Frederik Dalgaard1, Nicola P Bondonno2, Kevin Murray3, Catherine P Bondonno4, Joshua R Lewis4, Kevin D Croft5, Cecilie Kyrø6, Gunnar Gislason7, Augustin Scalbert8, Aedin Cassidy9, Anne Tjønneland6, Kim Overvad10, Jonathan M Hodgson4. 1. Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark. 2. School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, Australia. Electronic address: n.bondonno@ecu.edu.au. 3. School of Population and Global Health, University of Western Australia, Perth, WA, Australia. 4. School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, Australia. 5. School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, Australia. 6. Danish Cancer Society Research Centre, Copenhagen, Denmark. 7. Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark; National Institute of Public Health, University of Southern Denmark, Odense, Denmark; Danish Heart Foundation, Copenhagen, Denmark. 8. International Agency for Research on Cancer, Lyon, France. 9. Institute for Global Food Security, Queen's University Belfast, Belfast, UK. 10. Department of Public Health, Aarhus University, Aarhus, Denmark; Faculty of Medicine, Aalborg University Hospital, Aalborg, Denmark.
Abstract
BACKGROUND: Flavonoids, compounds found in plant-based foods and beverages, might ameliorate vascular damage and atherosclerosis. Therefore, our aim was to assess the association between flavonoid intake and hospital admissions due to atherosclerotic cardiovascular disease. METHODS: In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study were cross-linked with Danish nationwide registries. Eligible participants were aged 50-65 years, had no previous history of atherosclerotic cardiovascular disease, and had completed a food-frequency questionnaire at baseline. We examined associations between flavonoid intake (calculated from food-frequency questionnaires with use of the Phenol-Explorer database) and hospital admissions for atherosclerotic cardiovascular disease, ischaemic heart disease, ischaemic stroke, or peripheral arterial disease. We obtained hazard ratios (HRs) using restricted cubic splines based on Cox proportional hazards models. FINDINGS: Of the participants recruited to the Danish Diet, Cancer, and Health study between 1993 and 1997, our study population was comprised of 53 552 participants, with a median follow-up of 21 years (IQR 15-22). During follow-up, 8773 participants were admitted to hospital for atherosclerotic cardiovascular disease. We observed non-linear associations between flavonoid intake and hospital admissions, plateauing at total flavonoid intakes of approximately 1000 mg per day. Compared with an intake of 175 mg per day, an intake of 1000 mg per day was associated with a 14% lower risk of atherosclerotic cardiovascular disease (HR 0·86, 95% CI 0·81-0·91). For disease subtypes, we observed a 9% lower risk of ischaemic heart disease (0·91, 0·85-0·98), a non-significant 9% lower risk of ischaemic stroke (0·91, 0·82-1·01), and a 32% lower risk of peripheral artery disease (0·68, 0·60-0·78). The overall associations were stronger in smokers than in non-smokers, as well as stronger in consumers of high (>20 g per day) quantities of alcohol than in those consuming low-to-moderate (≤20 g per day) quantities. INTERPRETATION: Our results suggest that ensuring an adequate consumption of flavonoid-rich foods, particularly in subpopulations at risk of atherosclerosis such as smokers and consumers of high quantities of alcohol might mitigate some of the risk of atherosclerotic cardiovascular disease. More studies are needed to support and validate these data. FUNDING: Danish Cancer Society.
BACKGROUND:Flavonoids, compounds found in plant-based foods and beverages, might ameliorate vascular damage and atherosclerosis. Therefore, our aim was to assess the association between flavonoid intake and hospital admissions due to atherosclerotic cardiovascular disease. METHODS: In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study were cross-linked with Danish nationwide registries. Eligible participants were aged 50-65 years, had no previous history of atherosclerotic cardiovascular disease, and had completed a food-frequency questionnaire at baseline. We examined associations between flavonoid intake (calculated from food-frequency questionnaires with use of the Phenol-Explorer database) and hospital admissions for atherosclerotic cardiovascular disease, ischaemic heart disease, ischaemic stroke, or peripheral arterial disease. We obtained hazard ratios (HRs) using restricted cubic splines based on Cox proportional hazards models. FINDINGS: Of the participants recruited to the Danish Diet, Cancer, and Health study between 1993 and 1997, our study population was comprised of 53 552 participants, with a median follow-up of 21 years (IQR 15-22). During follow-up, 8773 participants were admitted to hospital for atherosclerotic cardiovascular disease. We observed non-linear associations between flavonoid intake and hospital admissions, plateauing at total flavonoid intakes of approximately 1000 mg per day. Compared with an intake of 175 mg per day, an intake of 1000 mg per day was associated with a 14% lower risk of atherosclerotic cardiovascular disease (HR 0·86, 95% CI 0·81-0·91). For disease subtypes, we observed a 9% lower risk of ischaemic heart disease (0·91, 0·85-0·98), a non-significant 9% lower risk of ischaemic stroke (0·91, 0·82-1·01), and a 32% lower risk of peripheral artery disease (0·68, 0·60-0·78). The overall associations were stronger in smokers than in non-smokers, as well as stronger in consumers of high (>20 g per day) quantities of alcohol than in those consuming low-to-moderate (≤20 g per day) quantities. INTERPRETATION: Our results suggest that ensuring an adequate consumption of flavonoid-rich foods, particularly in subpopulations at risk of atherosclerosis such as smokers and consumers of high quantities of alcohol might mitigate some of the risk of atherosclerotic cardiovascular disease. More studies are needed to support and validate these data. FUNDING: Danish Cancer Society.
Authors: Catherine P Bondonno; Nicola P Bondonno; Frederik Dalgaard; Kevin Murray; Samantha L Gardener; Ralph N Martins; Stephanie R Rainey-Smith; Aedín Cassidy; Joshua R Lewis; Kevin D Croft; Cecilie Kyrø; Gunnar Gislason; Augustin Scalbert; Anne Tjønneland; Kim Overvad; Jonathan M Hodgson Journal: Alzheimers Dement (N Y) Date: 2021-05-13
Authors: Gabriele Gratton; Samuel R Weaver; Claire V Burley; Kathy A Low; Edward L Maclin; Paul W Johns; Quang S Pham; Samuel J E Lucas; Monica Fabiani; Catarina Rendeiro Journal: Sci Rep Date: 2020-11-24 Impact factor: 4.379