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Flavonoid Intake and Mortality: A Prospective Study

11/26/2019 4:37:25 PM
flavonoidA higher intake of fruits and vegetables is associated with a lower risk of cardiovascular disease (CVD), cancer, and all-cause mortality. Many of the benefits of fruits and vegetables are attributable to the flavonoids they contain. Flavonoids are known to have antioxidant and anti-inflammatory effects that benefit overall health.
Short-term clinical trials have shown that flavonoids improve biomarkers of CVD risk. Observational studies suggest that flavonoids may offer more protection to people with lifestyle habits that put them at risk of disease than to people already living a healthy lifestyle. In a prospective cohort study that was published in Nature Communications in 2019, researchers investigated the associations between dietary flavonoid intake and deaths related to CVD, cancer, or any cause.

Study examines flavonoid intake and health

The prospective study involved 56,048 Danish citizens enrolled in the Danish Diet Cancer and Health Cohort. Participants were an average age of 56 at the time of enrollment. They completed a food-frequency questionnaire at baseline to determine flavonoid intake. Over 23 years of follow-up, there were 14,083 deaths in the cohort.
Results showed an inverse relationship between dietary intake of flavonoids and all-cause mortality with the highest tertile of flavonoids associated with a 17% reduction in all-cause mortality. Reduction in mortality remain constant with higher flavonoid intakes, suggesting a plateau at intakes beyond 500 mg per day. The same pattern was seen for CVD-related mortality. For cancer-related mortality, an inverse association between flavonoid intake and mortality plateaued beyond 1000 mg per day.

Higher flavonoid intake associated with lower mortality

The associations between flavonoid consumption and mortality were stronger in smokers than nonsmokers and stronger in people who consumed higher amounts of alcohol (> 20 grams per day) than lower. In these subgroups, the benefits of flavonoid consumption extended up to 1000-2000 mg per day.
Although the authors had hypothesized that the benefits of flavonoid consumption would also be more pronounced in obese participants because of increased inflammation and oxidative stress, the results showed otherwise. The association between flavonoid intake and mortality was weaker in obese participants than in those who were overweight or a healthy weight.
The information learned from this study is instantly applicable to the everyday practice of healthcare.  An intake of 500 mg of flavonoids can be achieved by eating one orange, one apple, one cup of blueberries, half a cup of broccoli, and a cup of tea. Higher intakes of flavonoids from plant foods should be advised for those who smoke or drink higher amounts of alcohol.
Bondonno NP, Dalgaard F, Kyrø C et al. Flavonoid intake is associated with lower mortality in the Danish Diet Cancer and Health Cohort. Nat Commun. 2019; 10: 3651.