Change in habitual intakes of flavonoid-rich foods and mortality in US males and females

Abstract

Background Higher baseline intakes of flavonoid-rich foods and beverages are associated with a lower risk of chronic disease and mortality in observational studies. However, associations between changes in intakes and mortality remain unclear. We aimed to evaluate associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a composite measure (termed the ‘flavodiet’) of foods and beverages that are known to be main contributors to flavonoid intake and subsequent total and cause-specific mortality. Methods We evaluated associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a novel ‘flavodiet’ score and total and cause-specific mortality. We included 55,786 females from the Nurses’ Health Study (NHS) and 29,800 males from the Health Professionals Follow-up Study (HPFS), without chronic disease at baseline in our analyses. Using multivariable-adjusted Cox proportional hazard models, we examined associations of 8-year changes in intakes of (1) flavonoid-rich foods and (2) the flavodiet score with subsequent 2-year lagged 6-year risk of mortality adjusting for baseline intakes. Data were pooled using fixed-effects meta-analyses. Results We documented 15,293 deaths in the NHS and 8988 deaths in HPFS between 1986 and 2018. For blueberries, red wine and peppers, a 5%, 4% and 9% lower risk of mortality, respectively, was seen for each 3.5 servings/week increase in intakes while for tea, a 3% lower risk was seen for each 7 servings/week increase [Pooled HR (95% CI) for blueberries; 0.95 (0.91, 0.99); red wine: 0.96 (0.93, 0.99); peppers: 0.91 (0.88, 0.95); and tea: 0.97 (0.95, 0.98)]. Conversely, a 3.5 servings/week increase in intakes of onions and grapefruit plus grapefruit juice was associated with a 5% and 6% higher risk of total mortality, respectively. An increase of 3 servings per day in the flavodiet score was associated with an 8% lower risk of total mortality [Pooled HR: 0.92 (0.89, 0.96)], and a 13% lower risk of neurological mortality [Pooled HR: 0.87 (0.79, 0.97)], after multivariable adjustments. Conclusions Encouraging an increased intake of specific flavonoid-rich foods and beverages, namely tea, blueberries, red wine, and peppers, even in middle age, may lower early mortality risk.

Winemaking: “With One Stone, Two Birds”? A Holistic Review of the Bio-Functional Compounds, Applications and Health Benefits of Wine and Wineries’ By-Products

“…Moreover, in another follow-up of the Nurses' Health Study, Nurses' Health Study II and Health Professionals Follow-Up Study, it was also proposed that in these three prospective cohorts, alcohol consumption was associated with reduced risk of pituitary adenoma, compared to almost no consumption of alcohol [165]. In another very recent follow-up study of the Nurses' Health Study and the Health Professionals Follow-Up Study, it was also proposed that encouraging an increased intake of specific flavonoid-rich foods and beverages, including tea and red wine, even in middle age, may lower early mortality risk [166] However, all these effects seem primarily to be associated with the amount of alcohol consumed, while the role of the different alcoholic beverages and of their minor components in this regard is in fact not clearly defined. It seems that the effect of alcohol consumption on cancer and health in general is far more complex, while the type of alcoholic beverage, the quantity consumed and the frequency of consumption (Supplementary Tables S1 and S2), as well as the type of cancer and the overall personalised health status and genetic profile of each individual, seem to also play a significant role in these contradictory associations.…”

“…Wine differs from other alcoholic beverages and its moderate consumption not only does not increase the risk of chronic degenerative diseases but is also associated with health benefits particularly when included in a Mediterranean diet model. Moreover, it is worth mentioning that follow-ups of such epidemiological studies [126,[164][165][166] and several other studies and especially interventions and clinical trials have outlined that adherence to a moderate wine consumption pattern provides antitumour protection against several types of cancer (Supplementary Table S2).…”

Hibiscus acetosella: An Unconventional Alternative Edible Flower Rich in Bioactive Compounds

“…Organic acids and phenolic compounds were identified, mainly the flavonoid derivatives of myricetin, quercetin, and kaempferol and the anthocyanins of delphinidin and cyanidin. Intaking of flavonoid-rich foods and beverages lowers the risk of chronic disease and mortality in supervision studies, as demonstrated by converging evidence from in vitro and clinical studies [ 33 , 34 ].…”

Alcohol, health loss and mortality: can wine really save the good name of moderate alcohol consumption?

“…78 These compounds could be responsible for the health -promoting properties of wine. A study by Bondonno et al, 88 including 55 786 women from the Nurses' Health Study and 29 800 men at a high cardiovascular risk, compared the Mediterranean diet (allowing, eg, for wine consumption in habitual drinkers ≥7 glasses/week with meals) supplemented with extra -virgin olive oil or nuts with a low -fat diet. After 4.8 years of observation, the individuals assigned to the Mediterranean diet had by 30% (HR, 0.7; 95% CI, 0.55-0.89) lower risk of major cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes).…”