Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), 28029, Madrid, Spain.
Group of Investigation in Interactions Gene-Environment and Health (GIIGAS)/Institute of Biomedicine (IBIOMED), Universidad de León, 24071, León, Spain.
Clin Nutr. 2023 Jul;42(7):1076-1085. doi: 10.1016/j.clnu.2023.05.020. Epub 2023 May 29.
Polyphenols are secondary metabolites present in small quantities in plant-based food and beverages, with antioxidant and anti-inflammatory properties. Main groups of polyphenols include flavonoids, phenolic acids, stilbenes, and lignans, but their association with mortality has barely been examined. We aimed to assess the association between the intake of 23 polyphenol subgroups and all-cause, cardiovascular, and cancer mortality in a representative sample of the Spanish adult population.
Population-based cohort study conducted with 12,161 individuals aged 18+ recruited in 2008-2010 and followed-up during a mean of 12.5 years. At baseline, food consumption was obtained with a validated dietary history, and the Phenol-Explorer database was used to estimate polyphenol intake. Associations were examined using Cox regression adjusted for main confounders.
During follow-up, 967 all-cause deaths occurred, 219 were cardiovascular, and 277 cancer. Comparing extreme categories of consumption, hazard ratios (95% CI) of total mortality for subgroups were: dihydroflavonols 0.85 (0.72-1.00; p-trend:0.046); flavonols 0.79 (0.63-0.97; p-trend:0.04); methoxyphenols 0.75 (0.59-0.94; p-trend:0.021); tyrosols 0.80 (0.65-0.98; p-trend:0.044); alkylmethoxyphenols 0.74 (0.59-0.93; p-trend:0.007); hydroxycinnamic acids 0.79 (0.64-0.98; p-trend:0.014); and hydroxyphenilacetic acids 0.82 (0.67-0.99; p-trend:0.064). For cardiovascular mortality, hazard ratios were: methoxyphenols 0.58 (0.38-0.89; p-trend:0.010); alkylmethoxyphenols 0.59 (0.39-0.90; p-trend:0.011); hydroxycinnamic acids 0.63 (0.42-0.94; p-trend:0.020); and hydroxyphenilacetic acids 0.69 (0.48-0.99; p-trend:0.044), when comparing extreme tertiles of consumption. No statistically significant associations were observed for cancer. The main food sources for these polyphenol subgroups were red wine, leafy green vegetables, olive oil, green olives, and coffee (the latter being the major contributor of methoxyphenols, alkylmethoxyphenols, and hydroxycinnamic acids).
In the Spanish adult population, intake of specific polyphenol subgroups was prospectively associated with a 20% lower all-cause mortality risk. This decrease was mainly due to a 40% lower cardiovascular mortality risk over time.
多酚是植物性食物和饮料中含量较少的次生代谢物，具有抗氧化和抗炎特性。多酚的主要类别包括类黄酮、酚酸、芪类和木脂素，但它们与死亡率的关系几乎没有被研究过。我们旨在评估西班牙成年人群体中 23 个多酚亚组的摄入量与全因、心血管和癌症死亡率之间的关系。
这是一项基于人群的队列研究，共纳入了 2008-2010 年招募的 12161 名 18 岁及以上的个体，并在平均 12.5 年的随访期间进行了随访。在基线时，通过验证后的饮食史获得食物消耗情况，并使用 Phenol-Explorer 数据库估计多酚摄入量。使用调整了主要混杂因素的 Cox 回归来检验关联。
在随访期间，发生了 967 例全因死亡，219 例心血管死亡和 277 例癌症死亡。比较摄入量的极端类别，总死亡率的危险比（95%CI）为：二氢黄酮醇 0.85（0.72-1.00；p 趋势：0.046）；类黄酮 0.79（0.63-0.97；p 趋势：0.04）；甲氧基酚 0.75（0.59-0.94；p 趋势：0.021）；酪醇 0.80（0.65-0.98；p 趋势：0.044）；烷基甲氧基酚 0.74（0.59-0.93；p 趋势：0.007）；羟基肉桂酸 0.79（0.64-0.98；p 趋势：0.014）；和羟基苯乙酸 0.82（0.67-0.99；p 趋势：0.064）。对于心血管死亡率，危险比为：甲氧基酚 0.58（0.38-0.89；p 趋势：0.010）；烷基甲氧基酚 0.59（0.39-0.90；p 趋势：0.011）；羟基肉桂酸 0.63（0.42-0.94；p 趋势：0.020）；和羟基苯乙酸 0.69（0.48-0.99；p 趋势：0.044），当比较摄入量的极端三分位时。未观察到癌症的统计学显著关联。这些多酚亚组的主要食物来源是红酒、绿叶蔬菜、橄榄油、绿橄榄和咖啡（后者是甲氧基酚、烷基甲氧基酚和羟基肉桂酸的主要来源）。
在西班牙成年人群中，特定多酚亚组的摄入与全因死亡率降低 20%呈前瞻性相关。这种下降主要是由于心血管死亡率随时间降低了 40%。
