School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, Western Australia, Australia.
School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Sir Charles Gairdner Hospital Unit, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
Clin Nutr. 2020 Jan;39(1):141-150. doi: 10.1016/j.clnu.2019.01.004. Epub 2019 Jan 17.
Higher intakes of flavonoids provide health benefits, however, the importance of each flavonoid class and which population groups may receive the greatest protection from higher flavonoid intake warrants further investigation.
To explore the associations of flavonoid and flavonoid-rich wholefood intakes with all-cause mortality and the moderating effects of early mortality risk factors.
The study included 2349 participants of The Blue Mountains Eye Study, with a mean ± SD age at baseline of 64.7 ± 9.2 years. Flavonoid intake was calculated from baseline food frequency questionnaires using US Department of Agriculture food composition databases. Associations were examined using adjusted Cox proportional hazards models.
After 14 years of follow-up, 677 participants died. There was a flavonoid threshold effect with the greatest risk reduction seen between low and moderate intakes of total flavonoids, flavonoid classes and flavonoid-rich foods. Amongst the whole cohort, participants in the highest tertile of anthocyanidin intake had a significantly lower risk of all-cause mortality [multivariable adjusted HR (95%CI): 0.76 (0.61, 0.94)] when compared to those in the lowest tertile. Amongst participants with at least one early mortality risk factor (smoking, high alcohol consumption, no regular exercise or obesity), risk of all-cause mortality was lower in those in the highest intake tertile for total flavonoids [adjusted HR: 0.77 (0.59, 1.00)], flavan-3-ols [0.75 (0.58, 0.98)], anthocyanidins [0.70 (0.54, 0.92)], and proanthocyanidins [0.69 (0.52, 0.92)], compared to those in the lowest tertile. No similar associations were observed among those without any risk factors. Similarly, consumption of apples, tea and the individual flavonoid compounds, quercetin and epicatechin, were associated with a lower risk of all-cause mortality among participants with at least one risk factor, but not amongst other participants.
Moderate to high intakes of flavonoids and certain flavonoid subclasses may provide health benefits, particularly for individuals with at least one early mortality risk factor.
摄入更多的类黄酮对健康有益，然而，每种类黄酮的重要性以及哪些人群可能从更高的类黄酮摄入中获得最大的保护，这仍需要进一步研究。
探索类黄酮和富含类黄酮的全食物摄入量与全因死亡率的关系，以及早期死亡率危险因素的调节作用。
本研究纳入了 2349 名参加蓝山眼研究的参与者，基线时的平均年龄为 64.7±9.2 岁。类黄酮的摄入量是根据基线时的食物频率问卷，使用美国农业部的食物成分数据库计算得出的。使用调整后的 Cox 比例风险模型来检验关联。
经过 14 年的随访，有 677 名参与者死亡。类黄酮摄入量与全因死亡率之间存在一个阈值效应，在低和中等摄入量的总类黄酮、类黄酮类和富含类黄酮的食物中，风险降低最大。在整个队列中，与最低三分位组相比，摄入最高三分位组的花色苷的参与者全因死亡率显著降低[多变量调整后的 HR（95%CI）：0.76（0.61，0.94）]。在至少有一个早期死亡风险因素（吸烟、大量饮酒、不经常运动或肥胖）的参与者中，总类黄酮[调整后的 HR：0.77（0.59，1.00）]、黄烷-3-醇[0.75（0.58，0.98）]、花色苷[0.70（0.54，0.92）]和原花青素[0.69（0.52，0.92）]摄入量最高的三分位组的全因死亡率较低，与最低三分位组相比。在没有任何风险因素的参与者中，没有观察到类似的关联。同样，在至少有一个风险因素的参与者中，摄入苹果、茶和个别类黄酮化合物槲皮素和表儿茶素与全因死亡率降低相关，但在其他参与者中则没有。
中等到高剂量的类黄酮和某些类黄酮亚类可能对健康有益，特别是对至少有一个早期死亡风险因素的个体。
