Tresserra-Rimbau Anna, Rimm Eric B, Medina-Remón Alexander, Martínez-González Miguel A, López-Sabater M Carmen, Covas María I, Corella Dolores, Salas-Salvadó Jordi, Gómez-Gracia Enrique, Lapetra José, Arós Fernando, Fiol Miquel, Ros Emili, Serra-Majem Lluis, Pintó Xavier, Muñoz Miguel A, Gea Alfredo, Ruiz-Gutiérrez Valentina, Estruch Ramón, Lamuela-Raventós Rosa M
Nutrition and Food Science Department, XaRTA, INSA, Pharmacy School, University of Barcelona, Barcelona, Spain.
BMC Med. 2014 May 13;12:77. doi: 10.1186/1741-7015-12-77.
Polyphenols may lower the risk of cardiovascular disease (CVD) and other chronic diseases due to their antioxidant and anti-inflammatory properties, as well as their beneficial effects on blood pressure, lipids and insulin resistance. However, no previous epidemiological studies have evaluated the relationship between the intake of total polyphenols intake and polyphenol subclasses with overall mortality. Our aim was to evaluate whether polyphenol intake is associated with all-cause mortality in subjects at high cardiovascular risk.
We used data from the PREDIMED study, a 7,447-participant, parallel-group, randomized, multicenter, controlled five-year feeding trial aimed at assessing the effects of the Mediterranean Diet in primary prevention of cardiovascular disease. Polyphenol intake was calculated by matching food consumption data from repeated food frequency questionnaires (FFQ) with the Phenol-Explorer database on the polyphenol content of each reported food. Hazard ratios (HR) and 95% confidence intervals (CI) between polyphenol intake and mortality were estimated using time-dependent Cox proportional hazard models.
Over an average of 4.8 years of follow-up, we observed 327 deaths. After multivariate adjustment, we found a 37% relative reduction in all-cause mortality comparing the highest versus the lowest quintiles of total polyphenol intake (hazard ratio (HR) = 0.63; 95% CI 0.41 to 0.97; P for trend = 0.12). Among the polyphenol subclasses, stilbenes and lignans were significantly associated with reduced all-cause mortality (HR =0.48; 95% CI 0.25 to 0.91; P for trend = 0.04 and HR = 0.60; 95% CI 0.37 to 0.97; P for trend = 0.03, respectively), with no significant associations apparent in the rest (flavonoids or phenolic acids).
Among high-risk subjects, those who reported a high polyphenol intake, especially of stilbenes and lignans, showed a reduced risk of overall mortality compared to those with lower intakes. These results may be useful to determine optimal polyphenol intake or specific food sources of polyphenols that may reduce the risk of all-cause mortality.
ISRCTN35739639.
由于具有抗氧化和抗炎特性，以及对血压、血脂和胰岛素抵抗的有益作用，多酚类物质可能会降低心血管疾病（CVD）和其他慢性病的风险。然而，以前没有流行病学研究评估总多酚摄入量和多酚亚类摄入量与全因死亡率之间的关系。我们的目的是评估在心血管疾病高风险人群中，多酚摄入量是否与全因死亡率相关。
我们使用了PREDIMED研究的数据，这是一项有7447名参与者的平行组、随机、多中心、为期五年的对照喂养试验，旨在评估地中海饮食在心血管疾病一级预防中的作用。通过将重复食物频率问卷（FFQ）中的食物消费数据与酚类物质探索者数据库中每种报告食物的多酚含量进行匹配，计算多酚摄入量。使用时间依赖的Cox比例风险模型估计多酚摄入量与死亡率之间的风险比（HR）和95%置信区间（CI）。
在平均4.8年的随访中，我们观察到327例死亡。经过多变量调整后，我们发现，与总多酚摄入量最低五分位数相比，最高五分位数的全因死亡率相对降低了37%（风险比（HR）=0.63；95%CI为0.41至0.97；趋势P值=0.12）。在多酚亚类中，芪类和木脂素类与全因死亡率降低显著相关（HR分别为0.48；95%CI为0.25至0.91；趋势P值=0.04和HR为0.60；95%CI为0.37至0.97；趋势P值=0.03），其余类别（黄酮类或酚酸类）未显示出显著关联。
在高风险人群中，报告多酚摄入量高，尤其是芪类和木脂素类摄入量高的人群，与摄入量较低的人群相比，全因死亡风险降低。这些结果可能有助于确定最佳的多酚摄入量或特定的多酚食物来源，从而降低全因死亡风险。
ISRCTN35739639。
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