Flavonoid Intake and Cardiovascular Disease Mortality Among US Adults, Data from Third National Health and Nutrition Examination Survey Linked Mortality File (P18-013-19)

Abstract

ObjectivesThe objective of this research was to examine the association between total flavonoid intake and flavonoid sub-classes and CVD mortality among a nationally representative sample of US adults aged 40+ years at baseline and free of CVD. MethodsA nationally representative sample of adults from the NHANES III data (1988–1994; n = 7900; age > = 40 years) were matched with mortality data reported by the National Death Index through 2015 to examine associations between estimated usual intakes of total flavonoid intake and flavonoid sub-classes and CVD mortality. Cox Proportional Hazards regression models were constructed to estimate hazard ratios and 95% confidence intervals for CVD mortality. Up to four 24-hour recalls were used to estimate total flavonoid intake and flavonoid sub-class intake for participants at baseline. ResultsDuring a median follow-up of 17.9 years, there were 4245 death; 1629 CVD deaths (767 males, 862 females) documented. Mean flavonoid intake was 247.7 mg/day for males and 216 mg/day for males. We did not observe an inverse association between total flavonoid intake and CVD mortality for males (HR: 0.95, 95% CI 0.87, 1.03) or females (HR: 1.03, 95% CI 0.93, 1.14), after adjustments for demographic, lifestyle, clinical and dietary quality variables. We also did not find significant associations between intake of flavonoid sub-classes and CVD mortality. However, for males only, intake of flavanones was inversely associated with CVD mortality after adjustments for demographic variables, lifestyle, clinical variables and diet quality (HR: 0.93, 95% CI 0.87, 0.99, p-value < 0.04). ConclusionsIn this nationally representative study, with detailed information on flavonoid intake and CVD mortality data, we did not find an inverse association between total flavonoid intake and most flavonoid sub-classes and CVD mortality for adults aged 40+ years at baseline; however our findings do indicate a marginally significant inverse association between flavanone intake and CVD mortality for males only, after controlling for confounders. Funding SourcesNo funding sources to declare.