These findings support the rationale for making food-based dietary recommendations.

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