title: Antioxidant flavonols and ischemic heart disease in a Welsh population of men: the Caerphilly Study.
abstract: Antioxidant flavonols and their major food source, black tea, have been associated with a lower risk of ischemic heart disease (IHD) and stroke in Dutch men. We investigated whether flavonol intake predicted a lower rate of IHD in 1900 Welsh men aged 45-59 y, who were followed up for 14 y. Flavonol intake, mainly from tea to which milk is customarily added, was not related to IHD incidence [relative risk (RR), highest compared with lowest quartile: 1.0; 95% CI: 0.6, 1.6; P for trend = 0.996; n = 186] but was weakly positively related to IHD mortality (RR: 1.6; 95% CI: 0.9, 2.9; P = 0.119; n = 131) and cancer mortality (RR: 1.3; 95% CI: 0.7, 2.3; P = 0.150; n = 104) and strongly related to total mortality (RR: 1.4; 95% CI: 1.0, 2.0; P = 0.014; n = 334). Men with the highest consumption of tea (> 1.2 L, or > 8 cups/d) had an RR of 2.4 (95% CI: 1.5, 3.9) of dying in the follow-up period compared with men consuming < 300 mL/d (< 2 cups/d). We conclude that intake of antioxidant flavonols is not inversely associated with IHD risk in the United Kingdom. Possibly, flavonols from tea to which milk is added are not absorbed; experimental evidence suggests that adding milk to tea abolishes the plasma antioxidant-raising capacity of tea. The apparent association between tea consumption and increased mortality in this population merits further investigation.
authors.affiliation: Department of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and the Environment, Bilthoven, Netherlands. Michael.Hertog@rium.ml
authors.forename: M G
authors.initials: MG
authors.lastname: Hertog
authors.forename: P M
authors.initials: PM
authors.lastname: Sweetnam
authors.forename: A M
authors.initials: AM
authors.lastname: Fehily
authors.forename: P C
authors.initials: PC
authors.lastname: Elwood
authors.forename: D
authors.initials: D
authors.lastname: Kromhout
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000008:administration & dosage*; D005419:Flavonoids / Q000008:administration & dosage* / Q000009:adverse effects; D044948:Flavonols; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008892:Milk; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D009369:Neoplasms / Q000401:mortality; D012307:Risk Factors; D013662:Tea; D014852:Wales
chemical_list: D000975:Antioxidants; D005419:Flavonoids; D044948:Flavonols; D013662:Tea