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. 2019 Aug 13;10(1):3651.
doi: 10.1038/s41467-019-11622-x.

Flavonoid intake is associated with lower mortality in the Danish Diet Cancer and Health Cohort

Nicola P Bondonno  1   2 , Frederik Dalgaard  3 , Cecilie Kyrø  4 , Kevin Murray  5 , Catherine P Bondonno  6   7 , Joshua R Lewis  6   7 , Kevin D Croft  6 , Gunnar Gislason  3   8   9 , Augustin Scalbert  10 , Aedin Cassidy  11 , Anne Tjønneland  4 , Kim Overvad  12   13 , Jonathan M Hodgson  6   7
Affiliations

Flavonoid intake is associated with lower mortality in the Danish Diet Cancer and Health Cohort

Nicola P Bondonno et al. Nat Commun. .

Abstract

Flavonoids, plant-derived polyphenolic compounds, have been linked with health benefits. However, evidence from observational studies is incomplete; studies on cancer mortality are scarce and moderating effects of lifestyle risk factors for early mortality are unknown. In this prospective cohort study including 56,048 participants of the Danish Diet, Cancer, and Health cohort crosslinked with Danish nationwide registries and followed for 23 years, there are 14,083 deaths. A moderate habitual intake of flavonoids is inversely associated with all-cause, cardiovascular- and cancer-related mortality. This strong association plateaus at intakes of approximately 500 mg/day. Furthermore, the inverse associations between total flavonoid intake and mortality outcomes are stronger and more linear in smokers than in non-smokers, as well as in heavy (>20 g/d) vs. low-moderate (<20 g/d) alcohol consumers. These findings highlight the potential to reduce mortality through recommendations to increase intakes of flavonoid-rich foods, particularly in smokers and high alcohol consumers.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The association of total flavonoid intake with all-cause and cause-specific mortality. Hazard ratios are based on Cox proportional hazards models adjusted for age, sex, BMI, smoking status, physical activity, alcohol intake, hypertension, hypercholesterolemia, social economic status (income), and prevalent disease and are comparing the specific level of flavonoid intake (horizontal axis) to the median intake for participants in the lowest intake quintile
Fig. 2
Fig. 2
The association between flavonoid subclass intakes and all-cause mortality. Hazard ratios are based on Cox proportional hazards models adjusted for age, sex, BMI, smoking status, physical activity, alcohol intake, hypertension, hypercholesterolemia, social economic status (income), and prevalent disease and are comparing the specific level of flavonoid intake (horizontal axis) to the median intake for participants in the lowest intake quintile
Fig. 3
Fig. 3
The association of total flavonoid intake with all-cause mortality, stratified by risk factors. Multivariable-adjusted association between total flavonoid intake and all-cause mortality stratified by current smoking status, alcohol intake and BMI. Values are hazards ratios and 95% CI for the highest compared to the lowest quintiles of intake. All analyses were standardized for age, sex, BMI, physical activity, alcohol intake, hypertension, hypercholesterolemia, smoking status, social economic status (income), and prevalent disease, not including the stratification variable for the subgroups
Fig. 4
Fig. 4
Consort flow diagram. CVD cardiovascular disease
See this image and copyright information in PMC

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