title: Polyphenol intake and cardiovascular risk factors in a population with type 2 diabetes: The TOSCA.IT study.
abstract: The role of polyphenol intake on cardiovascular risk factors is little explored, particularly in people with diabetes.
  
  
  
  To evaluate the association between the intake of total polyphenols and polyphenol classes with the major cardiovascular risk factors in a population with type 2 diabetes.
  
  
  
  Dietary habits were investigated in 2573 males and females participants of the TOSCA.IT study. The European Prospective Investigation on Cancer and Nutrition (EPIC) questionnaire was used to assess dietary habits. In all participants, among others, we assessed anthropometry, plasma lipids, blood pressure, C-reactive protein and HbA1c following a standard protocol. The USDA and Phenol-Explorer databases were used to estimate the polyphenol content of the habitual diet.
  
  
  
  Average intake of polyphenols was 683.3 ± 5.8 mg/day. Flavonoids and phenolic acids were the predominant classes (47.5% and 47.4%, respectively). After adjusting for potential confounders, people with the highest intake of energy-adjusted polyphenols (upper tertile) had a more favorable cardiovascular risk factors profile as compared to people with the lowest intake (lower tertile) (BMI was 30.7 vs 29.9 kg/m2, HDL-cholesterol was 45.1 vs 46.9 mg/dl, LDL-cholesterol was 103.2 vs 102.1 mg/dl, triglycerides were 153.4 vs 148.0 mg/dl, systolic and diastolic blood pressure were respectively 135.3 vs 134.3 and 80.5 vs 79.6 mm/Hg, HbA1c was 7.70 vs 7.67%, and C-reactive Protein was 1.29 vs 1.25 mg/dl, p < .001 for all). The findings were very similar when the analysis was conducted separately for flavonoids or phenolic acids, the two main classes of polyphenols consumed in this population.
  
  
  
  Polyphenol intake is associated with a more favorable cardiovascular risk factors profile, independent of major confounders. These findings support the consumption of foods and beverages rich in different classes of polyphenols particularly in people with diabetes.
  
  
  
  http://www.clinicaltrials.gov; Study ID number: NCT00700856.
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università"Federico II", Naples, Italy.
authors.forename: Marilena
authors.initials: M
authors.lastname: Vitale
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università"Federico II", Naples, Italy.
authors.forename: Olga
authors.initials: O
authors.lastname: Vaccaro
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università"Federico II", Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Masulli
authors.affiliation: Dipartimento di Endocrinologia, Diabetologia e Metabolismo, Università di Verona, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Bonora
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Del Prato
authors.affiliation: ASL Torino 5, Chieri, Italy.
authors.forename: Carlo B
authors.initials: CB
authors.lastname: Giorda
authors.affiliation: CORESEARCH, Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Squatrito
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università"Federico II", Naples, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Auciello
authors.affiliation: Diabetologia, Ospedale Infermi di Rimini, Italy.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Babini
authors.affiliation: Dipartimento di Patologia Sperimentale, Ospedale di Desio, Università di Milano Bicocca, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bani
authors.affiliation: UOC di Diabetologia Universitaria, Ospedale Santa Maria Goretti, Latina, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Buzzetti
authors.affiliation: UOSD Diabetologia, Presidio Ospedaliero, Atri, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Cannarsa
authors.affiliation: UO Endocrinologia e Malattie del Metabolismo, AOU di Foggia, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Cignarelli
authors.affiliation: Dipartimento di Endocrinologia, Diabetologia e Metabolismo, Università di Verona, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Cigolini
authors.affiliation: IRPPS Research National Council, Penta di Fisciano, Salerno, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Clemente
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università"Federico II", Naples, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Cocozza
authors.affiliation: SSD Diabetologia e Malattie del Metabolismo, ASL 4 Chiavarese, Genova, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Corsi
authors.affiliation: UOC Malattie Metaboliche e Diabetologia, INRCA-IRCCS Institute, Ancona, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: D'Angelo
authors.affiliation: Dipartimento di Medicina Clinica e Sperimentale, Università di Parma, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Dall'Aglio
authors.affiliation: UOC Diabetologia, ASL 6, Livorno, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Di Cianni
authors.affiliation: UOC Diabetologia e Dietologia, Ospedale Pertini, Roma, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Fontana
authors.affiliation: UO Diabetologia e Malattie del Metabolismo, USL1 di Massa e Carrara, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Gregori
authors.affiliation: Unità di Epidemiologia e Prevenzione, Fondazione IRCCS, Istituto Nazionale Tumori, Milano, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Grioni
authors.affiliation: Dipartimento di Endocrinologia e Malattie Metaboliche, Università di Palermo, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Giordano
authors.affiliation: UOSD Diabetologia e Malattie del Metabolismo, Ospedale San Salvatore, L'Aquila, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Iannarelli
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università"Federico II", Naples, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Iovine
authors.affiliation: Dipartimento di Medicina, Università di Padova, Italy.
authors.forename: Annunziata
authors.initials: A
authors.lastname: Lapolla
authors.affiliation: Dipartimento di Medicina Interna, Università di Tor Vergata, Roma, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Lauro
authors.affiliation: Dipartimento Emergenza e Trapianti di Organi, Università"Aldo Moro", Bari, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Laviola
authors.affiliation: DIMI, Università di Genova, IRCCS San Martino, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mazzucchelli
authors.affiliation: Dipartimento di Patologia Sperimentale, Ospedale di Desio, Università di Milano Bicocca, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Signorini
authors.affiliation: SOC di Endocrinologia e Malattie del Metabolismo, AOU S. Maria della Misericordia, Udine, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Tonutti
authors.affiliation: USC Malattie Endocrine-Diabetologia, ASST "Papa Giovanni XXIII", Bergamo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Trevisan
authors.affiliation: UO Malattie Metaboliche, Dietologia e Nutrizione Clinica, AOU Arcispedale S. Anna, Ferrara, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Zamboni
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università"Federico II", Naples, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Riccardi
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Università"Federico II", Naples, Italy. Electronic address: rivelles@unina.it.
authors.forename: Angela A
authors.initials: AA
authors.lastname: Rivellese
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004032:Diet; D004305:Dose-Response Relationship, Drug; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage / Q000097:blood; D006801:Humans; D062385:Hydroxybenzoates / Q000008:administration & dosage / Q000097:blood; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D059808:Polyphenols / Q000008:administration & dosage* / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005419:Flavonoids; D062385:Hydroxybenzoates; D059808:Polyphenols; D014280:Triglycerides; C017616:phenolic acid
keywords: Cardiovascular risk; Dietary polyphenols; Flavonoids; Phenolic acids; Type 2 diabetes