Flavonoids and cardiovascular health -
The details of the Danish Diet, Cancer, and Health study, its procedures and population characteristics, have been reported elsewhere [ 17 ].
Briefly, between and , 57, male and female adults, aged 50—64 years old, who lived in the Copenhagen and Aarhus areas of Denmark were enrolled into this cohort [ 17 ]. Blood samples, anthropometric measures and medical history were obtained at study entry as were data on diet and lifestyle.
The study was approved by the Danish Data Protection Agency Ref no I-Suite nr: , VD and all participants provided informed consent. Requests to access the dataset may be sent to the Diet, Cancer and Health Steering Committee at the Danish Cancer Society. Habitual dietary intake was estimated using a item food frequency questionnaire FFQ which was specifically designed and validated to assess food consumption in Denmark [ 18 , 19 ].
Daily average intakes of nutrients and flavonoids were estimated from the FFQ using the software programme FoodCalc and the Phenol-Explorer food composition database, as described previously [ 16 , 17 , 20 , 21 ].
Briefly, intakes of individual nutrients and flavonoid compounds were calculated by multiplying the frequency of consumption of relevant foods by their nutrient and flavonoid contents for pre-specified portion sizes. Total flavonoid intake was estimated by the summation of all subclasses.
Danish nationwide registries were used to identity and record cases of IHD, classified until according to the International Classification of Diseases ICD 8 th revision ICD-8 and thereafter, according to the 10th revision ICD [ 22 ]. The primary outcome was defined as all first-time IHD events IHD-coded hospitalizations and deaths using ICD codes I20—I25 and ICD-8 codes Unknown deaths which may or may not be IHD-related-related were not considered in the primary outcome.
Hospitalizations for IHD were extracted from The Danish National Patient Register, a national collection of hospital discharge information, and death data was obtained from The Danish Register of Causes of Death. To verify the registry-based outcomes, we re-examined associations only using cases that have been previously medically reviewed and validated for first-time acute myocardial infarction ICD I21 , with a follow-up time frame of 19 years between February and April [ 24 ].
Information on lifestyle factors and medical history including sex, age, anthropometry, physical activity, education, smoking habits, alcohol consumption, medication use and diet were obtained from the baseline assessment.
For hypertension and diabetes mellitus, self-reported data were used due to the underreporting of these diagnosis in the Danish National Patient Register DNPR [ 23 ]. Comorbidities of peripheral artery disease, ischemic stroke, chronic kidney disease, chronic obstructive pulmonary disease, and atrial fibrillation were identified by ICD codes dated prior to enrollment Supplementary Table 1.
The association between flavonoid intake exposures and IHD risk was modeled using restricted cubic splines within Cox proportional hazards models. Time-to-event was calculated for each participant from enrollment until the end of follow-up August, , an IHD event, death, or emigration loss to follow-up [0.
Given the etiological focus, all deaths were censored rather than treated as a competing risk [ 25 ]. Proportional hazards assumptions were tested by visually inspecting log-log plots of the survival function versus time, with no violation found.
Analyses stratified by smoking status were additionally adjusted for pack-years of smoking duration in the relevant sub-group. During a median [IQR] of A total of 11, participants died from causes other than IHD and without a prior diagnosis of IHD.
The median age at baseline was 56 years, females constituted Participants with higher flavonoid intakes tended to smoke less, exercise more, maintain a lower BMI, and have a higher education and income. Those consuming more flavonoids also tended to eat more fish, fiber, whole-grain products, fruits, and vegetables, and eat less red and processed meat Table 1.
For intakes of total flavonoids beyond quintile 1, we observed a trend towards a lower risk of IHD, however this was not significant in models adjusted for demographics and lifestyle characteristics Model 2; Table 2 ; Fig. Hazard ratios are based on Cox proportional hazards models adjusted for age, sex, BMI, smoking status, physical activity, alcohol intake, education, socioeconomic status income , aspirin use, antihypertensive medication use and statin use and are comparing the specific level of flavonoid intake horizontal axis to the median intake for participants in the lowest intake quintile.
Using only validated first-time cases, participants were hospitalized or died from acute myocardial infarction. Although a lower risk of IHD was seen for higher intakes of total flavonoids, the association was not significant Model 2; Supplementary Fig. Stratified by sex, and after adjustment for demographic and lifestyle factors, higher total flavonoid intake was significantly associated with lower IHD risk in males but not females Model 2; Supplementary Table 2.
However, with additional adjustment for dietary confounders, no significant association was present in either sex Model 3; Supplementary Table 2.
When models were further adjusted for dietary covariates there was no compelling evidence of a lower IHD risk in either sex, with higher intakes, of any subclass Model 3; Supplementary Table 2. Stratified by smoking status, and after adjustment for demographic and lifestyle factors, higher total flavonoid intakes were significantly associated with lower IHD risk in ever-smokers but not never-smokers Model 2; Supplementary Table 3.
However, following additional adjustment for dietary confounders, a significant lower risk of IHD was not seen in ever-smokers nor never-smokers Model 3; Supplementary Table 3.
Of the individual flavonoid subclasses, among those who had never smoked, no significant inverse associations were seen Model 2; Model 3; Supplementary Table 3. In this prospective cohort study, of 54, Danish adults, aged 50—64 years, who were followed for up to 23 years, we did not observe clear associations between intakes of total flavonoids or flavonoid subclasses with IHD risk.
Nor did we observe compelling evidence of effect modification by sex, such that higher flavonoid intakes associated with lower IHD risk in one sex, but not the other. Thus, while the findings do not support a strong benefit of flavonoid intake on IHD risk, they also do not exclude the possibility that flavonoids may have a modest protective role in IHD, particularly for current or former smokers.
It is of particular relevance that we have observed in our previous investigations of the relationship between flavonoid intake and CVD in the Danish, Diet, Cancer and Health Study, that higher intakes of flavonoids was clearly associated with a lower risk of total atherosclerotic CVD and, more specifically, peripheral artery disease and ischemic stroke in the total population [ 14 , 15 , 16 ].
This suggests that the observed associations between flavonoid intake and IHD risk may be a consequence of differing underlying dietary patterns. Given our promising prior results, and the common etiology of atherosclerosis in CVD, it is thus surprising that the present analysis did not find clear evidence of associations between flavonoids and IHD.
Similar seemingly disparate findings have previously been observed. For example, in the Health Professionals Follow-Up study, higher flavanone consumption strongly associated with a lower risk of stroke but not myocardial infarction, and in the NutriNet-Santé Cohort, higher intakes of flavonols and catechins were associated with a lower risk of stroke but not coronary heart disease [ 27 , 28 ].
The reasons for the differing results between CVD types are less certain, yet may allude to differences in the underlying pathology and the relative contributions of flavonoids on these pathologies.
Ischemic stroke, PAD and IHD are often discussed as diseases of the same entity: atherosclerotic arterial disease. The pathophysiology of these diseases involve many common risk pathways, but it is possible that inflammation, hyperlipidaemia and hypertension, along with other risk factors, contribute differentially to atherosclerosis of the cerebral, coronary and peripheral vascular beds.
In fact, growing evidence does suggest a heterogeneous impact of atherosclerotic risk factors on different vascular regions.
Several cohort studies have reported higher blood pressure is a stronger predictor of ischemic stroke than IHD and that elevated blood lipids appear to play a more important role in the development of IHD than ischemic stroke [ 29 , 30 , 31 ].
Consequently, the effect of reducing blood pressure or blood lipids may be more pronounced on the CVD type with which the risk factor is more strongly associated [ 32 ]. For flavonoids, the evidence to date appears to indicate a stronger anti-hypertensive action, than hypo-lipidemic action [ 8 , 13 ].
As a result, the habitual intake of flavonoids may more strongly associate with ischemic stroke than IHD, which could explain our limited findings. A growing body of data also reports hypercoagulability is a stronger risk factor for ischemic stroke than for myocardial infarction [ 33 ].
Flavonoids appear to modulate key events in the pathogenesis of thrombosis via multiple mechanisms, such as reducing platelet activation, enhancing NO production and blocking TxA 2 receptors [ 34 ]. As such, the anti-thrombotic activities of flavonoids may be further contributing to divergent associations among CVD types.
It is also known, that even though IHD, cerebrovascular disease, and PAD all share atherogenic pathophysiology, the mechanisms underlying the occurrence of acute events largely differ.
Indeed, while progressive stenosis of carotid and of peripheral arteries primarily account for non-cardio-embolic ischemic strokes and for symptomatic PAD, most acute coronary syndromes are caused by atherosclerotic plaque ruptures at sites with only mild arterial narrowing [ 35 ].
It has been shown that coronary atherosclerotic plaque morphology is a more important prognostic factor for acute cardiac events than the degree of stenosis, with most events occurring in plaques with a phenotype characterized by a thin-cap fibroatheroma and a large plaque burden [ 36 ].
Therefore, the impact of flavonoids may address diseases in which the degree of arterial stenosis represents a stronger pathophysiological component. In contrast to the results of our study, among previous cohort investigations of flavonoids, their subclasses and IHD, significant inverse associations have been observed [ 7 ].
Indeed, other cohort studies have observed evidence for a benefit of intake of certain subclasses on IHD risk, but not for cerebrovascular disease [ 37 , 38 ]. These findings are difficult to reconcile, yet may be due to one or more underlying, unidentified, clinical e.
Indeed, we saw significant beneficial associations for all subclasses and total flavonoid intake in models adjusted for age and sex, but when socio-demographic data was added, nearly all these associations became statistically non-significant.
It may therefore be, that the present study may not have failed to reproduce previously identified associations, instead the previous studies may have failed to identify all relevant confounders as well as the current investigation. Indeed, we found evidence of effect modification by smoking status, which is likely of consequence when examining results of different cohort studies.
In the present study, we observed effect modification by smoking status. The association between flavonoid intake and IHD was present in ever-smokers but not never-smokers.
This is of note as in our previous studies of flavonoid intake and disease risk in the Danish Diet Cancer and Health cohort, those diseases for which smoking is a more influential risk factor, have all been more strongly associated with flavonoid intake.
This extends to peripheral artery disease [ 15 ], abdominal aortic aneurysm [ 15 ], and chronic obstructive pulmonary disease [ 39 ]. There are several intriguing explanations for these observations. With regards to IHD specifically, cigarette smoking increases the risk at least partly through increasing systemic thrombotic propensity, oxidative stress and inflammation—mechanisms which appear attenuated via flavonoid intake [ 34 , 40 , 41 ].
Despite this, we have previously shown that smokers consuming high flavonoids still have a much higher risk of CVD than non-smokers consuming low flavonoids [ 14 ]. As such, public health campaigns for the primary prevention of IHD should prioritize smoking cessation. This study has several limitations.
While the cohort had a long follow up period, a high number of IHD cases, and complete data available on most participants, the assessment of demographics, lifestyle, and health habits at baseline alone means that we were unable to account for changes during follow-up.
The methods of dietary assessment also lessen our certainty of the findings and further observational studies using biomarkers of flavonoid intake would be beneficial to determine if an association with IHD is seen using objective measures [ 42 ].
To this end, while Phenol Explorer represents the current state of the art for flavonoid-food composition databases, it is thought that this database will continue to be refined, and in years to come, more complete composition data, may become available; in this instance, updated analyses, testing our initial hypotheses, may be of value.
It should be noted that several recent meta-analyses indicate higher intakes of flavonols, anthocyanins and flavanols are associated with lower IHD risk, and as such, we cannot rule out a potential beneficial relationship [ 11 , 12 , 13 ]. Indeed, in this population, tea, chocolate, wine, apples and pears appear to drive flavonoid intake, which is similar to other European and Western Countries, including the United States and Australia [ 6 , 43 , 44 ].
Even so, elucidating the impact of flavonoids on IHD via observational studies restricts our ability to infer causality or exclude the possibility of confounding. Moreover, the number of exposure-outcome combinations tested in our analysis increases the possibility of spurious findings. To this end, we did observe that females appeared to be at higher IHD risk with higher anthocyanin intakes, which we contend is unlikely.
Although, this association may have arisen due to residual confounding from higher intakes of certain anthocyanin-bearing foods or beverages, which are not necessarily healthy when consumed in excess quantities, such as red wine or cordial-like fruit squash.
Finally, considering the Danish population is more homogeneous than many other countries, the results of the present analysis may only be generalizable to other populations of similar age, race, health status and socioeconomic standing. In conclusion, we did not observe clear associations between higher intakes of total flavonoids or flavonoid subclasses and lower IHD risk.
However, we did observe a lower risk of IHD with higher intake of certain flavonoid subtypes among ever-smokers and thus we cannot rule out a benefit of flavonoid intake, especially among specific sub-groups at higher risk of atherosclerosis.
These findings warrant additional research to further clarify the association between habitual dietary flavonoid intake and IHD. The data that support the findings of this study are available from Diet, Cancer and Health Steering Committee at the Danish Cancer Society but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available.
Barquera S, Pedroza-Tobías A, Medina C, Hernández-Barrera L, Bibbins-Domingo K, Lozano R, et al. Global overview of the epidemiology of atherosclerotic cardiovascular disease.
Arch Med Res. Article Google Scholar. Yuyun MF, Sliwa K, Kengne AP, Mocumbi AO, Bukhman G. Cardiovascular diseases in sub-saharan Africa compared to high-income countries: An epidemiological perspective. Glob Heart. Libby P, Theroux P.
Pathophysiology of coronary artery disease. Davies MJ. The pathophysiology of acute coronary syndromes. Article CAS Google Scholar. Del Rio D, Rodriguez-Mateos A, Spencer JPE, Tognolini M, Borges G, Crozier A. Dietary poly phenolics in human health: Structures, bioavailability, and evidence of protective effects against chronic diseases.
Antioxid Redox Signal. Parmenter BH, Croft KD, Cribb L, Cooke MB, Bondonno CP, Lea A, et al. Higher habitual dietary flavonoid intake associates with lower central blood pressure and arterial stiffness in healthy older adults. Br J Nutr. Parmenter BH, Croft KD, Hodgson JM, Dalgaard F, Bondonno CP, Lewis JR, et al.
An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk. Food Funct. Hooper L, Kroon PA, Rimm EB, Cohn JS, Harvey I, Le Cornu KA, et al.
Flavonoids, flavonoid-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials. Am J Clin Nutr. Maleki SJ, Crespo JF, Cabanillas B Anti-inflammatory effects of flavonoids.
Food Chem. Lilamand M, Kelaiditi E, Guyonnet S, Antonelli Incalzi R, Raynaud-Simon A, Vellas B, et al. Flavonoids and arterial stiffness: Promising perspectives.
Nutr Metab Cardiovasc Dis. 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. Huxley RR, Neil HAW. The relation between dietary flavonol intake and coronary heart disease mortality: a meta-analysis of prospective cohort studies.
Eur J Clin Nutr. Raman G, Avendano EE, Chen S, Wang J, Matson J, Gayer B, et al. Dietary intakes of flavanols and cardiometabolic health: systematic review and meta-analysis of randomized trials and prospective cohort studies.
Parmenter BH, Dalgaard F, Murray K, Cassidy A, Bondonno CP, Lewis JR, et al. Habitual flavonoid intake and ischemic stroke incidence in the Danish Diet, Cancer, and Health Cohort. Bondonno NP, Murray K, Cassidy A, Bondonno CP, Lewis JR, Croft KD, et al.
Higher habitual flavonoid intakes are associated with a lower risk of peripheral artery disease hospitalizations. Dalgaard F, Bondonno NP, Murray K, Bondonno CP, Lewis JR, Croft KD, et al. Associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort study.
Lancet Planet Heal. Tjønneland A, Olsen A, Boll K, Stripp C, Christensen J, Engholm G, et al. Study design, exposure variables, and socioeconomic determinants of participation in Diet, Cancer and Health: A population-based prospective cohort study of 57, men and women in Denmark.
Scand J Public Health. Overvad K, Jønneland AT, Haraldsdóttir J, Ewertz M, Jensen OM. Development of a semiquantitative food frequency questionnaire to assess food, energy and nutrient intake in Denmark. Int J Epidemiol. Jønneland AT, Overvad K, Haraldsdóttir J, Bang S, Ewertz M, Jensen OM.
Validation of a semiquantitative food frequency questionnaire developed in Denmark. Bondonno NP, Dalgaard F, Kyrø C, Murray K, Bondonno CP, Lewis JR, et al. Flavonoid intake is associated with lower mortality in the Danish Diet Cancer and Health Cohort. Nat Commun. Neveu V, Perez-Jiménez J, Vos F, Crespy V, du Chaffaut L, Mennen L, et al.
Phenol-Explorer: an online comprehensive database on polyphenol contents in foods. Lynge E, Sandegaard JL, Rebolj M. The Danish National Patient Register. Schmidt M, Schmidt SAJ, Sandegaard JL, Ehrenstein V, Pedersen L, Sørensen HT. The Danish National patient registry: a review of content, data quality, and research potential.
Clin Epidemiol. Hansen CP, Overvad K, Tetens I, Tjonneland A, Parner ET, Jakobsen MU, et al. Adherence to the Danish food-based dietary guidelines and risk of myocardial infarction: a cohort study. Public Health Nutr. Noordzij M, Leffondré K, Van Stralen KJ, Zoccali C, Dekker FW, Jager KJ.
When do we need competing risks methods for survival analysis in nephrology? Nephrol Dial Transpl. R Core Team. R: a language and environment for statistical computing. Adriouch S, Lampuré A, Nechba A, Baudry J, Assmann K, Kesse-Guyot E, et al. Prospective association between total and specific dietary polyphenol intakes and cardiovascular disease risk in the Nutrinet-Santé French Cohort.
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. Leening MJG, Cook NR, Franco OH, Manson JAE, Lakshminarayan K, LaMonte MJ, et al. Comparison of cardiovascular risk factors for coronary heart disease and stroke type in women.
J Am Heart Assoc. Stoekenbroek RM, Matthijs Boekholdt S, Luben R, Kees Hovingh G, Zwinderman AH, Wareham NJ, et al. Heterogeneous impact of classic atherosclerotic risk factors on different arterial territories: the EPIC-Norfolk prospective population study.
Eur Heart J. Everett BM, Kurth T, Buring JE, Ridker PM. The relative strength of C-reactive protein and lipid levels as determinants of ischemic stroke compared with coronary heart disease in women.
Flavanones were inversely associated with a borderline significantly lower risk and anthocyanidins with a significantly lower risk of cardiovascular disease mortality in this cohort. In summary, in the three prospective cohorts in which flavonol and flavone intakes and total cardiovascular mortality were examined Iowa, 77 Kuopio, 78 WHS 80 , there was no observed relationship between these intakes and death from cardiovascular disease.
However, the flavanones and anthocyanidins were significantly associated with lower risk of cardiovascular disease mortality in a recent analysis of the Iowa cohort. The relationship between flavonoid intakes and coronary heart disease incidence either as nonfatal or nonfatal and fatal disease combined was investigated in 11 studies.
Higher intakes were nonsignificantly associated with lower incidence of coronary heart disease. In contrast, there were no observed associations between intakes of either the flavonols individually kaempferol, myricetin, quercetin or the flavonol and flavone classes combined and coronary heart disease incidence in the HPFS cohort Rimm 79 of US men after 6 years of follow-up.
Other flavonoid classes. No prospective cohort studies were available on nonfatal coronary heart disease and the other five classes of flavonoids. In summary, three of the four cohorts 65 , — 79 that examined flavonoid intakes and nonfatal coronary heart disease were null for flavonols and flavones.
Only one study 69 reported a protective association with the flavonol plus flavones classes combined. Nine studies in seven cohorts 63 , — 81 examined the relationship between flavonoid intake and fatal and nonfatal coronary heart disease combined. Among elderly Dutch men in Zutphen, flavonols and flavones combined were inversely but not significantly associated with nonfatal and fatal coronary heart disease at 5 years 66 and 10 years 67 of follow-up.
In the Caerphilly study, neither quercetin a flavonol nor total flavonol intakes were associated with incident coronary heart disease after 10 years of follow-up. Similarly, no significant associations for individual flavonol and flavone compounds or flavonols plus flavones combined were found among men and women in the Finnish Turku study 76 after 10 years of follow-up, except for the flavone luteolin, which was significantly associated with lower coronary heart disease incidence.
Other flavonoid classes flavanols, isoflavones. In summary, only one cohort 76 found protective associations between flavonoid intake the flavone luteolin and lower risk of fatal and non-fatal coronary heart disease.
Nine studies from seven cohorts 63 , — 81 assessed the relationship between flavonoid intakes and both fatal and nonfatal stroke. Other flavonoid classes flavanols, flavanones, isoflavones, and anthocyanidins. In the Finnish Mobile Clinic cohort, 74 in addition to the flavonol kaempferol, as noted above, the flavanone hesperetin and the flavanone naringenin as well as total intakes of flavonols, flavones, and flavanones combined were inversely and significantly associated with stroke incidence.
In summary, only three 71 , — 78 of nine studies from seven prospective cohorts 63 , — 81 reported lower risk of fatal and nonfatal stroke combined, and these inverse associations were confined to flavonols and flavones , and flavanones and flavonols and flavones.
Three studies from two cohorts examined hemorrhagic stroke. No association was seen between intake of the flavonols quercetin 72 , 74 and myricetin 74 and incident hemorrhagic or ischemic stroke. Other flavonoid classes flavanones. In summary, only one 74 of the three studies of two cohorts 70 , — 74 that examined flavonoid intakes in relation to hemorrhagic or ischemic stroke incidence found a significant association with intakes of the flavonol kaempferol, the flavanones hesperetin and naringenin, and the flavanones, flavonols, and flavones combined and a lower risk of ischemic stroke.
Studies of only two cohorts WHS 80 and Dutch EPIC 81 examined the relationship between flavonoids and cardiovascular disease incidence, and no associations were found in either cohort. They found no associations between total intakes of flavonols and flavones or the individual compounds quercetin, kaempferol, myricetin, apigenin, luteolin and cardiovascular disease incidence.
Other flavonoid classes isoflavones. In summary, the limited data on associations between flavonoids and cardiovascular disease incidence were null. Intakes of flavonoids, particularly of the flavonol and flavone classes, were associated with lower cardiovascular disease mortality and incidence in 8 of the 20 prospective studies reviewed 6 of 12 cohorts , although the results were not entirely consistent for any particular flavonoid class or compound Table 4.
The associations between flavonoid consumption and non-fatal cardiovascular disease were weaker, but there were fewer studies of these outcomes. The present review of existing cohort studies of flavonoid intake and cardiovascular disease risk in Europe and the United States provides some, albeit limited, evidence that certain flavonoids are related to lower risk of mortality from coronary heart disease.
What was strikingly apparent in this review was the need for greater uniformity regarding a number of study factors before definitive conclusions can be drawn. Comparisons among the studies included in this review of European and US cohorts were complicated by variability in the study designs, including the flavonoid classes assessed, the dietary assessment tools used, the population characteristics such as age, sex, and health status , the cardiovascular endpoints chosen, and the length of follow-up.
Although there are many putative biological mechanisms underlying a possible cardioprotective role for flavonoids, , including antioxidant, 16 , — vasodilatory, , — antithrombotic, 23 , — anti-inflammatory, 19 , — and endothelial protective 23 , — properties of some of the compounds, the effects of the flavonoids appear to vary from compound to compound within each class, rather than being inherent in all compounds in each of the several classes.
Because the flavonoids are very diverse in their physiochemical properties lipophilicity, polarity, etc. as well as very different in their bioavailability and bioactivity such as antioxidant capacity or binding at receptor sites , the rationale for assuming that exposures to all flavonoid classes might have effects on cardiovascular disease needs more consideration.
At present, the evidence that flavonoid classes or compounds have an impact on cardiovascular disease relies chiefly on in vitro 12 , — 14 and animal studies. Differences between compounds within each class may be significant.
The associations between flavonoid intakes and coronary heart disease mortality in the studies reviewed were strongest for the flavonol class. These results support the findings of a prior meta-analysis of flavonol intakes and coronary heart disease mortality that covered six 67 , — 82 of the eight prospective cohorts 67 , — 82 included here.
Among the studies reviewed here, protective associations for the flavanones or anthocyanidins against coronary heart disease mortality were somewhat stronger in a recent study 77 that used more complete food flavonoid composition tables. In contrast to findings for coronary heart disease mortality, only 1 of the 11 studies 63 , — 81 of coronary heart disease incidence among the nine cohorts was statistically significant, and that finding was solely for the flavone luteolin.
Unlike the positive findings for reduced risk of coronary heart disease mortality, three studies from two cohorts 63 , — 82 of stroke mortality were null.
However, three 71 , — 78 of the nine studies seven cohorts of stroke incidence 63 , — 81 reported some associations between greater consumption of flavonols and flavones , and flavanones and flavonols and flavones and reduced risk.
Total cardiovascular disease coronary heart disease and stroke combined was examined in four studies conducted in four cohorts, 77 , — 82 but only one of them 77 found significant inverse associations for flavonoids, specifically for intakes of flavanones or anthocyanidins and cardiovascular mortality.
The inconsistencies across the epidemiologic studies that were evident in this review complicated interpretation. Differences in exposure assessment were many due to varied dietary assessment instruments and incompleteness of the flavonoid food composition databases used , making comparisons between studies difficult.
Errors of exposure measurement were due in large part to the lack of analytic values for specific foods and flavonoid classes. The more recent studies 77 , 78 assessed more flavonoid classes, taking advantage of the newer flavonoid analytic techniques and flavonoid food data that have resulted in more comprehensive flavonoid databases.
Additional errors in exposure assessment may have arisen from underestimates of flavonoid content due to the use of food frequency questionnaires that grouped several foods together into a single category such as melons grouped with berries in early food intake studies. Although food frequency questionnaires may have limitations for assessing intakes of flavonoids, they are widely used in epidemiologic studies of the type reviewed here.
In the future, the use of food frequency questionnaires that are constructed to target flavonoid food sources more precisely may provide better information on flavonoid intakes and cardiovascular outcomes.
Biomarkers of intakes were not used in the studies reviewed. Although there have been several recent studies of flavonoid biomarkers , — and several studies validating isoflavone intakes, , — very few studies , — validating other flavonoids have been done that examined blood or urine samples for biomarkers.
Earlier investigations were probably too imprecise to uncover consistent statistically significant associations with cardiovascular endpoints if they were present. Comparisons across studies were also challenging because of differences in the age, sex, and health status of the populations, the length of follow-up, and the cardiovascular endpoints studied.
In most studies, diet was assessed only once, so diet consistency over time could not be measured or accounted for in the analyses. Eight of the studies included less than cases, 63 , — 78 thereby limiting statistical power.
The European and US cohorts in the studies reviewed appeared to be quite similar in their flavonoid intakes. While explorations of the associations between intakes of isoflavones or other flavonoids in Asian diets and cardiovascular disease outcomes in Asian populations were beyond the scope of the present review, they also deserve attention.
High levels of specific flavonoids, such as those observed in Asian cohorts or in studies of populations with greater intakes of these and other flavonoids e.
The studies reviewed here were primarily conducted in cohorts of older men and women who may have had advanced cardiovascular disease already. If the effects of the flavonoids occur earlier in the disease process, younger study populations might be more suitable.
Additional research is warranted on flavonoid and cardiovascular disease prevention and survival, since several flavonoids, including the anthocyanins, flavones, flavanols, and proanthocyanidins may have blood pressure-lowering effects 2 , — and may have beneficial effects on other cardiovascular disease risk factors as well.
Thus, the potential for confounding by other nutrients and bioactive compounds exists. It is, therefore, not known, based on the existing literature, whether flavonoid supplements in larger doses are safe , — or would afford meaningful protection. In spite of the limitations of many of the existing studies, particularly the earlier studies, evidence is building that some flavonoid classes flavonols, anthocyanidins, flavanones, and possibly flavanols appear to be associated with lower coronary heart disease mortality in these European and US cohorts.
Randomized controlled trials for the effects of flavonoid-containing foods on cardiovascular disease outcomes would be difficult and perhaps impractical to conduct, although studies of their effects on surrogate markers may be possible.
The flavanones and flavonols were also inversely related to stroke incidence in three out of seven cohorts. The overall findings from these cohorts suggest, but do not prove, that higher flavonoid consumption may be associated both with primary prevention of cardiovascular disease and, perhaps even more so, with a lower risk of cardiovascular disease mortality.
There is intriguing but not yet compelling evidence from European countries and the United States that relatively small amounts of certain of the dietary flavonoids may lower risk of coronary heart disease mortality.
More research is needed to establish that these bioactive compounds have cardiovascular effects and, if they prove to be protective, what consumption levels may be required to achieve health benefits. Future studies are needed that allow for more direct comparison of research findings using more complete and comprehensive flavonoid databases, more standardized and comprehensive dietary assessment methods, more information on the age, sex, health status, and other characteristics of populations studied, more complete cardiovascular outcome measures, and longer lengths of follow-up that will allow for more direct comparisons of research findings.
Funding and sponsorship. This work was supported in part with resources from the NIH's National Heart, Lung and Blood Institute grant R21HL PJ, JD, JP and the US Department of Agriculture Cooperative State Research, Education, and Extension Service grant , and the US Department of Agriculture, Agricultural Research Service, under agreement no.
Any opinions, findings, conclusions, or recommendations expressed in this article are those of the authors and do not necessarily reflect the view of the US Department of Agriculture. Declaration of interest.
The authors have no relevant interests to declare. JP did the data collection, interpretation, analysis as well as the writing.
JD participated fully in the writing of the article. PJ and MM participated in the writing and critical review of the manuscript. No other individuals were involved in writing and producing this article. Crozier A Jaganath IB Clifford MN.
Dietary phenolics: chemistry, bioavailability and effects on health. Nat Prod Rep. Google Scholar. Habitual intake of flavonoid subclasses and incident hypertension in adults. Am J Clin Nutr.
Chun OK Chung SJ Song WO. Estimated dietary flavonoid intake and major food sources of U. J Nutr. Fink BN Steck SE Wolff MS Kabat GC Gammon MD. Construction of a flavonoid database for assessing intake in a population-based sample of women on Long Island, New York.
Nutr Cancer. Dietary intake and major food sources of polyphenols in Finnish adults. Dietary intake of polyphenols in French adults. Song WO Chun OK. Tea is the major source of flavanol and flavonol in the U. Estimation of dietary sources and flavonoid intake in a Spanish adult population EPIC-Spain.
J Am Diet Assoc. Comparative effects of quercetin and its predominant human metabolites on adhesion molecule expression in activated human vascular endothelial cells.
Anthocyanin attenuates CDmediated endothelial cell activation and apoptosis by inhibiting CDinduced MAPK activation. Anthocyanin prevents CDactivated proinflammatory signaling in endothelial cells by regulating cholesterol distribution.
Arterioscler Thromb Vasc Biol. Macrophage as a target of quercetin glucuronides in human atherosclerotic arteries: implication in the anti-atherosclerotic mechanism of dietary flavonoids. J Biol Chem. Antiatherogenic effects of kaempferol and rhamnocitrin. J Agric Food Chem.
Dietary flavonoid apigenin inhibits high glucose and tumor necrosis factor alpha-induced adhesion molecule expression in human endothelial cells.
J Nutr Biochem. Arab L Liebeskind DS. Tea, flavonoids and stroke in man and mouse. Arch Biochem Biophys. Frei B Higdon JV. Antioxidant activity of tea polyphenols in vivo: evidence from animal studies.
Gandhi C Upaganalawar A Balaraman R. Free Radic Res. Karthikeyan K Bai BR Devaraj SN. Efficacy of grape seed proanthocyanidins on cardioprotection during isoproterenol-induced myocardial injury in rats.
J Cardiovasc Pharmacol. Specific dietary polyphenols attenuate atherosclerosis in apolipoprotein E-knockout mice by alleviating inflammation and endothelial dysfunction.
Anthocyanins from purple sweet potato Ipomoea batatas cultivar Ayamurasaki suppress the development of atherosclerotic lesions and both enhancements of oxidative stress and soluble vascular cell adhesion molecule-1 in apolipoprotein E-deficient mice.
Ramesh E Geraldine P Thomas PA. Regulatory effect of epigallocatechin gallate on the expression of C-reactive protein and other inflammatory markers in an experimental model of atherosclerosis.
Chem Biol Interact. Register TC. Primate models in women's health: inflammation and atherogenesis in female cynomolgus macaques Macaca fascicularis.
Am J Primatol. EGCG inhibits proliferation of cardiac fibroblasts in rats with cardiac hypertrophy. Planta Med. Cardioprotective potential of myricetin in isoproterenol-induced myocardial infarction in Wistar rats.
Phytother Res. Effects of the phytoestrogen genistein on some predictors of cardiovascular risk in osteopenic, postmenopausal women: a two-year randomized, double-blind, placebo-controlled study.
J Clin Endocrinol Metab. Effect of 6 months of exercise and isoflavone supplementation on clinical cardiovascular risk factors in obese postmenopausal women: a randomized, double-blind study. Chong MF Macdonald R Lovegrove JA.
Fruit polyphenols and CVD risk: a review of human intervention studies. Br J Nutr. Pasta naturally enriched with isoflavone aglycons from soy germ reduces serum lipids and improves markers of cardiovascular risk. Consumption of isoflavone-rich soy protein does not alter homocysteine or markers of inflammation in postmenopausal women.
Eur J Clin Nutr. Flavonoids, flavonoid-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials. Short-term effect of cocoa product consumption on lipid profile: a meta-analysis of randomized controlled trials.
Efficacy of genistein aglycone on some cardiovascular risk factors and homocysteine levels: a follow-up study. Nutr Metab Cardiovasc Dis. Inflammatory markers in a randomized soya intervention among men. Mulvihill EE Huff MW. Antiatherogenic properties of flavonoids: implications for cardiovascular health.
Can J Cardiol. Green tea catechins improve human forearm endothelial dysfunction and have antiatherosclerotic effects in smokers. Circ J. Lack of effects of isoflavones on the lipid profile of Brazilian postmenopausal women. Inhibition by soya isoflavones of human polymorphonuclear leukocyte function: possible relevance for the beneficial effects of soya intake.
Shenouda SM Vita JA. Effects of flavonoid-containing beverages and EGCG on endothelial function. J Am Coll Nutr. Soy isoflavones lower serum total and LDL cholesterol in humans: a meta-analysis of 11 randomized controlled trials.
The differential effect of the phytoestrogen genistein on cardiovascular risk factors in postmenopausal women: relationship with the metabolic status. Arts IC Hollman PC. Polyphenols and disease risk in epidemiologic studies.
Cano A Garcia-Perez MA Tarin JJ. Isoflavones and cardiovascular disease. Polyphenolic grape extract inhibits platelet activation through PECAM an explanation for the French paradox. Alcohol Clin Exp Res. Effects of cocoa flavanols on risk factors for cardiovascular disease.
Asia Pac J Clin Nutr. Higdon JV Frei B. Tea catechins and polyphenols: health effects, metabolism, and antioxidant functions. Crit Rev Food Sci Nutr. Huntley AL. The health benefits of berry flavonoids for menopausal women: cardiovascular disease, cancer and cognition.
Flavonoid-rich grapeseed extracts: a new approach in high cardiovascular risk patients? Int J Clin Pract. Selected dietary flavonoids are associated with markers of inflammation and endothelial dysfunction in U. Manach C Mazur A Scalbert A. Polyphenols and prevention of cardiovascular diseases.
Curr Opin Lipidol. Middleton E Jr Kandaswami C Theoharides TC. The effects of plant flavonoids on mammalian cells: implications for inflammation, heart disease, and cancer. Pharmacol Rev.
Dietary proanthocyanidins: occurrence, dietary intake, bioavailability, and protection against cardiovascular disease. Mol Nutr Food Res. Soy protein, isoflavones, and cardiovascular health: an American Heart Association Science Advisory for professionals from the Nutrition Committee.
The effect of the phytoestrogen genistein on myocardial protection and preconditioning in hypercholesterolemia. Cardiovasc Drugs Ther. Basu A Rhone M Lyons TJ. Berries: emerging impact on cardiovascular health. Nutr Rev. Flavonoids and heart health: proceedings of the ILSI North America Flavonoids Workshop, May 31—June 1, , Washington, DC.
Analysis of flavanols in foods: what methods are required to enable meaningful health recommendations? Rudkowska I.
Functional foods for cardiovascular disease in women. Menopause Int. Rudkowska I Jones PJ. Functional foods for the prevention and treatment of cardiovascular diseases: cholesterol and beyond. Expert Rev Cardiovasc Ther. Antioxidant effects of cocoa and cocoa products ex vivo and in vivo: is there evidence from controlled intervention studies?
Curr Opin Clin Nutr Metab Care. Recommending flavanols and procyanidins for cardiovascular health: current knowledge and future needs. Mol Aspects Med. Sies H. Polyphenols and health: update and perspectives. Steinberg FM Bearden MM Keen CL. Cocoa and chocolate flavonoids: implications for cardiovascular health.
Catechin intake might explain the inverse relation between tea consumption and ischemic heart disease: the Zutphen Elderly Study. Dietary catechins in relation to coronary heart disease death among postmenopausal women.
Inverse association of tea and flavonoid intakes with incident myocardial infarction: the Rotterdam Study. Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Hertog MG Feskens EJ Kromhout D. Antioxidant flavonols and coronary heart disease risk. Antioxidant flavonols and ischemic heart disease in a Welsh population of men: the Caerphilly Study.
Intake of flavonols and flavones and risk of coronary heart disease in male smokers. Intake of flavonoids, carotenoids, vitamins C and E, and risk of stroke in male smokers. Dietary flavonoids, antioxidant vitamins, and incidence of stroke: the Zutphen study.
Arch Intern Med. Quercetin intake and the incidence of cerebrovascular disease. Flavonoid intake and coronary mortality in Finland: a cohort study. Flavonoid intake and risk of chronic diseases.
Dietary intakes of flavonols and flavones and coronary heart disease in US women. Am J Epidemiol. Dietary and serum vitamins and minerals as predictors of myocardial infarction and stroke in elderly subjects. Flavonoid intake and cardiovascular disease mortality: a prospective study in postmenopausal women.
Flavonoid intake and the risk of ischemic stroke and CVD mortality in middle-aged Finnish men: the Kuopio Ischemic Heart Disease Risk Factor Study. Relation between intake of flavonoids and risk for coronary heart disease in male health professionals. Ann Intern Med.
Flavonoid intake and the risk of cardiovascular disease in women. Prospective study on usual dietary phytoestrogen intake and cardiovascular disease risk in Western women. Dietary flavonoid intake and risk of cardiovascular disease in postmenopausal women. Intake of specific flavonoid classes and coronary heart disease — a case-control study in Greece.
Intake of specific flavonoids and risk of acute myocardial infarction in Italy. Public Health Nutr. Willett W. Nutritional Epidemiology , 2nd ed. New York: Oxford University Press ; Google Preview.
Hertog MG. Flavonols and flavones in foods and their relation with cancer and coronary heart disease risk. PhD dissertation.
Koninklijke Bibliotheek, The Hague, Hertog MGL Hollman PCH Katan MB. Content of potentially anticarcinogenic flavonoids of 28 vegetables and 9 fruits commonly consumed in the Netherlands.
Intake of potentially anticarcinogenic flavonoids and their determinants in adults in The Netherlands. Hertog MGL Hollman PCH van de Putte B. Content of potentially anticarcinogenic flavonoids in tea infusions, wine and fruit juices. Hertog MGL Hollman PCH Venema DP. Optimization of a quantitative HPLC determination of potentially anticarcinogenic flavonoids in vegetables and fruits.
Arts ICW Hollman PCH. Optimization of a quantitative method for the determination of catechins in fruits and legumes. Arts IC van de Putte B Hollman PC. Catechin contents of foods commonly consumed in The Netherlands. Fruits, vegetables, staple foods, and processed foods.
Arts IC van De Putte B Hollman PC. Tea, wine, fruit juices, and chocolate milk. Intake of dietary phytoestrogens by Dutch women.
US Department of Agriculture. Usda Database for the Flavonoid Content of Selected Foods. Beltsville, MD: Agricultural Research Service, Nutrient Data Laboratory; Usda-Iowa State University Database on the Isoflavone Content of Foods.
Usda database for the proanthocyanidin content of selected foods. Content of the flavonols quercetin, myricetin, and kaempferol in 25 edible berries. Starke H Herrmann K. Die phenolischen Inhaltsstoffe des Obstes.
Veränderungen des Flavonolgehaltes während der Fruchtenwicklung. Changes in flavonol concentrations during fruit development]. Z Lebensm Unters Forsch. Wildanger W Herrmann K. Die Flavonole des Obstes [The phenolics of fruits. The flavonols of fruits]. Mattila P Astola J Kumpulainen J.
Determination of flavonoids in plant material by HPLC with diode-array and electro-array detections. Flavonol and flavone intakes in US health professionals. US Department of Agriculture , Agricultural Research Service. USDA Database for the Isoflavone Content of Selected Foods, Release 2.
Could a cup of tea or anc apple Flavonoidds day carxiovascular Cognitive health optimization the doctor away? Maybe not — heapth new research suggests Cognitive health optimization a diet high in flavonoids such as Circadian rhythm sleep patterns, fruits, and cruciferous vegetables Flavonoids and cardiovascular health lower your risk of heart Flavonoida. A Flavonoids and cardiovascular health study from researchers at Edith Cowan University ECU in Australia found that older women who consumed high levels of flavonoids from plant-based food sources were less likely to have extensive abdominal aortic calcification AAC. AAC happens when calcium deposits build up in your abdominal aorta, a large artery that supplies blood from your heart to your abdominal organs and lower body. People with AAC have an increased risk of cardiovascular disease, such as heart attack and stroke. The ECU study was recently published in the journal Arteriosclerosis, Thrombosis, and Vascular Biologywhich is a journal of the American Heart Association. Flavonoids are a type of plant compound found in fruits, vegetables, spices, tea, and other plant-based foods.Could a Joint mobility supplements of tea or heath apple a day really keep the doctor cardiovaacular Maybe not — but new research cardiovacular that a diet cardiovsscular in flavonoids such as tea, fruits, and cruciferous vegetables may carciovascular your risk of heart disease.
A recent study from researchers at Edith Cardiovasdular Cognitive health optimization ECU in Australia Caffeine and hair growth that older women who consumed high levels of Flzvonoids from plant-based food sources were healyh likely to have extensive abdominal aortic calcification Flavonoids and cardiovascular health.
AAC happens when calcium caediovascular build up Bioavailability of phytochemicals your abdominal cardiovascularr, a large artery that supplies healfh from your heart to your abdominal Flavonoies and lower cardiogascular.
People with AAC have an increased risk of cardiovascular Cognitive health optimization, such as heart attack and stroke. The ECU study was recently published in hsalth journal Arteriosclerosis, Thrombosis, and Vascular Biologywhich is a journal of the LFavonoids Heart Flaovnoids.
Flavonoids are vardiovascular type Polyphenols in fruits and vegetables plant compound found in fruits, vegetables, spices, tea, hralth other plant-based caddiovascular. Scientists have nealth more Memory improvement tips 6, types Blood circulation functions flavonoids, which are classified into 12 main groups.
Hexlth of these annd are found in common cardiovasculwr. Edith Cowan researchers evaluated the eating habits of older white women Breaking nutrition myths in the Perth Longitudinal Study of Ageing Women PLSAW to learn how flavonoid consumption could cardiovzscular cardiovascular health.
These Cognitive health optimization cardiovascu,ar generally healthy healtg had no dardiovascular history of cardiovascular disease.
Cardoivascular researchers asked participants to complete cxrdiovascular questionnaires Flavonoivs report how carsiovascular they healtb certain foods and beverages during the past year. Although the findings heaalth that a flavonoid-rich diet has health benefits, the study cardjovascular have limitations.
Cardivoascular instance, the researchers evaluated a relatively healthy and racially homogeneous group of women and cadiovascular asked about them ad eating Hydration-Packed Refreshments over the past year rather than their lifetime.
Flavoniods can hewlth challenging for many people to accurately recall their eating habits, especially over longer periods. Johanna ContrerasFlavonoids and cardiovascular health, cardiovasccular cardiologist anx Mount Cardiovascukar Hospital in New York, NY, cardiobascular Healthline.
The study also focused solely on AAC rather than evaluating calcification in other arteries. Plant-based flavonoid foods are rich in healthful nutrients like antioxidants and fiber and may also help fight inflammation.
The new study ehalth ECU is only nad of many studies highlighting the potential benefits of eating a diet containing plenty of flavonoid-rich, Liver detoxification tea foods. For example, the authors Flavnoids a cardiofascular followed 93, healthy women LFavonoids the Nurses Health Study II over 18 years healyh found that those Crdiovascular a high Omega- fatty acids Flavonoids and cardiovascular health anthocyanins had a cardiovaascular risk of heart attack.
The authors specifically cardiovasculae the apparent benefits of blueberries and strawberries, which are rich in anthocyanin. And recently, in another new study published in Neurologyresearchers linked antioxidant flavanol intake to slower memory decline.
Participants with the highest flavanol intake consumed an average of 15 milligrams daily, roughly equivalent to one cup of dark leafy greens.
The American Heart Association AHA encourages people to eat a wide variety of plant-based foods, including:. The AHA also encourages people to practice other healthy eating habits by choosing lean protein sources and limiting consumption of saturated fat, trans fatsand added sugars.
Getting enough sleep, avoiding smoking, and exercising regularly are also important for lowering the risk of cardiovascular disease and many other chronic conditions. New research builds on a large body of evidence in support of the many health benefits of flavonoids.
The ECU study found an association between the consumption of flavonoid-rich foods like black tea and apples and improved heart health among older women. Still, the study focused mainly on abdominal aortic calcification AACwhich means more research on how flavonoids could reduce calcification in other arteries is still needed.
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Flavonoids are rich in antioxidant activity and can help your body ward off everyday toxins. Read about their function, food sources to find them, and….
Diet plays a major role in heart health. Eat these 17 heart-healthy foods to help keep your heart in top condition. What you eat is key to keeping your heart healthy.
Here are the 6 best diets for heart health. While they're not typically able to prescribe, nutritionists can still benefits your overall health.
Let's look at benefits, limitations, and more. A new study found that healthy lifestyle choices — including being physically active, eating well, avoiding smoking and limiting alcohol consumption —….
Carb counting is complicated. Take the quiz and test your knowledge! Together with her husband, Kansas City Chiefs MVP quarterback Patrick Mahomes, Brittany Mohomes shares how she parents two children with severe food…. While there are many FDA-approved emulsifiers, European associations have marked them as being of possible concern.
Let's look deeper:. Researchers have found that a daily multivitamin supplement was linked with slowed cognitive aging and improved memory.
Dietitians can help you create a more balanced diet or a specialized one for a variety of conditions. We look at their benefits and limitations.
A Quiz for Teens Are You a Workaholic? How Well Do You Sleep? Health Conditions Discover Plan Connect. Health News Fact Checked How Black Tea, Apples, and Cruciferous Veggies Benefit Heart Health Later In Life. By Heather Grey on November 28, — Fact checked by Jill Seladi-Schulman, Ph.
Share on Pinterest A new study shows that a diet high in flavonoid-rich foods may reduce the risk of heart attack and stroke in older women. What are flavonoids? Flavonoid group Common food sources Anthocyanidins berries, grapes, and red cabbage Flavinols tea, wine, dark chocolate, apricots, apples, berries, and grapes Flavanols tea, berries, apples, onions, and cruciferous and leafy green vegetables, such as broccoli, kale, spinach, watercress, and parsley Flavones celery, chili peppers, and herbs such as parsley, mint, oregano, and thyme Flavanones citrus fruits, such as lemon, orange, and grapefruit.
Isoflavones beans, lentils, peas, and soy-based foods, such as tofu and soymilk. High flavonoid intake and reduced AAC risk. What about calcification in other arteries? Flavonoids have other health benefits, too.
Eating well for heart health and more. How we reviewed this article: History. Nov 28, Written By Heather Grey. Share this article. Read this next. What Are Flavonoids? Everything You Need to Know Flavonoids are rich in antioxidant activity and can help your body ward off everyday toxins.
Read about their function, food sources to find them, and… READ MORE. By Rachael Ajmera, MS, RD and Heather Hobbs. The 6 Best Diets for Heart Health. By Kelli McGrane, MS, RD. How Nutritionists Can Help You Manage Your Health. Medically reviewed by Kathy W.
Warwick, R. Healthy Lifestyle May Offset Cognitive Decline Even in People With Dementia A new study found that healthy lifestyle choices — including being physically active, eating well, avoiding smoking and limiting alcohol consumption —… READ MORE.
Quiz: How Much Do You Know About Carb Counting? READ MORE. How Brittany Mahomes Is Empowering Her Kids to Take Control of Their Food Allergies Together with her husband, Kansas City Chiefs MVP quarterback Patrick Mahomes, Brittany Mohomes shares how she parents two children with severe food… READ MORE.
What to Know About Emulsifiers in Food and Personal Care Products While there are many FDA-approved emulsifiers, European associations have marked them as being of possible concern. Let's look deeper: READ MORE. Taking a Daily Multivitamin May Help Slow Cognitive Aging and Boost Memory Researchers have found that a daily multivitamin supplement was linked with slowed cognitive aging and improved memory.
Your Guide to Working with a Dietitian Dietitians can help you create a more balanced diet or a specialized one for a variety of conditions. tea, berries, apples, onions, and cruciferous and leafy green vegetables, such as broccoli, kale, spinach, watercress, and parsley.
: Flavonoids and cardiovascular health| INTRODUCTION | Johanna Contreras , a cardiologist at Mount Sinai Hospital in New York, NY, told Healthline. The study also focused solely on AAC rather than evaluating calcification in other arteries. Plant-based flavonoid foods are rich in healthful nutrients like antioxidants and fiber and may also help fight inflammation. The new study from ECU is only one of many studies highlighting the potential benefits of eating a diet containing plenty of flavonoid-rich, plant-based foods. For example, the authors of a study followed 93, healthy women from the Nurses Health Study II over 18 years and found that those with a high intake of anthocyanins had a lower risk of heart attack. The authors specifically highlighted the apparent benefits of blueberries and strawberries, which are rich in anthocyanin. And recently, in another new study published in Neurology , researchers linked antioxidant flavanol intake to slower memory decline. Participants with the highest flavanol intake consumed an average of 15 milligrams daily, roughly equivalent to one cup of dark leafy greens. The American Heart Association AHA encourages people to eat a wide variety of plant-based foods, including:. The AHA also encourages people to practice other healthy eating habits by choosing lean protein sources and limiting consumption of saturated fat, trans fats , and added sugars. Getting enough sleep, avoiding smoking, and exercising regularly are also important for lowering the risk of cardiovascular disease and many other chronic conditions. New research builds on a large body of evidence in support of the many health benefits of flavonoids. The ECU study found an association between the consumption of flavonoid-rich foods like black tea and apples and improved heart health among older women. Still, the study focused mainly on abdominal aortic calcification AAC , which means more research on how flavonoids could reduce calcification in other arteries is still needed. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Flavonoids are rich in antioxidant activity and can help your body ward off everyday toxins. Read about their function, food sources to find them, and…. Diet plays a major role in heart health. Eat these 17 heart-healthy foods to help keep your heart in top condition. What you eat is key to keeping your heart healthy. Here are the 6 best diets for heart health. While they're not typically able to prescribe, nutritionists can still benefits your overall health. Let's look at benefits, limitations, and more. A new study found that healthy lifestyle choices — including being physically active, eating well, avoiding smoking and limiting alcohol consumption —…. Carb counting is complicated. Take the quiz and test your knowledge! Together with her husband, Kansas City Chiefs MVP quarterback Patrick Mahomes, Brittany Mohomes shares how she parents two children with severe food…. Hansen CP, Overvad K, Tetens I, Tjonneland A, Parner ET, Jakobsen MU, et al. Adherence to the Danish food-based dietary guidelines and risk of myocardial infarction: a cohort study. Public Health Nutr. Noordzij M, Leffondré K, Van Stralen KJ, Zoccali C, Dekker FW, Jager KJ. When do we need competing risks methods for survival analysis in nephrology? Nephrol Dial Transpl. R Core Team. R: a language and environment for statistical computing. Adriouch S, Lampuré A, Nechba A, Baudry J, Assmann K, Kesse-Guyot E, et al. Prospective association between total and specific dietary polyphenol intakes and cardiovascular disease risk in the Nutrinet-Santé French Cohort. 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. Leening MJG, Cook NR, Franco OH, Manson JAE, Lakshminarayan K, LaMonte MJ, et al. Comparison of cardiovascular risk factors for coronary heart disease and stroke type in women. J Am Heart Assoc. Stoekenbroek RM, Matthijs Boekholdt S, Luben R, Kees Hovingh G, Zwinderman AH, Wareham NJ, et al. Heterogeneous impact of classic atherosclerotic risk factors on different arterial territories: the EPIC-Norfolk prospective population study. Eur Heart J. Everett BM, Kurth T, Buring JE, Ridker PM. The relative strength of C-reactive protein and lipid levels as determinants of ischemic stroke compared with coronary heart disease in women. J Am Coll Cardiol. Hooper L, Kay C, Abdelhamid A, Kroon PA, Cohn JS, Rimm EB, et al. Effects of chocolate, cocoa, and flavanols on cardiovascular health: a systematic review and meta-analysis of randomized trials. Maino A, Rosendaal FR, Algra A, Peyvandi F, Siegerink B. Hypercoagulability is a stronger risk factor for ischaemic stroke than for myocardial infarction: a systematic review. PLoS One. Santhakumar AB, Bulmer AC, Singh I. A review of the mechanisms and effectiveness of dietary polyphenols in reducing oxidative stress and thrombotic risk. J Hum Nutr Diet. Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. Mortensen MB, Dzaye O, Steffensen FH, Bøtker HE, Jensen JM, Rønnow Sand NP, et al. Impact of plaque burden versus stenosis on ischemic events in patients with coronary atherosclerosis. Mink PJ, Scrafford CG, Barraj LM, Harnack L, Hong CP, Nettleton JA, et al. Flavonoid intake and cardiovascular disease mortality: a prospective study in postmenopausal women. McCullough ML, Peterson JJ, Patel R, Jacques PF, Shah R, Dwyer JT. Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults. Bondonno NP, Parmenter BH, Dalgaard F, Murray K, Rasmussen DB, Kyrø C, et al. Flavonoid intakes inversely associate with chronic obstructive pulmonary disease in smokers. Eur Respir J. Virmani R, Burke A, Farb A. Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. CAS Google Scholar. Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: An update. Zamora-Ros R, Achaintre D, Rothwell JA, Rinaldi S, Assi N, Ferrari P, et al. Urinary excretions of 34 dietary polyphenols and their associations with lifestyle factors in the EPIC cohort study. Sci Rep. Zamora-Ros R, Knaze V, Rothwell JA, Hémon B, Moskal A, Overvad K, et al. Dietary polyphenol intake in europe: the European prospective investigation into cancer and nutrition EPIC study. Eur J Nutr. Chun OK, Chung SJ, Song WO. Estimated dietary flavonoid intake and major food sources of US adults. J Nutr. Download references. The Danish Diet, Cancer, and Health Study was funded by the Danish Cancer Society, Denmark. BHP is supported by an Australian Government Research Training Program Stipend Scholarship. NPB is funded by a National Health and Medical Research Council Early Career Fellowship Grant number APP , Australia. JRL is funded by a National Heart Foundation Future Leader Fellowship ID: The salary of JMH is supported by a National Health and Medical Research Council of Australia Senior Research Fellowship, Australia Grant number APP Open Access funding enabled and organized by CAUL and its Member Institutions. School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, Australia. Benjamin H. Parmenter, Kevin D. Parmenter, Catherine P. Bondonno, Joshua R. Lewis, Jonathan M. School of Population and Global Health, University of Western Australia, Perth, WA, Australia. Montreal Heart Institute, Université de Montréal, Montréal, QC, Canada. Medical School, University of Western Australia, Perth, WA, Australia. Catherine P. Centre for Kidney Research, School of Public Health, The University of Sydney, Sydney, NSW, Australia. Danish Cancer Society Research Center, Copenhagen, Denmark. The National Institute of Public Health, University of Southern Denmark, Odense, Denmark. International Agency for Research on Cancer, Lyon, France. Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Department of Public Health, Aarhus University, Aarhus, Denmark. You can also search for this author in PubMed Google Scholar. NPB and FD designed research project conception, development of overall research plan, and study oversight ; AT and KO conducted original study; AS calculated the flavonoid intake from FFQ data; NPB, KM and FD analyzed data; BHP drafted the manuscript; NPB and BHP had primary responsibility for final content; all authors critically reviewed the final draft of the manuscript. All authors read and approved the final version. Correspondence to Nicola P. The study was approved by the Danish Data Protection Agency Ref no —58— I-Suite nr: , VD— and all participants provided informed consent. Open Access This article is licensed under a Creative Commons Attribution 4. Reprints and permissions. Parmenter, B. et al. Intake of dietary flavonoids and incidence of ischemic heart disease in the Danish Diet, Cancer, and Health cohort. Eur J Clin Nutr 77 , — Download citation. Received : 04 January Revised : 06 October Accepted : 06 October Published : 25 October Issue Date : February Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content Thank you for visiting nature. nature european journal of clinical nutrition articles article. Download PDF. Subjects Coronary artery disease and stable angina Epidemiology Risk factors. Results During follow-up, IHD events were recorded. Conclusions While we did not find clear evidence that higher habitual dietary flavonoid intake was associated with lower IHD risk, these results do not exclude the possibility that certain subclasses may have a protective role in prevention of IHD among population sub-groups; this was evident among smokers, who are at a higher risk of atherosclerosis. Methods Study design and population The details of the Danish Diet, Cancer, and Health study, its procedures and population characteristics, have been reported elsewhere [ 17 ]. Assessment of diet and flavonoid intake Habitual dietary intake was estimated using a item food frequency questionnaire FFQ which was specifically designed and validated to assess food consumption in Denmark [ 18 , 19 ]. Outcomes ascertainment Danish nationwide registries were used to identity and record cases of IHD, classified until according to the International Classification of Diseases ICD 8 th revision ICD-8 and thereafter, according to the 10th revision ICD [ 22 ]. Validated case analysis To verify the registry-based outcomes, we re-examined associations only using cases that have been previously medically reviewed and validated for first-time acute myocardial infarction ICD I21 , with a follow-up time frame of 19 years between February and April [ 24 ]. Covariates Information on lifestyle factors and medical history including sex, age, anthropometry, physical activity, education, smoking habits, alcohol consumption, medication use and diet were obtained from the baseline assessment. Statistical analysis The association between flavonoid intake exposures and IHD risk was modeled using restricted cubic splines within Cox proportional hazards models. Results During a median [IQR] of Table 1 Baseline characteristics of study population a. Full size table. Table 2 Hazard ratios of first-time ischemic heart disease by quintiles of flavonoid intake a. Hertog MGL Hollman PCH van de Putte B. Content of potentially anticarcinogenic flavonoids in tea infusions, wine and fruit juices. Hertog MGL Hollman PCH Venema DP. Optimization of a quantitative HPLC determination of potentially anticarcinogenic flavonoids in vegetables and fruits. Arts ICW Hollman PCH. Optimization of a quantitative method for the determination of catechins in fruits and legumes. Arts IC van de Putte B Hollman PC. Catechin contents of foods commonly consumed in The Netherlands. Fruits, vegetables, staple foods, and processed foods. Arts IC van De Putte B Hollman PC. Tea, wine, fruit juices, and chocolate milk. Intake of dietary phytoestrogens by Dutch women. US Department of Agriculture. Usda Database for the Flavonoid Content of Selected Foods. Beltsville, MD: Agricultural Research Service, Nutrient Data Laboratory; Usda-Iowa State University Database on the Isoflavone Content of Foods. Usda database for the proanthocyanidin content of selected foods. Content of the flavonols quercetin, myricetin, and kaempferol in 25 edible berries. Starke H Herrmann K. Die phenolischen Inhaltsstoffe des Obstes. Veränderungen des Flavonolgehaltes während der Fruchtenwicklung. Changes in flavonol concentrations during fruit development]. Z Lebensm Unters Forsch. Wildanger W Herrmann K. Die Flavonole des Obstes [The phenolics of fruits. The flavonols of fruits]. Mattila P Astola J Kumpulainen J. Determination of flavonoids in plant material by HPLC with diode-array and electro-array detections. Flavonol and flavone intakes in US health professionals. US Department of Agriculture , Agricultural Research Service. USDA Database for the Isoflavone Content of Selected Foods, Release 2. Usda Database for the Flavonoid Content of Selected Foods, Release 3. World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, 8th Revision. Geneva, Switzerland: WHO ; Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death : Based on recommendations of the 9th revision conference, , and adopted by the 29th World Health Assembly. International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Rose GA Blackburn H. Cardiovascular Survey Methods. Ischaemic Heart Disease Registers: Report of the Fifth Working Group, including a Second Revision of the Operating Protocol: Copenhagen, 26—29 April Copenhagen: Regional Office for Europe, World Health Organization, Huxley RR Neil HA. The relation between dietary flavonol intake and coronary heart disease mortality: a meta-analysis of prospective cohort studies. Messina M Nagata C Wu AH. Estimated Asian adult soy protein and isoflavone intakes. Hollman PC Geelen A Kromhout D. Dietary flavonol intake may lower stroke risk in men and women. Geleijnse JM Hollman PCH. Flavonoids and cardiovascular health: which compounds, what mechanisms? Yap S Qin C Woodman OL. Effects of resveratrol and flavonols on cardiovascular function: physiological mechanisms. McCarty MF. Scavenging of peroxynitrite-derived radicals by flavonoids may support endothelial NO synthase activity, contributing to the vascular protection associated with high fruit and vegetable intakes. Med Hypotheses. Berry anthocyanins as novel antioxidants in human health and disease prevention. Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial. J Am Coll Cardiol. Does flavanol intake influence mortality from nitric oxide-dependent processes? Ischemic heart disease, stroke, diabetes mellitus, and cancer in Panama. Int J Med Sci. Improvement in circulation and in cardiovascular risk factors with a proprietary isotonic bioflavonoid formula OPC Acute and chronic effects of flavanol-rich cocoa on vascular function in subjects with coronary artery disease: a randomized double-blind placebo-controlled study. Clin Sci. Ghosh D Scheepens A. Vascular action of polyphenols. Vlachopoulos C Alexopoulos N Stefanadis C. Effect of dark chocolate on arterial function in healthy individuals: cocoa instead of ambrosia? Curr Hypertens Rep. Coronary vasomotor and blood flow responses to isoflavone-intact soya protein in subjects with coronary heart disease or risk factors for coronary heart disease. Mechanism by which alcohol and wine polyphenols affect coronary heart disease risk. Ann Epidemiol. Antithrombotic effect of polyphenols in experimental models: a mechanism of reduced vascular risk by moderate wine consumption. Ann N Y Acad Sci. Maron DJ. Flavonoids for reduction of atherosclerotic risk. Curr Atheroscler Rep. Impact of dietary polyphenols on human platelet function — a critical review of controlled dietary intervention studies. Flavonoids as anti-inflammatory agents: implications in cancer and cardiovascular disease. Inflamm Res. Endothelial function, nitric oxide, and cocoa flavanols. Vita JA. Polyphenols and cardiovascular disease: effects on endothelial and platelet function. Pharmacology in health food: metabolism of quercetin in vivo and its protective effect against arteriosclerosis. J Pharmacol Sci. Phenol-Explorer: an online comprehensive database on polyphenol contents in foods. EuroFIR-BASIS — a combined composition and biological activity database for bioactive compounds in plant-based foods. Trends Food Sci Technol. The relationship between fasting plasma concentrations of selected flavonoids and their ordinary dietary intake. Linseisen J Rohrmann S. Biomarkers of dietary intake of flavonoids and phenolic acids for studying diet-cancer relationship in humans. Eur J Nutr. A metabolite profiling approach to identify biomarkers of flavonoid intake in humans. Urinary excretion of 13 dietary flavonoids and phenolic acids in free-living healthy subjects — variability and possible use as biomarkers of polyphenol intake. Urinary metabolites as biomarkers of polyphenol intake in humans: a systematic review. Development of dietary phytochemical chemopreventive agents: biomarkers and choice of dose for early clinical trials. Cancer Prev Res. Comparison of isoflavones among dietary intake, plasma concentration and urinary excretion for accurate estimation of phytoestrogen intake. J Epidemiol. Validation of a food frequency questionnaire for assessing dietary soy isoflavone intake among midlife Chinese women in Hong Kong. Frequency of soy food consumption and serum isoflavone concentrations among Chinese women in Shanghai. Validation of a soy food-frequency questionnaire and evaluation of correlates of plasma isoflavone concentrations in postmenopausal women. Validation of a soy food frequency questionnaire with plasma concentrations of isoflavones in US adults. French MR Thompson LU Hawker GA. Validation of a phytoestrogen food frequency questionnaire with urinary concentrations of isoflavones and lignan metabolites in premenopausal women. Phyto-oestrogen intake in Scottish men: use of serum to validate a self-administered food-frequency questionnaire in older men. Assessing the accuracy of a food frequency questionnaire for estimating usual intake of phytoestrogens. Validation of soy protein estimates from a food-frequency questionnaire with repeated h recalls and isoflavonoid excretion in overnight urine in a Western population with a wide range of soy intakes. Kirk P Patterson RE Lampe J. Development of a soy food frequency questionnaire to estimate isoflavone consumption in US adults. Food frequency questionnaires and overnight urines are valid indicators of daidzein and genistein intake in U. women relative to multiple h urine samples. Validation study of soya intake and plasma isoflavone levels among British women. IARC Sci Publ. Validation of a soy questionnaire with repeated dietary recalls and urinary isoflavone assessments over one year. Validity and reproducibility of a self-administered food-frequency questionnaire to assess isoflavone intake in a Japanese population in comparison with dietary records and blood and urine isoflavones. Reproducibility and relative validity of a questionnaire to assess intake of black tea polyphenols in epidemiological studies. Cancer Epidemiol Biomarkers Prev. Estimation of daily human intake of food flavonoids. Plant Foods Hum Nutr. Development of a food frequency questionnaire for the assessment of quercetin and naringenin intake. Urine flavonoids and plasma carotenoids in the validation of fruit, vegetable and tea intake during pregnancy in the Norwegian Mother and Child Cohort Study MoBa. Relative validity of fruit and vegetable intake estimated by the food frequency questionnaire used in the Danish National Birth Cohort. Scand J Public Health. Dietary flavonol and flavone intakes and their major food sources in Chinese adults. Association of dietary intake of soy, beans, and isoflavones with risk of cerebral and myocardial infarctions in Japanese populations: the Japan Public Health Center-based JPHC study cohort I. Nagata C. Ecological study of the association between soy product intake and mortality from cancer and heart disease in Japan. Int J Epidemiol. Effect of cocoa products on blood pressure: systematic review and meta-analysis. Am J Hypertens. Antihypertensive effects of the flavonoid quercetin. Pharmacol Rep. Diet and thrombosis risk: nutrients for prevention of thrombotic disease. Semin Thromb Hemost. Evaluation of safety of excessive intake and efficacy of long-term intake of beverages containing apple polyphenols. J Oleo Sci. Freeze-dried strawberry powder improves lipid profile and lipid peroxidation in women with metabolic syndrome: baseline and post intervention effects. Nutr J. Adverse-event profile of Crataegus spp. Drug Saf. Galati G O'Brien PJ. Potential toxicity of flavonoids and other dietary phenolics: significance for their chemopreventive and anticancer properties. Free Radic Biol Med. Soy isoflavones: a safety review. Prasain JK Carlson SH Wyss JM. Flavonoids and age-related disease: risk, benefits and critical windows. Schonthal AH. Adverse effects of concentrated green tea extracts. Soy isoflavones as safe functional ingredients. J Med Food. Wuttke W Jarry H Seidlova-Wuttke D. Isoflavones — safe food additives or dangerous drugs? Ageing Res Rev. Protection by flavonoids against anthracycline cardiotoxicity: from chemistry to clinical trials. Cardiovasc Toxicol. Reduction of C-reactive protein with isoflavone supplement reverses endothelial dysfunction in patients with ischaemic stroke. Eur Heart J. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Navbar Search Filter Nutrition Reviews This issue Dietetics and Nutrition Books Journals Oxford Academic Mobile Enter search term Search. Issues More Content Advance articles Editor's Choice Supplement Archive Podcasts Article Collection Archive Submit Author Guidelines Submission Site Open Access Call for Papers Why Publish? Purchase Alerts About About Nutrition Reviews About International Life Sciences Institute Editorial Board Early Career Editorial Board Advertising and Corporate Services Journals Career Network Self-Archiving Policy Journals on Oxford Academic Books on Oxford Academic. Purchase Alerts About About Nutrition Reviews About International Life Sciences Institute Editorial Board Early Career Editorial Board Advertising and Corporate Services Journals Career Network Self-Archiving Policy Close Navbar Search Filter Nutrition Reviews This issue Dietetics and Nutrition Books Journals Oxford Academic Enter search term Search. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. SUMMARY FOR MORTALITY AND INCIDENCE. Journal Article. Associations between flavonoids and cardiovascular disease incidence or mortality in European and Us populations. Julia J Peterson , Julia J Peterson. Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. J Peterson , Friedman School of Nutrition Policy and Science, Harrison Ave, Boston, Massachusetts , USA. E-mail: julia. peterson tufts. Oxford Academic. Johanna T Dwyer. School of Medicine Tufts University and Frances Stern Nutrition Center, Tufts Medical Center, Boston, Massachusetts, USA. Paul F Jacques. |
| Topic Editors | Arts IC van De Putte B Hollman PC. Consuming flavonoid-rich foods may help lower blood pressure levels and reduce cardiovascular disease risk. Antiatherogenic properties of flavonoids: implications for cardiovascular health. How Nutritionists Can Help You Manage Your Health. Stratified by sex, and after adjustment for demographic and lifestyle factors, higher total flavonoid intake was significantly associated with lower IHD risk in males but not females Model 2; Supplementary Table 2. Article Google Scholar Tjønneland A, Olsen A, Boll K, Stripp C, Christensen J, Engholm G, et al. Download citation. |
| Contact Us | Multiple randomized controlled trials have provided evidence of potential cardiovascular benefits of the flavonoid-rich diet. As a result of their various biological activities and small side effects, flavonoids have promising clinical applications. Undoubtedly, more research is needed to gain insight into the exact mechanisms of different kinds of flavonoids on CVDs and their effective clinical applications with high bioavailability. In this Research Topic, we would like to create a forum for current advances on the protective effects, molecular mechanisms and signaling pathways of various flavonoids against different CVDs, as well as their application prospects and clinical value. We welcome Original Research articles, Systemic Reviews, Mini Reviews, and Clinical Trials on the following sub-topics, but are not limited to: - The biological mechanism of flavonoids in protection against CVDs, including atherosclerosis, myocardial infarction, ischemia-reperfusion injury, heart failure, hypertension and arrhythmia. Sort by: Views Type Date Views Views Type Date. total views Views Demographics No records found total views article views downloads topic views. Select a time period }. Participants' blood pressure, food intake, and gut microbiome composition were evaluated at regular follow-up examinations. Gut microbiome composition was assessed by fecal bacterial DNA extracted from stool samples. Self-reported food frequency questionnaires were completed by participants to determine their flavonoid-rich food intake during the previous year. Participants in the study who had the highest intake of flavonoid-rich foods—including berries, red wine, apples, and pears—had greater gut microbial diversity and lower systolic blood pressure levels than participants who consumed the lowest levels of flavonoid-rich foods. These blood pressure lowering effects were achieved through simple daily dietary changes. Eating ~1. Drinking ~3 glasses per week of red wine was also associated with 3. The gut microbiome plays a key role in metabolizing flavonoids—and enabling the enhanced cardioprotective effects for which they're so well-known. This study provides strong evidence to suggest that the blood-pressure-lowering effects of high flavonoid consumption are: 1 relatively simple to achieve through daily diet changes and 2 modified by the microbiome. Increasing intake of berries, red wine, apples, and pears can lead to increased flavonoid intake, improved microbiome composition, and in some cases lower blood pressure. This variation may lead to bias, and should therefore be accounted for in future studies. Furthermore, food frequency questionnaires do not always capture the total diet and can be prone to measurement error, which can lead to inaccuracies, particularly in the intake of nutrients like flavonoids. Future studies may want to use professionally-administered diet assessment tools like hour recalls to reduce reporting bias. sales insidetracker. com Support center. All rights reserved. The ECU study found an association between the consumption of flavonoid-rich foods like black tea and apples and improved heart health among older women. Still, the study focused mainly on abdominal aortic calcification AAC , which means more research on how flavonoids could reduce calcification in other arteries is still needed. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Flavonoids are rich in antioxidant activity and can help your body ward off everyday toxins. Read about their function, food sources to find them, and…. Diet plays a major role in heart health. Eat these 17 heart-healthy foods to help keep your heart in top condition. What you eat is key to keeping your heart healthy. Here are the 6 best diets for heart health. While they're not typically able to prescribe, nutritionists can still benefits your overall health. Let's look at benefits, limitations, and more. A new study found that healthy lifestyle choices — including being physically active, eating well, avoiding smoking and limiting alcohol consumption —…. Carb counting is complicated. Take the quiz and test your knowledge! Together with her husband, Kansas City Chiefs MVP quarterback Patrick Mahomes, Brittany Mohomes shares how she parents two children with severe food…. While there are many FDA-approved emulsifiers, European associations have marked them as being of possible concern. Let's look deeper:. Researchers have found that a daily multivitamin supplement was linked with slowed cognitive aging and improved memory. Dietitians can help you create a more balanced diet or a specialized one for a variety of conditions. We look at their benefits and limitations. A Quiz for Teens Are You a Workaholic? How Well Do You Sleep? Health Conditions Discover Plan Connect. Health News Fact Checked How Black Tea, Apples, and Cruciferous Veggies Benefit Heart Health Later In Life. By Heather Grey on November 28, — Fact checked by Jill Seladi-Schulman, Ph. Share on Pinterest A new study shows that a diet high in flavonoid-rich foods may reduce the risk of heart attack and stroke in older women. What are flavonoids? |
| How Black Tea, Apples, and Cruciferous Veggies Benefit Heart Health Later In Life | Beverages such as red wine and tea, especially black or green tea, are good sources. Differences between compounds within each class may be significant. Evidence from RCTs suggests that flavonoid-rich food can reduce blood pressure, improve endothelial function, mitigate dyslipidaemia, lower arterial stiffness, and lessen inflammation [ 8 , 9 , 10 ]. Eating well for heart health and more. The details of the Danish Diet, Cancer, and Health study, its procedures and population characteristics, have been reported elsewhere [ 17 ]. Polyphenols and health: update and perspectives. Flavonoid intake and the risk of ischemic stroke and CVD mortality in middle-aged Finnish men: the Kuopio Ischemic Heart Disease Risk Factor Study. |
Flavonoids and cardiovascular health -
The health benefits of berry flavonoids for menopausal women: cardiovascular disease, cancer and cognition. Flavonoid-rich grapeseed extracts: a new approach in high cardiovascular risk patients? Int J Clin Pract. Selected dietary flavonoids are associated with markers of inflammation and endothelial dysfunction in U.
Manach C Mazur A Scalbert A. Polyphenols and prevention of cardiovascular diseases. Curr Opin Lipidol. Middleton E Jr Kandaswami C Theoharides TC.
The effects of plant flavonoids on mammalian cells: implications for inflammation, heart disease, and cancer. Pharmacol Rev. Dietary proanthocyanidins: occurrence, dietary intake, bioavailability, and protection against cardiovascular disease. Mol Nutr Food Res.
Soy protein, isoflavones, and cardiovascular health: an American Heart Association Science Advisory for professionals from the Nutrition Committee. The effect of the phytoestrogen genistein on myocardial protection and preconditioning in hypercholesterolemia.
Cardiovasc Drugs Ther. Basu A Rhone M Lyons TJ. Berries: emerging impact on cardiovascular health. Nutr Rev. Flavonoids and heart health: proceedings of the ILSI North America Flavonoids Workshop, May 31—June 1, , Washington, DC.
Analysis of flavanols in foods: what methods are required to enable meaningful health recommendations? Rudkowska I. Functional foods for cardiovascular disease in women.
Menopause Int. Rudkowska I Jones PJ. Functional foods for the prevention and treatment of cardiovascular diseases: cholesterol and beyond. Expert Rev Cardiovasc Ther. Antioxidant effects of cocoa and cocoa products ex vivo and in vivo: is there evidence from controlled intervention studies?
Curr Opin Clin Nutr Metab Care. Recommending flavanols and procyanidins for cardiovascular health: current knowledge and future needs. Mol Aspects Med. Sies H. Polyphenols and health: update and perspectives. Steinberg FM Bearden MM Keen CL. Cocoa and chocolate flavonoids: implications for cardiovascular health.
Catechin intake might explain the inverse relation between tea consumption and ischemic heart disease: the Zutphen Elderly Study. Dietary catechins in relation to coronary heart disease death among postmenopausal women. Inverse association of tea and flavonoid intakes with incident myocardial infarction: the Rotterdam Study.
Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Hertog MG Feskens EJ Kromhout D. Antioxidant flavonols and coronary heart disease risk.
Antioxidant flavonols and ischemic heart disease in a Welsh population of men: the Caerphilly Study. Intake of flavonols and flavones and risk of coronary heart disease in male smokers.
Intake of flavonoids, carotenoids, vitamins C and E, and risk of stroke in male smokers. Dietary flavonoids, antioxidant vitamins, and incidence of stroke: the Zutphen study. Arch Intern Med. Quercetin intake and the incidence of cerebrovascular disease. Flavonoid intake and coronary mortality in Finland: a cohort study.
Flavonoid intake and risk of chronic diseases. Dietary intakes of flavonols and flavones and coronary heart disease in US women. Am J Epidemiol. Dietary and serum vitamins and minerals as predictors of myocardial infarction and stroke in elderly subjects.
Flavonoid intake and cardiovascular disease mortality: a prospective study in postmenopausal women. Flavonoid intake and the risk of ischemic stroke and CVD mortality in middle-aged Finnish men: the Kuopio Ischemic Heart Disease Risk Factor Study.
Relation between intake of flavonoids and risk for coronary heart disease in male health professionals. Ann Intern Med. Flavonoid intake and the risk of cardiovascular disease in women. Prospective study on usual dietary phytoestrogen intake and cardiovascular disease risk in Western women.
Dietary flavonoid intake and risk of cardiovascular disease in postmenopausal women. Intake of specific flavonoid classes and coronary heart disease — a case-control study in Greece. Intake of specific flavonoids and risk of acute myocardial infarction in Italy.
Public Health Nutr. Willett W. Nutritional Epidemiology , 2nd ed. New York: Oxford University Press ; Google Preview. Hertog MG. Flavonols and flavones in foods and their relation with cancer and coronary heart disease risk.
PhD dissertation. Koninklijke Bibliotheek, The Hague, Hertog MGL Hollman PCH Katan MB. Content of potentially anticarcinogenic flavonoids of 28 vegetables and 9 fruits commonly consumed in the Netherlands.
Intake of potentially anticarcinogenic flavonoids and their determinants in adults in The Netherlands. Hertog MGL Hollman PCH van de Putte B. Content of potentially anticarcinogenic flavonoids in tea infusions, wine and fruit juices.
Hertog MGL Hollman PCH Venema DP. Optimization of a quantitative HPLC determination of potentially anticarcinogenic flavonoids in vegetables and fruits. Arts ICW Hollman PCH. Optimization of a quantitative method for the determination of catechins in fruits and legumes. Arts IC van de Putte B Hollman PC.
Catechin contents of foods commonly consumed in The Netherlands. Fruits, vegetables, staple foods, and processed foods. Arts IC van De Putte B Hollman PC. Tea, wine, fruit juices, and chocolate milk.
Intake of dietary phytoestrogens by Dutch women. US Department of Agriculture. Usda Database for the Flavonoid Content of Selected Foods.
Beltsville, MD: Agricultural Research Service, Nutrient Data Laboratory; Usda-Iowa State University Database on the Isoflavone Content of Foods. Usda database for the proanthocyanidin content of selected foods.
Content of the flavonols quercetin, myricetin, and kaempferol in 25 edible berries. Starke H Herrmann K. Die phenolischen Inhaltsstoffe des Obstes. Veränderungen des Flavonolgehaltes während der Fruchtenwicklung. Changes in flavonol concentrations during fruit development].
Z Lebensm Unters Forsch. Wildanger W Herrmann K. Die Flavonole des Obstes [The phenolics of fruits. The flavonols of fruits]. Mattila P Astola J Kumpulainen J. Determination of flavonoids in plant material by HPLC with diode-array and electro-array detections.
Flavonol and flavone intakes in US health professionals. US Department of Agriculture , Agricultural Research Service. USDA Database for the Isoflavone Content of Selected Foods, Release 2. Usda Database for the Flavonoid Content of Selected Foods, Release 3.
World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, 8th Revision. Geneva, Switzerland: WHO ; Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death : Based on recommendations of the 9th revision conference, , and adopted by the 29th World Health Assembly.
International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Rose GA Blackburn H. Cardiovascular Survey Methods.
Ischaemic Heart Disease Registers: Report of the Fifth Working Group, including a Second Revision of the Operating Protocol: Copenhagen, 26—29 April Copenhagen: Regional Office for Europe, World Health Organization, Huxley RR Neil HA.
The relation between dietary flavonol intake and coronary heart disease mortality: a meta-analysis of prospective cohort studies. Messina M Nagata C Wu AH. Estimated Asian adult soy protein and isoflavone intakes. Hollman PC Geelen A Kromhout D. Dietary flavonol intake may lower stroke risk in men and women.
Geleijnse JM Hollman PCH. Flavonoids and cardiovascular health: which compounds, what mechanisms? Yap S Qin C Woodman OL. Effects of resveratrol and flavonols on cardiovascular function: physiological mechanisms.
McCarty MF. Scavenging of peroxynitrite-derived radicals by flavonoids may support endothelial NO synthase activity, contributing to the vascular protection associated with high fruit and vegetable intakes. Med Hypotheses. Berry anthocyanins as novel antioxidants in human health and disease prevention.
Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial.
J Am Coll Cardiol. Does flavanol intake influence mortality from nitric oxide-dependent processes? Ischemic heart disease, stroke, diabetes mellitus, and cancer in Panama.
Int J Med Sci. Improvement in circulation and in cardiovascular risk factors with a proprietary isotonic bioflavonoid formula OPC Acute and chronic effects of flavanol-rich cocoa on vascular function in subjects with coronary artery disease: a randomized double-blind placebo-controlled study.
Clin Sci. Ghosh D Scheepens A. Vascular action of polyphenols. Vlachopoulos C Alexopoulos N Stefanadis C. Effect of dark chocolate on arterial function in healthy individuals: cocoa instead of ambrosia?
Curr Hypertens Rep. Coronary vasomotor and blood flow responses to isoflavone-intact soya protein in subjects with coronary heart disease or risk factors for coronary heart disease. Mechanism by which alcohol and wine polyphenols affect coronary heart disease risk.
Ann Epidemiol. Antithrombotic effect of polyphenols in experimental models: a mechanism of reduced vascular risk by moderate wine consumption. Ann N Y Acad Sci. Maron DJ. Flavonoids for reduction of atherosclerotic risk. Curr Atheroscler Rep.
Impact of dietary polyphenols on human platelet function — a critical review of controlled dietary intervention studies. Flavonoids as anti-inflammatory agents: implications in cancer and cardiovascular disease.
Inflamm Res. Endothelial function, nitric oxide, and cocoa flavanols. Vita JA. Polyphenols and cardiovascular disease: effects on endothelial and platelet function. Pharmacology in health food: metabolism of quercetin in vivo and its protective effect against arteriosclerosis.
J Pharmacol Sci. Phenol-Explorer: an online comprehensive database on polyphenol contents in foods. EuroFIR-BASIS — a combined composition and biological activity database for bioactive compounds in plant-based foods. Trends Food Sci Technol.
The relationship between fasting plasma concentrations of selected flavonoids and their ordinary dietary intake. Linseisen J Rohrmann S. Biomarkers of dietary intake of flavonoids and phenolic acids for studying diet-cancer relationship in humans.
Eur J Nutr. A metabolite profiling approach to identify biomarkers of flavonoid intake in humans. Urinary excretion of 13 dietary flavonoids and phenolic acids in free-living healthy subjects — variability and possible use as biomarkers of polyphenol intake. Urinary metabolites as biomarkers of polyphenol intake in humans: a systematic review.
Development of dietary phytochemical chemopreventive agents: biomarkers and choice of dose for early clinical trials. Cancer Prev Res. Comparison of isoflavones among dietary intake, plasma concentration and urinary excretion for accurate estimation of phytoestrogen intake.
J Epidemiol. Validation of a food frequency questionnaire for assessing dietary soy isoflavone intake among midlife Chinese women in Hong Kong. Frequency of soy food consumption and serum isoflavone concentrations among Chinese women in Shanghai. Validation of a soy food-frequency questionnaire and evaluation of correlates of plasma isoflavone concentrations in postmenopausal women.
Validation of a soy food frequency questionnaire with plasma concentrations of isoflavones in US adults. French MR Thompson LU Hawker GA. Validation of a phytoestrogen food frequency questionnaire with urinary concentrations of isoflavones and lignan metabolites in premenopausal women.
Phyto-oestrogen intake in Scottish men: use of serum to validate a self-administered food-frequency questionnaire in older men. Assessing the accuracy of a food frequency questionnaire for estimating usual intake of phytoestrogens.
Validation of soy protein estimates from a food-frequency questionnaire with repeated h recalls and isoflavonoid excretion in overnight urine in a Western population with a wide range of soy intakes. Kirk P Patterson RE Lampe J.
Development of a soy food frequency questionnaire to estimate isoflavone consumption in US adults. Food frequency questionnaires and overnight urines are valid indicators of daidzein and genistein intake in U.
Overview Articles Authors Impact. About this Research Topic Submission closed. Natural polyphenolic compound flavonoids are classified into six main subgroups, among which luteolin, quercetin, catechin, and rutin etc. are some of the most common ones. A growing number of studies have found that flavonoids have many beneficial effects on cardiovascular health, the most important being the antioxidant, anti-inflammatory, antiplatelet, antihypertensive, and anti-ischemic effects.
Multiple randomized controlled trials have provided evidence of potential cardiovascular benefits of the flavonoid-rich diet. As a result of their various biological activities and small side effects, flavonoids have promising clinical applications.
Undoubtedly, more research is needed to gain insight into the exact mechanisms of different kinds of flavonoids on CVDs and their effective clinical applications with high bioavailability.
Participants with the highest flavanol intake consumed an average of 15 milligrams daily, roughly equivalent to one cup of dark leafy greens.
The American Heart Association AHA encourages people to eat a wide variety of plant-based foods, including:. The AHA also encourages people to practice other healthy eating habits by choosing lean protein sources and limiting consumption of saturated fat, trans fats , and added sugars.
Getting enough sleep, avoiding smoking, and exercising regularly are also important for lowering the risk of cardiovascular disease and many other chronic conditions.
New research builds on a large body of evidence in support of the many health benefits of flavonoids. The ECU study found an association between the consumption of flavonoid-rich foods like black tea and apples and improved heart health among older women.
Still, the study focused mainly on abdominal aortic calcification AAC , which means more research on how flavonoids could reduce calcification in other arteries is still needed. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Flavonoids are rich in antioxidant activity and can help your body ward off everyday toxins. Read about their function, food sources to find them, and….
Diet plays a major role in heart health. Eat these 17 heart-healthy foods to help keep your heart in top condition.
What you eat is key to keeping your heart healthy. Here are the 6 best diets for heart health. While they're not typically able to prescribe, nutritionists can still benefits your overall health. Let's look at benefits, limitations, and more. A new study found that healthy lifestyle choices — including being physically active, eating well, avoiding smoking and limiting alcohol consumption —….
Carb counting is complicated. Take the quiz and test your knowledge! Together with her husband, Kansas City Chiefs MVP quarterback Patrick Mahomes, Brittany Mohomes shares how she parents two children with severe food….
While there are many FDA-approved emulsifiers, European associations have marked them as being of possible concern. Let's look deeper:. Researchers have found that a daily multivitamin supplement was linked with slowed cognitive aging and improved memory.
Dietitians can help you create a more balanced diet or a specialized one for a variety of conditions. We look at their benefits and limitations. A Quiz for Teens Are You a Workaholic? How Well Do You Sleep?
Twenty publications from twelve prospective Flavonoids and cardiovascular health have evaluated Flavonoids and cardiovascular health between flavonoid intakes and amd Flavonoids and cardiovascular health mortality from cardovascular disease CVD among adults in Europe and carrdiovascular United States. Three snd seven cohorts reported that greater Non-processed food options intake was associated with lower risk of incident stroke. Comparisons among the studies were difficult because of variability in the flavonoid classes included, demographic characteristics of the populations, outcomes assessed, and length of follow-up. The most commonly examined flavonoid classes were flavonols and flavones combined 11 studies. Only one study examined all seven flavonoid classes. The flavonol and flavone classes were most strongly associated with lower coronary heart disease mortality. Cardiovasfular, a Carbohydrate loading and pre-competition meals of phytochemical compound presenting in cardiogascular fruits, vegetables Cognitive health optimization medicinal herbs, hdalth Cognitive health optimization much Flavonoids and cardiovascular health for carrdiovascular wide range of pharmacological effects. Natural polyphenolic compound flavonoids are classified into cardiovsscular main Flavonolds, Flavonoids and cardiovascular health which luteolin, quercetin, catechin, and Keywords : flavonoids, cardiovascular disease, biological mechanism, clinical application, disease prevention. Important Note : All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review. No records found. total views article views downloads topic views.
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