title: Dietary flavonoid intake at midlife and healthy aging in women.
abstract: BACKGROUND
  Dietary flavonoids have been related to lower risks of various chronic diseases, but it is unclear whether flavonoid intake in midlife helps to maintain good health and wellbeing in aging.
  
  
  OBJECTIVE
  We examined the relation of flavonoid intake in midlife with the prevalence of healthy aging.
  
  
  METHODS
  We included 13,818 women from the Nurses' Health Study with dietary data and no major chronic diseases in 1984-1986 when they were aged in their late 50s (median age: 59 y); all women provided information on multiple aspects of aging an average of 15 y later. Intakes of 6 major flavonoid subclasses in midlife were ascertained on the basis of averaged intakes of flavonoid-rich foods from 2 food-frequency questionnaires (1984-1986). We defined healthy compared with usual aging as of age 70 y; healthy aging was based on survival to ≥70 y with maintenance of 4 health domains (no major chronic diseases or major impairments in cognitive or physical function or mental health).
  
  
  RESULTS
  Of women who survived until ≥70 y of age, 1517 women (11.0%) met our criteria for healthy aging. Compared with women in the lowest quintile of intake, women in the highest quintile of intake of several flavonoid subclasses at midlife had greater odds of healthy aging. After multivariable adjustment, ORs were as follows: flavones, 1.32 (95% CI: 1.10, 1.58); flavanone, 1.28 (95% CI: 1.08, 1.53); anthocyanin, 1.25 (95% CI: 1.04, 1.50); and flavonol, 1.18 (95% CI: 0.98, 1.42) (all P-trend ≤ 0.02). Consistently, greater intakes of major sources of these flavonoids (i.e., oranges, berries, onions, and apples) were associated with increased odds of healthy aging. We showed no association with flavan-3-ol monomers (P-trend = 0.80) or polymers (P-trend = 0.63).
  
  
  CONCLUSIONS
  Higher intake of flavonoids at midlife, specifically flavones, flavanones, anthocyanins, and flavonols, is associated with greater likelihood of health and wellbeing in individuals surviving to older ages.
authors.affiliation: From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (CS, QS, MKT, EBR, and FG); Institut National pour la Santé et la Recherche Médicale (INSERM), Centre INSERM U897-Epidémiologie-Biostatistiques and Université de Bordeaux, Bordeaux, France (CS); and the Departments of Epidemiology (EBR and FG) and Nutrition (QS and EBR), Harvard School of Public Health, Boston, MA.
authors.forename: Cécilia
authors.initials: C
authors.lastname: Samieri
authors.affiliation: From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (CS, QS, MKT, EBR, and FG); Institut National pour la Santé et la Recherche Médicale (INSERM), Centre INSERM U897-Epidémiologie-Biostatistiques and Université de Bordeaux, Bordeaux, France (CS); and the Departments of Epidemiology (EBR and FG) and Nutrition (QS and EBR), Harvard School of Public Health, Boston, MA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (CS, QS, MKT, EBR, and FG); Institut National pour la Santé et la Recherche Médicale (INSERM), Centre INSERM U897-Epidémiologie-Biostatistiques and Université de Bordeaux, Bordeaux, France (CS); and the Departments of Epidemiology (EBR and FG) and Nutrition (QS and EBR), Harvard School of Public Health, Boston, MA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Townsend
authors.affiliation: From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (CS, QS, MKT, EBR, and FG); Institut National pour la Santé et la Recherche Médicale (INSERM), Centre INSERM U897-Epidémiologie-Biostatistiques and Université de Bordeaux, Bordeaux, France (CS); and the Departments of Epidemiology (EBR and FG) and Nutrition (QS and EBR), Harvard School of Public Health, Boston, MA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.affiliation: From the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (CS, QS, MKT, EBR, and FG); Institut National pour la Santé et la Recherche Médicale (INSERM), Centre INSERM U897-Epidémiologie-Biostatistiques and Université de Bordeaux, Bordeaux, France (CS); and the Departments of Epidemiology (EBR and FG) and Nutrition (QS and EBR), Harvard School of Public Health, Boston, MA.
authors.forename: Francine
authors.initials: F
authors.lastname: Grodstein
mesh_terms: D000328:Adult; D000375:Aging; D032084:Citrus sinensis; D005247:Feeding Behavior; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage*; D005500:Follow-Up Studies; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D027845:Malus; D008875:Middle Aged; D015999:Multivariate Analysis; D019697:Onions; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D005419:Flavonoids
keywords: cohort studies; flavonoid; healthy aging; public health; risk factors in epidemiology