title: Associations between flavonoids and cardiovascular disease incidence or mortality in European and US populations.
abstract: Twenty publications from twelve prospective cohorts have evaluated associations between flavonoid intakes and incidence or mortality from cardiovascular disease (CVD) among adults in Europe and the United States. The most common outcome was coronary heart disease mortality, and four of eight cohort studies reported significant inverse associations for at least one flavonoid class (multivariate adjusted p(trend) < 0.05). Three of seven cohorts reported that greater flavonoid 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. Evidence for protection from other flavonoid classes and CVD outcomes was more limited. The hypothesis that flavonoid intakes are associated with lower CVD incidence and mortality requires further study.
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts 02111, USA. julia.peterson@tufts.edu
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Peterson
authors.forename: Johanna T
authors.initials: JT
authors.lastname: Dwyer
authors.forename: Paul F
authors.initials: PF
authors.lastname: Jacques
authors.forename: Marjorie L
authors.initials: ML
authors.lastname: McCullough
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D004032:Diet; D005060:Europe / Q000453:epidemiology; D005419:Flavonoids / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D009752:Nutritional Status; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D005419:Flavonoids