Dietary Flavonoid Intake and Body Measures Related to CVD Risk: Results from What We Eat in America, NHANES 2007–2010

Abstract

Flavonoids appear to reduce risk of cardiovascular disease (CVD). Obesity, especially abdominal obesity, increases CVD risk. Whereas multiple studies have found inverse associations between flavonoid intake and either BMI or waist circumference (WC), no research has examined whether flavonoid intake is related to class of CVD risk as based on a combination of these variables. The purpose of this study was to investigate in a large, nationally representative sample of U.S. adults whether flavonoid intake is related to having combined body measures that put one at very or extremely high risk for diabetes, high blood pressure, and CVD (hereafter termed “very high CVD risk”). Data from one 24‐hour recall for 5,232 males and 5,306 non‐pregnant, non‐lactating females age ≥20 years participating in What We Eat in America (WWEIA), NHANES 2007–2010 were analyzed. CVD risk was assessed based on BMI and WC, as described in NIH National Heart, Lung, and Blood Institute guidelines. Very high CVD risk was defined as either BMI = 30.0–34.9 and large WC (>102 cm for men, >88 cm for women) or BMI ≥ 35.0 (any WC). Intakes of total flavonoids and five flavonoid classes (anthocyanidins, flavan‐3‐ols, flavanones, flavones, and flavonols) were determined using the recently released, comprehensive database Flavonoid Values for USDA Survey Foods and Beverages 2007–2010. For total flavonoids and for each class, individuals were divided into four categories of intake. Percentages of individuals at very high CVD risk by category of flavonoid intake were estimated using logistic regression with adjustment for confounding variables. Trends in the percentage at very high CVD risk were assessed via orthogonal polynomial contrasts. One‐third of adults (34%) were classified at very high CVD risk. For all adults, inverse trends were observed between percentages of individuals at very high CVD risk and intakes of anthocyanidins, flavan‐3‐ols, and flavanones (p<0.01). Having very high CVD risk was less likely among individuals in the highest versus those in the lowest intake category for anthocyanidins (OR: 0.65; 99% CI: 0.54, 0.79) and flavan‐3‐ols (OR: 0.68; 99% CI: 0.54, 0.85). Higher anthocyanidin intake was associated with a lower percentage of individuals at very high CVD risk among both men and women; for flavan‐3‐ols, this relationship was observed for men only, and for flavanones it was found for women only. No significant associations were seen between intakes of total flavonoids, flavones, or flavonols and very high CVD risk. Among U.S. adults, intakes of some classes of flavonoids, in particular those contributed primarily by tea and fruits (but not vegetables), are inversely associated with levels of BMI and WC that are predictive of high or extremely high CVD risk.Support or Funding InformationARS, USDA.