Dietary patterns and food availability differ greatly between regions and countries around the world. As a result, there is a large variability in the intake of total flavonoids and flavonoid subclasses, and subsequently in their major food sources. However, we need to be aware of certain methodological issues when we compare studies on flavonoid intake.In order to evaluate the intake of flavonoids, the different potential dietary assessment methodologies (dietary questionnaires and biomarkers) will be presented. Advantages and limitations of using of the two main food composition databases on flavonoids (US Department of Agriculture and Phenol-Explorer databases) will be discussed. The intake of total flavonoid and flavonoid subclasses in the various studies around the world will be comprehensively reviewed. The major food sources of flavonoids by region/country will be described. The main determinants of the intake of flavonoids will be explained as well.Calculating the intake of flavonoids is the first step before estimating their potential protective effects against chronic diseases and is an essential step for developing future dietary guidelines on flavonoids.
Fruit and vegetable (F&V) intake is considered as probably protective against overall cancer risk, but results in previous studies are not consistent for thyroid cancer (TC). The purpose of this study is to examine the association between the consumption of fruits, vegetables, fruit juices and differentiated thyroid cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The EPIC study is a cohort including over half a million participants, recruited between 1991 and 2000. During a mean follow-up of 14 years, 748 incident first primary differentiated TC cases were identified. F&V and fruit juice intakes were assessed through validated country-specific dietary questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models adjusted for potential confounding factors. Comparing the highest versus lowest quartile of intake, differentiated TC risk was not associated with intakes of total F&V (HR: 0.89; 95% CI: 0.68-1.15; p-trend = 0.44), vegetables (HR: 0.89; 95% CI: 0.69-1.14; p-trend = 0.56), or fruit (HR: 1.00; 95% CI: 0.79-1.26; p-trend = 0.64). No significant association was observed with any individual type of vegetable or fruit. However, there was a positive borderline trend with fruit juice intake (HR: 1.23; 95% CI: 0.98-1.53; p-trend = 0.06). This study did not find any significant association between F&V intakes and differentiated TC risk; however a positive trend with fruit juice intake was observed, possibly related to its high sugar content.
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