title: Flavonoid and lignan intake in a Mediterranean population: proposal for a holistic approach in polyphenol dietary analysis, the Moli-sani Study.
abstract: OBJECTIVE
  The objective of this study is to extract and assess data on the dietary intake of flavonoids and lignans in a healthy free-living Mediterranean population, using newly updated harmonized European Union food composition data. This work also aimed at analyzing in a holistic way the total content of the diet in major classes of polyphenols.
  
  
  METHODS
  Six thousand nine hundred and eighty-one men and 7048 women (aged ⩾ 35 years) of the Moli-sani cohort, randomly recruited from the general population, were analyzed. The European Prospective Investigation into Cancer (EPIC) and Nutrition-Food Frequency Questionnaire was used for dietary assessment. The polyphenol content of each food group was evaluated using Eurofir BioActive Substances in Food Information System and the United States Department of Agriculture food composition tables (FCTs), when data were missing. Flavonol, flavone, flavanone, flavanol, anthocyanin, isoflavone and lignan intakes were calculated and polyphenol antioxidant content (PAC) score (-28, 28) constructed, to assess the total content of the diet in these nutrients.
  
  
  RESULTS
  Seasonal and citrus fruits, leafy, grain, pod and root vegetables, and onions and garlic accounted for different proportions (11-70%) of the total intake of different polyphenols. Within the Moli-sani population, men or older, or no/former smokers, or physically active or obese/overweight individuals presented higher consumption of flavonoids, lignans and PAC score (P for all <0.01). Multiple regression analysis showed that PAC score and its seven components were positively associated with Mediterranean diet (MeD) adherence in both genders (β-coefficient >0, P<0.001). In addition, 1 unit increase in PAC score was associated with 7.1-7.8% increase in the likelihood of high MeD adherence (P<0.001).
  
  
  CONCLUSIONS
  The intake of flavonoids and lignans in an European Union population was calculated using harmonized European Union FCT data. In addition, a holistic approach in dietary analysis of polyphenol intake was proposed.
authors.affiliation: Laboratory of Molecular and Nutritional Epidemioloy, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pounis
authors.affiliation: Laboratory of Molecular and Nutritional Epidemioloy, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Castelnuovo
authors.affiliation: Laboratory of Molecular and Nutritional Epidemioloy, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bonaccio
authors.affiliation: Laboratory of Molecular and Nutritional Epidemioloy, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: S
authors.initials: S
authors.lastname: Costanzo
authors.affiliation: Laboratory of Molecular and Nutritional Epidemioloy, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: M
authors.initials: M
authors.lastname: Persichillo
authors.affiliation: Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Krogh
authors.affiliation: Laboratory of Molecular and Nutritional Epidemioloy, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: M B
authors.initials: MB
authors.lastname: Donati
authors.affiliation: Laboratory of Molecular and Nutritional Epidemioloy, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: G
authors.initials: G
authors.lastname: de Gaetano
authors.affiliation: Laboratory of Molecular and Nutritional Epidemioloy, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: L
authors.initials: L
authors.lastname: Iacoviello
mesh_terms: D000328:Adult; D000368:Aged; D000872:Anthocyanins / Q000008:administration & dosage / Q000032:analysis; D004032:Diet; D038441:Diet, Mediterranean; D002523:Edible Grain; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage / Q000032:analysis*; D005638:Fruit; D006801:Humans; D007529:Isoflavones / Q000008:administration & dosage / Q000032:analysis; D017705:Lignans / Q000008:administration & dosage / Q000032:analysis*; D008297:Male; D019083:Mediterranean Region; D008875:Middle Aged; D015596:Nutrition Assessment; D059808:Polyphenols / Q000008:administration & dosage / Q000032:analysis*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014675:Vegetables
chemical_list: D000872:Anthocyanins; D005419:Flavonoids; D007529:Isoflavones; D017705:Lignans; D059808:Polyphenols