Consumption Of Flavonoids Research Articles

Inverse association between dietary flavonoid intake and nocturia in middle-aged and older adults from NHANES 2007–2010

Nocturia is an increasingly prevalent chronic disease that affects the quality of an individual’s life. The prevalence of nocturia exceeds 50% among older adults in the U.S. Inflammation and oxidative stress are considered potential factors affecting nocturia, according to prior research. Flavonoids have attracted considerable interest due to their anti-inflammatory, antioxidant, and anti-aging properties. The association between flavonoid consumption and nocturia has been rarely investigated. For this cross-sectional study, we selected 5926 middle-aged and older adults over 40 from the 2007–2010 National Health and Nutrition Examination Survey (NHANES). Daily dietary flavonoid consumption was assessed through two 24-hour dietary recall interviews and the principal outcome was assessed based on a standardized questionnaire administered by trained interviewers. Weighted multivariate logistic regression and stratified analysis were employed to evaluate the impact of dietary total flavonoid consumption on nocturia. Restricted cubic spline (RCS) was utilized to explore whether there is a non-linear association between total flavonoid intake and nocturia. In addition, we performed weighted logistic regression and weighted quantile sum (WQS) regression by six flavonoid species (isoflavones, anthocyanins, flavan-3-ols, flavanones, flavonoids and flavonols) to estimate a combined mixture sum effect as well as the contribution of each mixture component. Subgroup analysis help us identify heterogeneity in these relationships and enhances the applicability of the research findings across different groups. After fully adjusting for confounders, weighted logistic regression models indicated that dietary flavonoid intake was significantly associated with a decreased prevalence of nocturia (OR: 0.93; 95% CI: 0.88-1.00, P-value = 0.036). This trend remained significant in the analysis stratified by quartile level of flavonoid intake. RCS analysis demonstrated an inverse linear correlation between total flavonoid consumption and nocturia. Analysis conducted through quartile stratification of six flavonoid species and WQS regressions showed that anthocyanins, flavan-3-ols, and flavonols were crucial elements. Within these subclasses, Peonidin in anthocyanins, Catechin and Theaflavin-3,3’-digallate in flavan-3-ols, and Isorhamnetin, Kaempferol, and Quercetin in flavonols were also investigated and may have contributed significantly. Our study revealed an inverse association between dietary flavonoid intake and nocturia in middle-aged and older adults, and anthocyanins, flavan-3-ols and flavonols were protectively associated with nocturia.

Estimated dietary flavonoid intake and major food contributors in the Portuguese population: results from the National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016).

Flavonoids are a key class of polyphenols, i.e., phytochemical compounds present in foods and beverages, which have been described as having health benefits in preventing several chronic diseases. Estimating flavonoid intake has already been conducted in several countries but has yet to be performed in Portugal. This study included 5,005 participants aged 3-84 years and aimed to estimate dietary flavonoid intake in the Portuguese population, using data from the National Food and Physical Activity Survey 2015-2016, providing information on intake, main food contributors, and the socio-demographic factors associated with the intake. Food intake data from the Survey was converted to flavonoid intake using a database built to include the most updated USDA databases on flavonoids, isoflavones and proanthocyanidins, and the Phenol-Explorer database. The rationale for combining food consumption data and different flavonoid databases using the FoodEx2 classification system was established. Linear regressions assessed the associations between socio-demographic factors and dietary flavonoid intake. The total flavonoid intake of the Portuguese population was estimated to be 107.3 mg/day. Flavanols were the most representative subclass, followed by flavonols, anthocyanidins, flavanones, flavones and isoflavones. Fruits and vegetables were the primary food contributors, providing 31.5% and 12.4% of the total flavonoid intake. Adolescents had the lowest total flavonoid intake, and older adults had the highest. This study provides information on the Portuguese population's dietary flavonoids, allowing for international comparisons. It can also streamline forthcoming investigations into the link between flavonoid consumption and its impact on health, contributing to the future establishment of dietary reference values.

The mediating role of C-reactive protein (CRP) in the dietary intake of flavonoids and the risk of albuminuria.

Background: Prior experimental investigations have highlighted the beneficial effects of flavonoid consumption on renal function. However, a comprehensive evaluation of their impact on modulating albuminuria risk within population-based epidemiological studies is still limited. This study aimed to fill this gap by examining the correlation between flavonoid intake and albuminuria risk, while also shedding light on the potential mediating influence of inflammation in this association. Methods: We utilized data from 29 940 participants spanning three cycles (2007-2008, 2009-2010, and 2017-2018) of the National Health and Nutrition Examination Survey (NHANES). We employed rigorous analytical methods, encompassing logistic regression, restricted cubic splines (RCS), and mediation analysis, to assess the link between dietary flavonoid intake and albuminuria risk. Results: Our findings reveal consistent negative associations between total flavonoids and specific subclasses, including flavonols, flavones, flavan-3-ols, anthocyanidins, and catechins, and the risk of albuminuria. Specifically, after adjusting for confounding factors, each logarithmic unit increase in these flavonoid categories was associated with a decrease in albuminuria risk ranging from 3% to 12%. The mediating proportion of C-reactive protein (CRP) in the relationships between the intake of total flavonoids, flavonols, flavones, catechins, and flavan-3-ols and albuminuria risk was 7.3%, 5.6%, 2.3%, 7.7%, and 4.6%, respectively. Conclusions: These results indicate that increased consumption of flavonoid-rich foods contributes to a reduced risk of albuminuria.

Dietary flavonoid intakes are associated with lower risk of NAFLD: a UK biobank study

Mechanistic studies and short-term randomised trials suggest that higher intakes of dietary flavonoids may protect against non-alcoholic fatty liver disease (NAFLD)(1–3). However, little research has been conducted at a population level, and to date no long term prospective study has assessed the associations between flavonoid intakes and NAFLD risk(4). We aim to perform the first population-based study with long-term follow-up on flavonoid consumption and NAFLD incidence.In a prospective study, we assessed the associations between flavonoid intakes based on ≥2 24hour dietary assessments and NAFLD risk among 121,563 adults aged 40 to 69 years by multivariable regression analyses. Flavonoid intakes were assessed on three levels: a novel flavodiet score (FDS), flavonoid rich foods, and flavonoid subclasses. Cox proportional hazard models were used to assess NAFLD risk, and linear trend tests were used to test for significance. Additional sensitivity analysis was conducted using both a FDS excluding red wine, and non flavonoid containing equivalent foods as negative controls.Over 10 years of follow-up, 1090 cases of NAFLD were observed. When compared to the lowest Quartile, the highest quartile (Q4) of the Flavodiet Score (FDS) was associated with a 20% lower risk of NAFLD (HR (95%CI): 0.80 (0.66−0.96), P trend = 0.02). Additionally, higher apple intake was associated with a 22% lower risk of NAFLD (HR (95%CI): 0.78 (0.66 - 0.92), P trend = <0.01), while higher tea consumption was associated with a 13% lower risk of NAFLD (HR (95%CI): 0.87 (0.73 -1.03), P trend = 0.046). Of the flavonoid subclasses, we observed that higher intakes of proanthocyanidins, theaflavins and thearubigins, flavonols and flavan-3-ols were also associated with lower risk.In a large UK cohort, we demonstrate for the first time that flavonoid-rich diets, containing approximately 6-servings of flavonoid rich food per day, are associated with lower risk of NAFLD. As such, the consumption of flavonoid-rich foods may reduce the risk of NAFLD and its sequalae among middle-aged adults.

A flavonoid-rich diet is associated with lower risk and improved imaging biomarkers of nonalcoholic fatty liver disease: a prospective cohort study

BackgroundMechanistic studies and short-term randomized trials suggest higher intakes of dietary flavonoids may protect against nonalcoholic fatty liver disease (NAFLD). ObjectivesWe aimed to perform the first population-based study with long-term follow-up on flavonoid consumption, incident NAFLD, and validated NAFLD biomarkers. MethodsIn a prospective study, we assessed the associations between flavonoid intake based on ≥2 24-h dietary assessments and NAFLD risk among 121,064 adults aged 40–69 y by multivariable Cox regression analyses. We further assessed the associations between flavonoid intake and magnetic resonance imaging-derived liver fat (a subset of n = 11,435) and liver-corrected T1 values (cT1; a subset of n = 9570), a marker of steatosis, more sensitive to inflammatory pathology. ResultsOver 10 y of follow-up, 1081 cases of NAFLD were identified. Participants in the highest quartile (Q4) of the flavodiet score reflecting the consumption of foods high in flavonoids, had a 19% lower risk of NAFLD compared to the lowest quartile (Q1) [hazard ratio (HR) (95% confidence interval (CI): 0.81 (0.67, 0.97), P-trend = 0.02)]. Moreover, participants in the Q4 of the flavodiet score had lower liver fat and cT1 values than those in Q1 (liver fat: relative difference Q1 compared with Q4: –5.28%, P-trend = <0.001; cT1: relative difference Q1 compared with Q4: –1.73%, P-trend = <0.001). When compared to low intakes, high intakes of apples and tea were associated with lower NAFLD risk [apples: HR (95% CI): 0.78 (0.67, 0.92), P-trend = <0.01; tea: HR (95% CI): 0.86 (0.72, 1.02), P-trend = 0.03)]. Additionally, when compared to low intakes, high apple, tea, and dark chocolate intakes were significantly associated with lower liver fat values, whereas high tea and red pepper intakes were significantly associated with lower cT1 values. ConclusionsThe consumption of flavonoid-rich foods was associated with a reduced risk of NAFLD among middle-aged adults.

Association between dietary intake of flavonoid and chronic kidney disease in US adults: Evidence from NHANES 2007-2008, 2009-2010, and 2017-2018.

Studies investigating the relationship between flavonoid intake and chronic kidney disease (CKD) are limited. This study investigated the association between daily flavonoid intake and CKD in US adults by using data for 2007-2008, 2009-2010, and 2017-2018 from the National Health and Nutrition Examination Survey (NHANES) database. This study employed a cross-sectional design and used data from three cycles of the continuous NHANES: 2007-2008, 2009-2010, and 2017-2018. NHANES researchers collected data related to consumption of various food and beverages from participants by employing 24-h dietary recall questionnaires. CKD is defined as an estimated glomerular filtration rate of < 60 mL/min/1.73m2 or a urine albumin-to-creatinine ratio of ≥ 30 mg/g. The odds ratios (OR) for CKD risk in the second (Q2), third (Q3), and fourth (Q4) quartiles of total flavonoid intake, compared with that in the first (Q1) quartile, were 0.780 (95% CI: 0.600, 1.015), 0.741 (95% CI: 0.573, 0.957), and 0.716 (95% CI: 0.554, 0.925), respectively (with a P value for the trend of 0.040). According to the restricted cubic spline analysis, total flavonoid intake exhibited a non-linear relationship with CKD risk (P < 0.001). Our findings suggest that a potential J-shaped relationship was observed between total flavonoid consumption and CKD risk, with an inflection point at 69.58 mg/d. Our study indicates that a moderate intake of flavonoids may confer renal benefits which may offer novel strategies for CKD treatment.

Exploring flavonoid intake and all-cause mortality in diverse health conditions: Insights from NHANES 2007–2010 and 2017–2018

ObjectivesFlavonoids exhibit antioxidative, anti-inflammatory, and anticancer properties, yet the relationship between flavonoid intake and all-cause mortality in the obese population remains unclear. MethodsThis study included NHANES participants from 2007 to 2010 and 2017 to 2018. Cox regression analysis evaluated the impact of total flavonoid intake on all-cause mortality among participants with varying comorbidity profiles. Subgroup analysis was conducted by separately analyzing the six sub-classes of total flavonoids (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones). Sensitivity analysis was used to investigate the impact of total flavonoid intake on all-cause mortality among patients with different comorbidities. ResultsDuring a median follow-up period of 9.92 years (interquartile range (IQR), 5.54–14.29 years), a total of 639 participants died. COX regression analysis revealed a positive impact of flavonoid intake on all-cause mortality among participants with chronic kidney disease, with greater benefits observed in obese participants [hazard ratio (HR): 0.22, 95% CI: 0.11–0.44). In metabolically healthy obese participants (HR: 0.15, 95% CI: 0.07–0.35), obese individuals with diabetes (HR: 0.51, 95% CI: 0.29–0.88), and obese individuals with comorbid cardiovascular disease (HR: 0.37, 95% CI: 0.17–0.83), flavonoid intake was associated with a reduced risk of all-cause mortality. Restricted cubic spline (RCS) analysis indicated a non-linear relationship in obese participants, with optimal intake levels ranging from 319.4978 to 448.6907 mg/day, varying based on different comorbidity profiles. Subgroup analysis revealed varying effects of total flavonoid components in different health conditions, with hazard ratios ranging from 0.06 for higher levels of flavonol to 0.59 for higher levels of anthocyanidins in the Cox model. Sensitivity analyses further indicated that individuals with obesity and comorbid diabetes or CKD see the greatest benefit from flavonoid intake. ConclusionsThe consumption of flavonoids may be associated with a decreased risk of all-cause mortality. Consumption of flavonoids is particularly beneficial for individuals with obesity and comorbidities.

Intake of dietary flavonoids in relation to overactive bladder among U.S. adults: a nutritional strategy for improving urinary health.

The increasing influence of overactive bladder (OAB) on physical as well as mental health of individuals is becoming more pronounced annually, as evidenced by the urge urinary incontinence and nocturia. Symptoms in OAB patients may be influenced by inflammation and oxidative stress. Flavonoids are recognized as significant anti-inflammatory and antioxidant agents, which are commonly available in fruits, tea, vegetables, etc. Previous research has demonstrated the therapeutic potential of flavonoids and their subclasses in treating inflammation, and oxidative stress. Despite this, there remains a paucity of research exploring the potential correlation between flavonoid consumption, specifically within distinct subclasses, and OAB. Thus, our study aims to investigate the relationship between flavonoid intake and OAB to identify possible dietary interventions for OAB management. We utilized the survey data from the National Health and Nutrition Examination Survey (NHANES) and the USDA Food and Nutrient Database for Dietary Studies (FNDDS) to investigate the relationship between dietary intake of total and subclass flavonoids and the risk of OAB based on 13,063 qualified American adults. The dietary flavonoid intake was estimated from two 24-h dietary recalls. Weighted multivariate logistic regression model, quantile-based g-computation, restricted cubic spline model, and stratified analysis were used to explore the association between flavonoid intake and OAB, respectively. The participants diagnosed with OAB exhibited a higher percentage of being female, older, Non-Hispanic Black, unmarried, former drinkers, having a lower annual household income, lower poverty to income ratio, lower educational attainment, and a higher likelihood of being obese and smokers. Upon adjusting for confounding factors, the weighted logistic regression models revealed that the third quartile of consumption of anthocyanidin and the second quartile of consumption of flavone were significantly associated with the reduced odds of OAB, while total flavonoid consumption did not show a significant correlation with the risk of OAB. The quantile-based g-computation model indicated that flavone, anthocyanidin and flavonol were the primary contributors to the observed negative correlation. Furthermore, the restricted cubic spline models demonstrated a J-shaped non-linear exposure-response association between anthocyanidin intake and the risk of OAB (P nonlinear = 0.00164). The stratified and interaction analyses revealed that the relationship between anthocyanidin intake and the risk of OAB was significantly influenced by age (P interaction = 0.01) and education level (P interaction = 0.01), while the relationship between flavone intake and the risk of OAB was found to vary by race (P interaction = 0.02) and duration of physical activity (P interaction = 0.05). Our research suggests that consuming a diet rich in flavonoid subclass anthocyanidin and flavone is associated with a reduced risk of OAB, potentially offering clinical significance in the prevention of OAB development. This underscores the importance of dietary adjustments in the management of OAB symptoms.

Flavonoids intake and weight-adjusted waist index: insights from a cross-sectional study of NHANES.

This study conducted data on 15,446 adults to explore the impact of flavonoids on weight-adjusted waist index (WWI). This was a nationwide cross-sectional study among US adults aged 20 years or older. Dietary intake of flavonoids was assessed through 24-h recall questionnaire. WWI was calculated by dividing waist circumference (WC) by the square root of weight. We utilized weighted generalized linear regression to evaluate the association between flavonoids intake and WWI, and restricted cubic splines (RCS) to explore potential non-linear relationships. Our findings indicated that individuals with lower WWI experienced a notable increase in their consumption of total flavonoids, flavanones, flavones, flavan-3-ols, and anthocyanidins intake (β (95% CI); -0.05(-0.09, -0.01); -0.07(-0.13, 0.00); -0.07(-0.11, -0.02); -0.06(-0.11, 0.00); -0.13(-0.18, -0.08), respectively), with the exception of flavonols and isoflavones. Additionally, consumption of total flavonoids, flavonols, flavanones, isoflavones, and flavan-3-ols had a non-linear relationship with WWI (all P for non-linearity < 0.05). Furthermore, the effect of total flavonoids on WWI varied in race (P for interaction = 0.011), gender (P for interaction = 0.038), and poverty status (P for interaction = 0.002). These findings suggested that increase the intake of flavonoids might prevent abdominal obesity, but further prospective studies are requested before dietary recommendation.

Dietary Flavonoids Consumption and Health: An Umbrella Review.

The current evidence between dietary flavonoids consumption and multiple health outcomes is inadequate and inconclusive. To summarize and evaluate the evidence for dietary flavonoids consumption and multiple health outcomes, an umbrella review of meta-analyses and systematic reviews is conducted. PubMed, Ovid-EMBASE, and the Cochrane Database of Systematic Reviews are searched up to January 2024. The study includes a total of 32 articles containing 24 unique health outcomes in this umbrella review. Meta-analyses are recalculated by using a random effects model. Separate analyses are performed based on the kind of different flavonoid subclasses. The study finds some unique associations such as flavonol and gastric cancer, isoflavone and uterine fibroids and endometrial cancer, total flavonoids consumption and lung cancer, ovarian cancer, and prostate cancer. Overall, the study confirms the negative associations between dietary flavonoids consumption and type 2 diabetes mellitus, cardiovascular diseases, breast cancer, colorectal cancer, lung cancer, and mortality, while positive associations are observed for prostate cancer and uterine fibroids. Although dietary flavonoids are significantly associated with many outcomes, firm generalizable conclusions about their beneficial or harmful effects cannot be drawn because of the low certainty of evidence for most of outcomes. More well-designed primary studies are needed.

Associations of Flavonoid Intakes with Mortality among Populations with Hypertension: A Prospective Cohort Study.

The effect of flavonoid consumption on all-cause and special-cause mortality remains unclear among populations with hypertension. A total of 6110 people with hypertension from three NHANES survey cycles (2007-2008, 2009-2010, and 2017-2018) were enrolled in this study. Cox proportional hazard models were conducted to estimate the association between the intake of total flavonoids and flavonoid subclasses and all-cause, cancer-related, and cardiovascular disease (CVD)-related mortality. Nonlinear relationships were identified using restricted cubic splines (RCS). During 43,977 person-years of follow-up, 1155 participants died from any cause, 282 participants died from CVD, and 265 participants died from cancer. After adjusting for relevant confounders, including demographic, lifestyle, and dietary intake, a higher intake of total flavonoids was significantly associated with lower all-cause mortality but not CVD-related and cancer-related mortality among the population with hypertension. Compared with extreme quartiles, the hazard ratio (HR) and 95% confidence interval (CI) were 0.74 (0.56-0.97) for all-cause mortality, 0.77 (0.40-1.46) for CVD-related mortality, and 0.62 (0.35-1.08) for cancer-related mortality. In terms of all-cause mortality, this inverse association was optimized at total flavonoid consumption of approximately 375 mg/day. In addition, the negative association between total flavonoid consumption and all-cause mortality was more pronounced in non-obese (BMI < 30 kg/m2) compared to obese (BMI ≥ 30 kg/m2) populations. Higher intakes of anthocyanidin, flavan-3-ol, flavonol, and isoflavone were significantly associated with lower all-cause mortality (HR (95%CI): 0.70 (0.55-0.89); 0.76 (0.59-0.96); 0.66 (0.46-0.94); 0.79 (0.67-0.93), respectively). Higher intakes of anthocyanidin, flavan-3-ol, and flavonol were significantly associated with lower cancer-related mortality (HR (95%CI): 0.55 (0.32-0.93); 0.51 (0.31-0.82); 0.52 (0.28-0.96), respectively). This study suggests that a heightened consumption of total flavonoids and some flavonoid subclasses was linked to lower mortality, which supports the proposal of increasing flavonoid intake as part of healthy diets in patients with hypertension.

Association of dietary flavonoid intakes with prevalence of chronic respiratory diseases in adults

Background and aimsFlavonoids are a class of secondary plant metabolites that have been shown to have multiple health benefits, including antioxidant and anti-inflammatory. This study was to explore the association between dietary flavonoid consumption and the prevalence of chronic respiratory diseases (CRDs) in adults.Methods and resultsThe six main types of flavonoids, including isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols, were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 and 2017–2018 by the two 24-h recall interviews. The prevalence of CRDs, including asthma, emphysema, and chronic bronchitis, was determined through a self-administered questionnaire. The analysis included 15,753 participants aged 18 years or older who had completed a diet history interview. After adjustment for potential confounders, the inverse link was found with total flavonoids, anthocyanidins, flavanones, and flavones, with an OR (95%CI) of 0.86 (0.75–0.98), 0.84 (0.72–0.97), 0.80(0.69–0.92), and 0.85(0.73–0.98) for the highest group compared to the lowest group. WQS regression revealed that the mixture of flavonoids was negatively linked with the prevalence of CRDs (OR = 0.88 [0.82–0.95], P < 0.01), and the largest effect was mainly from flavanones (weight = 0.41). In addition, we found that flavonoid intake was negatively linked with inflammatory markers, and systemic inflammation significantly mediated the associations of flavonoids with CRDs, with a mediation rate of 12.64% for CRP (P < 0.01).ConclusionHigher flavonoid intake was related with a lower prevalence of CRDs in adults, and this relationship may be mediated through systemic inflammation.

The Probable Impact of Soy Isoflavones in Bone Fracture Downturn: A Systematic Review

Background: There is a direct relationship between taking soy isoflavones and higher bone density, but there is a paucity of studies examining the relationship between flavonoid consumption and fracture risk. This study aimed to assess the bone fracture and its relationship to soy product intake by performing a systematic review. Methods: Scopus, PubMed, and Web of science were searched to find studies on the effect of soy isoflavones on bone fracture, without any time and language of publication restrictions. Key words of SoyMilk, soymilk, soybeans, soybean, soy, soya, Isoflavones, Isoflavone, ipriflavone, equol, genistein, daidzein, glycitin, fractures, and broken bone were used. Results: From a total of 1675 articles, 27 studies (cross-sectional studies (n=1), case-control studies (n=1), cohort (n=11), and randomized control trials (n=14)) were identified, and their quality was assessed. Eighteen studies highlighted mainly positive results in preventive influence of soy bone fractures. Two papers reported a positive effect was observed in men with cancer. No significant association was found between soy intake and bone prevention fracture in eight distinct papers. Conclusion: Intake of soy isoflavones can make a significant preventive effect on bone fracture; however, the results of some studies are controversial. Therefore, it is necessary to survey more studies to identify the relationship between isoflavones and bone fracture.

Consumption of Berries and Flavonoids in Relation to Mortality in NHANES, 1999–2014

BackgroundBerries are foods that are abundant in nutrients, especially flavonoids, that promote good health; however, the effects of total berries on mortality are not well characterized. ObjectivesWe evaluated whether intakes of total berries and specific berry types including blueberries, strawberries, cranberries, flavonoids, and subclasses of flavonoids (anthocyanidins, flavonols, flavones, flavanones, flavan-3-ols, and isoflavones) in relation to mortality risk in United States adults. MethodsA nationally representative sample of the United States adult population was obtained using data from the 1994–2014 NHANES (n = 37,232). Intake of berries was estimated using 24-h food recalls (1999–2014), and flavonoids intake was calculated using the matched USDA’s expanded flavonoid database. Mortality outcomes based on 8 y of follow-up were obtained using linked death certificates. ResultsCompared with nonconsumers, the multivariable-adjusted hazard ratio for all-cause mortality was 0.79 [95% confidence intervals (CI): 0.7, 0.89] for any berry consumption, 0.86 (0.75, 0.99) for strawberry consumption 0.79 (0.66, 0.95) for blueberries, and 0.69 (0.51, 0.93) for cranberries. Compared with the lower median of intake, risk of all-cause mortality for greater intake was 0.85 (0.74, 0.97) for total flavonoids, 0.85 (0.76, 0.95) for anthocyanidins, 0.9 (0.82, 0.99) for flavan-3-ols, 0.89 (0.79, 0.9) for flavanols, and 0.89 (0.8, 0.99) for flavones. There was a dose–response relationship between intakes of total flavonoids, anthocyanidins, and flavones and lower all-cause mortality risks (Ptrend < 0.05). Risk for cardiometabolic mortality was 0.75 (0.58, 0.98) for berry consumers and 0.49 (0.25, 0.98) for cranberry consumers. For respiratory disease mortality, risk was 0.41 (0.2, 0.86), compared with blueberry nonconsumers. ConclusionHigher intakes of berries and flavonoids were associated with a lower overall mortality risk in adult Americans. Few adults regularly consume berries, indicating that increased intake of berries and flavonoid-rich foods may be beneficial to health.

Association between dietary flavonoid intake and depressive symptoms: A cross-sectional research

ObjectiveTo investigate the relationship between dietary flavonoid intake and depression symptoms in American adults. MethodsData sets were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007–2008, 2009–2010, and 2017–2018 survey cycles. Both males and females aged 18 years and older with complete information about dietary flavonoid intake (isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols), depression symptoms, and covariates were included. Logistic regression models were conducted to calculate the odds ratio (OR) of single dietary flavonoid subclass intake on depression, and the restricted cubic spline (RCS) models were utilized to explore the corresponding dose-response relationships. Additionally, we implemented the weighted quantile sum (WQS) regression and quantile g-computation (qgcomp) models to estimate the mixed effects of six flavonoid subclasses and identify the predominant types. ResultsAfter multivariable adjustments, people with higher consumption of flavanones (OR: 0.68, 95% CI: 0.52–0.90, p = 0.008), flavones (OR: 0.63, 95% CI: 0.46–0.87, p = 0.007), flavonols (OR: 0.66, 95% CI: 0.49–0.89, p = 0.008), and total flavonoids (OR: 0.69, 95% CI: 0.50–0.95, p = 0.024) had lower odds of depression symptoms. Meanwhile, significant dose-response relationships were supported by the RCS models. However, no obvious associations between isoflavones, anthocyanidins, flavan-3-ols, and the odds of suffering from depression symptoms were found by the logistic regression models and RCS models. As for the mixed effect, the WQS and qgcomp models both demonstrated that the mixture of six flavonoid subclasses was inversely related to the odds ratios of depression symptoms, and flavones, flavanones, and anthocyanidins were the top 3 contributors. ConclusionOur study implied dietary flavonoid intake was associated with the decreased probability of depression symptoms in U.S. adults, among which flavones, flavanones, and anthocyanidins may occupy the predominant roles.

Analysis of Beneficial Effects of Flavonoids in Patients with Atherosclerosis Risk on Blood Pressure or Cholesterol during Random Controlled Trials: A Systematic Review and Meta-Analysis

Flavonoids are plant-secondary metabolites with cardiovascular protective properties. Few studies have examined specific flavonoid classes or pure flavonoids concerning some common cardiovascular risks. To obtain information in a systematic review to analyze in a meta-analysis, data were recovered regarding flavonoid intake in random controlled trials and atherosclerosis disease, related to risk factors such as blood pressure, total cholesterol (TC), and low-density lipoprotein cholesterol (LDLc). Our aim was to conduct a meta-analysis using the Scopus and PubMed databases without restrictions on the year of publication, extracting articles over the period 1–15 April 2023, searching for randomized controlled trials (RCTs) that investigated different types of flavonoids, measuring blood pressure and low-density cholesterol plasmatic concentration. This paper’s Prospero registration is CRD 42023414153. There were 19 RCTs: twelve RCTs were considered for blood pressure data analysis and fifteen RCTs for total cholesterol and LDL cholesterol data analysis. The meta-analysis showed no significant differences between placebo treatments and treatments with different flavonoids on blood pressure. However, there was a significant difference found in quantitative analysis for TC and LDLc. In conclusion, flavonoid consumption can be associated with a lower risk of LDLc and TC, and more RCTs are needed to specify the effect of more types of pure flavonoids in atherosclerotic patients.

Bioactive compounds intake in the Brazilian population: Trends and determinants of socioeconomic inequalities between 2008 and 2018.

The present study aims at evaluating trends and determinants of socioeconomic inequalities in consumption of bioactive compounds in representative sample of the Brazilian population the period from 2008-2009 to 2017-2018. Data from two cross-sectional population-based surveys were analyzed in the study, using descriptive analysis and estimation of inequalities in consumption. Trends in polyphenol and carotenoid intake were estimated using food consumption data from National Dietary Survey (NDS) 2008-2009 (n = 34,003) and 2017-2018 (n = 46,164). Evolution and determinants of inequalities in bioactive compounds intake were identified using analysis of inequality based on concentration index. Consumption of total polyphenols, phenolic acids, flavonoids and carotenoid classes (except for zeaxanthin) was significantly associated with per capita income after adjustment for potential confounders, being higher income associated with higher intake of bioactive compounds. Disaggregation of inequalities showed that education was the main factor associated with consumption of flavonoids, other polyphenols and β-cryptoxanthin in 2008-2009; whilst income was the main barrier to intake of polyphenols and carotenoids in 2017-2018. Income level and educational attainment have been important determinants to inequalities in bioactive compounds intake in the Brazilian population throughout the period of analysis, being higher intake of bioactive compounds-rich foods and beverages associated with higher income.

Low Dietary Flavonoid Consumption Is Associated to Severe Inflammatory Bowel Disease

Associations between diet habits and inflammatory bowel disease (IBD) have been widely described. Flavonoids are taken with vegetables, fruits, and green tea. Because of barrier-protective and anti-inflammatory effects, flavonoid consumption (FC) may influence the severity of IBD. The aim of this study was to reveal the role of FC in the course and severity of IBD. A prospective cohort study including 204 IBD patients (Crohn's disease n= 126, ulcerative colitis n= 78) was conducted between 2016 and 2021. FC was calculated using questionnaires. In addition to standard activity scores and different treatments, a "severity index" was related to individual FC. Differences between groups and odds ratios were analyzed. Inverse correlation (r=-0.0549; P= .01) between FC and severity of IBD was found. Patients were assigned to 3 different severity index ranges: mild, moderate, and severe disease. FC of patients with severe disease (331 ± 330 mg/week) was less than FC of patients with mild (1404 ± 1086 mg/ week) disease (P < .001). The risk of IBD patients with low FC (1000 mg/week) experiencing overall severe disease was 17 times increased (P < .001) compared to patients with high FC (>1000 mg/week). Patients with UC and low FC had a 9.6-times higher risk for disease progression (P < .001). Consumption of dietary flavonoids and the overall severity of IBD are inversely correlated. Patients with mild diseases consume higher amounts of flavonoids than patients with severe diseases. Low dietary flavonoids were related to a considerable risk of severeIBD.

Depression associated with dietary intake of flavonoids: An analysis of data from the National Health and Nutrition Examination Survey, 2007–2010

BackgroundFlavonoids may have a protective effect against depression. The purpose of this study was to examine whether flavonoid intake was associated with depression. MethodsThis is an observational cross-sectional study. We evaluated a sample of 8183 adults from the National Health and Nutrition Examination Survey (NHANES), 2007–2010. The participants had an average age of 46.7 years, and 48.4% of them were male. Flavonoid intake was obtained through dietary recall interviews, and it included six subclasses: isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols. Depression was identified using the Patient Health Questionnaire (PHQ-9). Logistic regression was utilized to evaluate the association between flavonoid intake and depression. Restricted cubic splines (RCS) were utilized to investigate nonlinear associations. Differences between subgroups were explored. Mediation analysis was used to explore confounding/mediating factors. These models were adjusted for age, sex, race/ethnicity, poverty status, education, smoking status, alcohol consumption, BMI, energy intake, physical activity, and chronic diseases. ResultsThere were 765 individuals with depression (PHQ-9 score ≥ 10) in the sample. After adjusting for covariates, flavanones, flavones, and total flavonoid intake were associated with a lower likelihood of depression (OR (95% CI): 0.73(0.64,0.84); 0.36(0.21,0.63); 0.86(0.74,0.99), respectively). A significant inverse correlation was observed between flavonoid consumption and the somatic symptom score of the PHQ-9. We observed a stronger association between flavonoids and depression in non-Hispanic white groups. The relationship between the total flavonoid intake and depression was explained to some extent by sleep duration (13.8%). ConclusionsFlavonoid intake was associated with lower odds of depression.

Dietary Flavonoid Intake and Carotid Calcification in Patients with Ischemic Stroke.

Owing to the antioxidant and anti-inflammatory effects, flavonoids can influence the initiation and development of atherosclerosis, but the underlying mechanisms remain largely undetermined. This study aimed to evaluate the associations between dietary flavonoids and carotid calcification in patients with ischemic stroke. This study screened consecutive patients with ischemic stroke via Nanjing Stroke Registry Program from February 2016 to April 2021. A semiquantitative food frequency questionnaire was used to evaluate dietary consumption of flavonoids and other nutritional components. Presence and degree of carotid calcification were determined according to Agatston scores on computer tomography angiography. Logistic regression was performed to evaluate the association between dietary flavonoids (total flavonoids, flavonols, flavones, flavanones, flavan-3-ols, anthocyanins, and isoflavones) and carotid calcification. Of the 601 enrolled patients, 368 (61.2%) were detected with carotid calcification. Patients with high intake of total flavonoids (the fifth quintile) had a 52% lower carotid calcification risk than those with low intake (the first quintile; odds ratio [OR] = 0.48; 95% confidence interval [CI], 0.26-0.90; p = 0.007 for trends) after adjusting for major confounders. Patients with high intake of flavan-3-ols (the fifth quintile) had a 51% lower carotid calcification risk than those with low intake (the first quintile; OR = 0.49; 95% CI, 0.25-0.97; p = 0.016 for trends). Dietary flavonoid intake is associated with carotid calcification, and, therefore, may influence the risk of stroke occurrence and recurrence.