title: Dietary intake and major food sources of polyphenols in people with type 2 diabetes: The TOSCA.IT Study.
abstract: OBJECTIVE
  Proper evaluation of polyphenols intake at the population level is a necessary step in order to establish possible associations with health outcomes. Available data are limited, and so far no study has been performed in people with diabetes. The aim of this work was to document the intake of polyphenols and their major food sources in a cohort of people with type 2 diabetes and in socio-demographic subgroups.
  
  
  METHODS
  We studied 2573 men and women aged 50-75 years. Among others, anthropometry was measured by standard protocol and dietary habits were investigated by food frequency questionnaire (EPIC). The intake of polyphenols was evaluated using US Department of Agriculture and Phenol-Explorer databases.
  
  
  RESULTS
  The mean total polyphenol intake was 683.3 ± 5.8 mg/day. Non-alcoholic beverages represented the main food source of dietary polyphenols and provided 35.5% of total polyphenol intake, followed by fruits (23.0%), alcoholic beverages (14.0%), vegetables (12.4%), cereal products and tubers (4.6%), legumes (3.7%) and oils (2.1%); chocolate, cakes and nuts are negligible sources of polyphenols in this cohort. The two most important polyphenol classes contributing to the total intake were flavonoids (47.5%) and phenolic acids (47.4%). Polyphenol intake increased with age and education level and decreased with BMI; furthermore, in the northern regions of Italy, the polyphenol intake was slightly, but significantly higher than in the central or southern regions.
  
  
  CONCLUSIONS
  The study documents for the first time the intake of polyphenols and their main food sources in people with diabetes using validated and complete databases of the polyphenol content of food. Compared with published data, collected in people without diabetes, these results suggest a lower intake and a different pattern of intake in people with diabetes.
authors.affiliation: Deparment of Clinical Medicine and Surgery, Medical School "Federico II" University of Naples, Via S. Pansini, n.5, 80131, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Vitale
authors.affiliation: Deparment of Clinical Medicine and Surgery, Medical School "Federico II" University of Naples, Via S. Pansini, n.5, 80131, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Masulli
authors.affiliation: Deparment of Clinical Medicine and Surgery, Medical School "Federico II" University of Naples, Via S. Pansini, n.5, 80131, Naples, Italy.
authors.forename: A A
authors.initials: AA
authors.lastname: Rivellese
authors.affiliation: Divisione di Endocrinologia, Diabete e Metabolismo, Dipartimento di Medicina, Università di Verona, Verona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bonora
authors.affiliation: Dipartimento di Patologia, Sperimentale, Ospedale di Desio, Università di Milano Bicocca, Milano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cappellini
authors.affiliation: CORESEARCH, Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nicolucci
authors.affiliation: Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Squatrito
authors.affiliation: U.O. Diabetologia e Malattie Metaboliche, Ospedale F. Renzetti, Lanciano, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Antenucci
authors.affiliation: U.O.C. Diabetologia, Endocrinologia, Malattie Metaboliche, Campobasso, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Barrea
authors.affiliation: U.O. Malattie Metaboliche e Diabetologia, Ospedale di Cisanello, Pisa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bianchi
authors.affiliation: Centro Studi ANMCO, Firenze, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bianchini
authors.affiliation: U.O.C. Diabetologia, Ospedale Sandro Pertini, Roma, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fontana
authors.affiliation: Dipartimento di Medicina Generale e Specialistica, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Fornengo
authors.affiliation: Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari "Aldo Moro", Bari, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Giorgino
authors.affiliation: U.O. di Malattie del Metabolismo, Università "Magna Graecia", Catanzaro, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gnasso
authors.affiliation: Divisione di Endocrinologia e Malattie del Metabolismo, Ospedale Careggi, Firenze, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Mannucci
authors.affiliation: SSD Malattie del Metabolismo, Policlinico S. Orsola Malphighi, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mazzotti
authors.affiliation: Deparment of Clinical Medicine and Surgery, Medical School "Federico II" University of Naples, Via S. Pansini, n.5, 80131, Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Nappo
authors.affiliation: Unità Complessa di Endocrinologia, San Giovanni Rotondo, Italy.
authors.forename: A P
authors.initials: AP
authors.lastname: Palena
authors.affiliation: U.O. Endocrinologia, "Ospedali Riuniti Papardo", Messina, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Pata
authors.affiliation: MISEM, Università di Perugia, Perugia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Perriello
authors.affiliation: Struttura complessa di Diabetologia, Ospedale Fiorini, Terracina, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Potenziani
authors.affiliation: UO Endocrinologia/Diabetologia, ASST Valle Olona, Varese, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Radin
authors.affiliation: Struttura complessa di Diabetologia, Ospedale San Donato, Arezzo, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Ricci
authors.affiliation: SC Malattie Metaboliche e Diabetologia, ASL Torino 5, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Romeo
authors.affiliation: Endocrinologia e Diabetologia di Cesena, ASL della Romagna, Romagna, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Santini
authors.affiliation: Servizio di Diabetologia, Ospedale San Matteo degli infermi, Spoleto, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Scarponi
authors.affiliation: Unità Operativa Funzionale di Diabetologia, Lecce, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Serra
authors.affiliation: MISEM, Università di Perugia, Perugia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Timi
authors.affiliation: Deparment of Clinical Medicine and Surgery, Medical School "Federico II" University of Naples, Via S. Pansini, n.5, 80131, Naples, Italy.
authors.forename: A A
authors.initials: AA
authors.lastname: Turco
authors.affiliation: Centro antidiabetico, Azienda Ospedaliera Giustinianeo, Padova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Vedovato
authors.affiliation: Unità Operativa di Diabetologia, Ospedale Guglielmo da Saliceto, Piacenza, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Zavaroni
authors.affiliation: Unità di Epidemiologia e Prevenzione Fondazione IRCCS, Istituto Nazionale Tumori, Milano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Grioni
authors.affiliation: Deparment of Clinical Medicine and Surgery, Medical School "Federico II" University of Naples, Via S. Pansini, n.5, 80131, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Riccardi
authors.affiliation: Deparment of Clinical Medicine and Surgery, Medical School "Federico II" University of Naples, Via S. Pansini, n.5, 80131, Naples, Italy. ovaccaro@unina.it.
authors.forename: O
authors.initials: O
authors.lastname: Vaccaro
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage* / Q000032:analysis; D001628:Beverages / Q000032:analysis; D002934:Cinnamates / Q000008:administration & dosage / Q000032:analysis; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000208:ethnology; D003927:Diet, Diabetic / Q000208:ethnology; D000072001:Diet, Healthy / Q000208:ethnology; D005260:Female; D005419:Flavonoids / Q000008:administration & dosage* / Q000032:analysis; D005638:Fruit / Q000737:chemistry; D006027:Glycosides / Q000008:administration & dosage / Q000032:analysis; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009753:Nutritive Value; D010349:Patient Compliance / Q000208:ethnology; D010636:Phenols / Q000008:administration & dosage* / Q000032:analysis; D059808:Polyphenols / Q000008:administration & dosage / Q000032:analysis
chemical_list: D000975:Antioxidants; D002934:Cinnamates; D005419:Flavonoids; D006027:Glycosides; D010636:Phenols; D059808:Polyphenols
keywords: Age; BMI; Diabetes; Diet; Flavonoids; Food groups; Geographical area; Intake; Phenolic acids; Polyphenols; TOSCA.IT study