title: Habitual intake of dietary flavonoids and risk of Parkinson disease.
abstract: OBJECTIVE
  To prospectively examine whether higher intakes of total flavonoids and their subclasses (flavanones, anthocyanins, flavan-3-ols, flavonols, flavones, and polymers) were associated with a lower risk of developing Parkinson disease (PD).
  
  
  METHODS
  In the current analysis, we included 49,281 men in the Health Professional Follow-up Study and 80,336 women from the Nurses' Health Study. Five major sources of flavonoid-rich foods (tea, berry fruits, apples, red wine, and orange/orange juice) were also examined. Flavonoid intake was assessed using an updated food composition database and a validated food frequency questionnaire.
  
  
  RESULTS
  We identified 805 participants (438 men and 367 women) who developed PD during 20-22 years of follow-up. In men, after adjusting for multiple confounders, participants in the highest quintile of total flavonoids had a 40%lower PD risk than those in the lowest quintile (hazard ratio [HR] = 0.60; 95% confidence interval 0.43, 0.83; p trend = 0.001). No significant relationship was observed in women (p trend = 0.62) or in pooled analyses (p trend = 0.23). In the pooled analyses for the subclasses, intakes of anthocyanins and a rich dietary source, berries, were significantly associated with a lower PD risk (HR comparing 2 extreme intake quintiles were 0.76 for anthocyanins and 0.77 for berries, respectively; p trend < 0.02 for both).
  
  
  CONCLUSIONS
  Our findings suggest that intake of some flavonoids may reduce PD risk, particularly in men, but a protective effect of other constituents of plant foods cannot be excluded.
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School,Boston, MA, USA. xiang.gao@channing.harvard.edu
authors.forename: X
authors.initials: X
authors.lastname: Gao
authors.forename: A
authors.initials: A
authors.lastname: Cassidy
authors.forename: M A
authors.initials: MA
authors.lastname: Schwarzschild
authors.forename: E B
authors.initials: EB
authors.lastname: Rimm
authors.forename: A
authors.initials: A
authors.lastname: Ascherio
mesh_terms: D000328:Adult; D000368:Aged; D000872:Anthocyanins / Q000008:administration & dosage; D001628:Beverages; D032084:Citrus sinensis; D015986:Confounding Factors, Epidemiologic; D005247:Feeding Behavior; D005260:Female; D044950:Flavanones / Q000008:administration & dosage; D047309:Flavones / Q000008:administration & dosage; D005419:Flavonoids / Q000008:administration & dosage*; D044948:Flavonols / Q000008:administration & dosage; D005500:Follow-Up Studies; D005638:Fruit; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D027845:Malus; D008875:Middle Aged; D016017:Odds Ratio; D010300:Parkinson Disease / Q000453:epidemiology* / Q000517:prevention & control*; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013662:Tea; D014920:Wine
chemical_list: D000872:Anthocyanins; D044950:Flavanones; D047309:Flavones; D005419:Flavonoids; D044948:Flavonols; D013662:Tea; C404987:flavan-3-ol