title: Dietary flavonoid intakes and risk of type 2 diabetes in US men and women.
abstract: BACKGROUND
  Data from mechanistic studies support a beneficial effect of specific flavonoids on insulin sensitivity. However, few studies have evaluated the relation between intakes of different flavonoid subclasses and type 2 diabetes.
  
  
  OBJECTIVE
  The objective was to evaluate whether dietary intakes of major flavonoid subclasses (ie, flavonols, flavones, flavanones, flavan-3-ols, and anthocyanins) are associated with the risk of type 2 diabetes in US adults.
  
  
  METHODS
  We followed up a total of 70,359 women in the Nurses' Health Study (NHS; 1984-2008), 89,201 women in the NHS II (1991-2007), and 41,334 men in the Health Professionals Follow-Up Study (1986-2006) who were free of diabetes, cardiovascular disease, and cancer at baseline.
  
  
  RESULTS
  During 3,645,585 person-years of follow-up, we documented 12,611 incident cases of type 2 diabetes. Higher intakes of anthocyanins were significantly associated with a lower risk of type 2 diabetes (pooled HR for the 3 cohorts from a comparison of extreme quintiles: 0.85; 95% CI: 0.80, 0.91; P-trend < 0.001) after multivariate adjustment for age, BMI, and lifestyle and dietary factors. Consumption of anthocyanin-rich foods, particularly blueberries (pooled HR: 0.77 from a comparison of ≥2 servings/wk with <1 serving/mo; 95% CI: 0.68, 0.87; P-trend < 0.001) and apples/pears (pooled HR: 0.77 from a comparison of ≥5 servings/wk with <1 serving/mo; 95% CI: 0.65, 0.83; P-trend < 0.001), was also associated with a lower risk of type 2 diabetes. No significant associations were found for total flavonoid intake or other flavonoid subclasses.
  
  
  CONCLUSIONS
  A higher consumption of anthocyanins and anthocyanin-rich fruit was associated with a lower risk of type 2 diabetes.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. nwedick@hsph.harvard.edu
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Wedick
authors.forename: An
authors.initials: A
authors.lastname: Pan
authors.forename: Aedín
authors.initials: A
authors.lastname: Cassidy
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.forename: Laura
authors.initials: L
authors.lastname: Sampson
authors.forename: Bernard
authors.initials: B
authors.lastname: Rosner
authors.forename: Walter
authors.initials: W
authors.lastname: Willett
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
mesh_terms: D000328:Adult; D000368:Aged; D000872:Anthocyanins / Q000008:administration & dosage / Q000032:analysis; D029798:Blueberry Plants / Q000737:chemistry; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000517:prevention & control*; D004032:Diet; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage* / Q000032:analysis; D005500:Follow-Up Studies; D005638:Fruit / Q000737:chemistry; D006801:Humans; D015994:Incidence; D008297:Male; D027845:Malus / Q000737:chemistry; D008875:Middle Aged; D011446:Prospective Studies; D031989:Pyrus / Q000737:chemistry; D012306:Risk; D014481:United States / Q000453:epidemiology
chemical_list: D000872:Anthocyanins; D005419:Flavonoids