Carnauba Renata A, Sarti Flavia M, Coutinho Camille P, Hassimotto Neuza Ma, Marchioni Dirce M, Lotufo Paulo A, Bensenor Isabela M, Lajolo Franco M
Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil; Food Research Center, CEPID-FAPESP (Research Innovation and Dissemination Centers, São Paulo Research Foundation), São Paulo, Brazil.
Center for Research in Complex Systems Modeling, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil.
J Nutr. 2025 Feb;155(2):570-579. doi: 10.1016/j.tjnut.2024.11.016. Epub 2024 Nov 26.
Fruit- and vegetable-rich diets may protect against metabolic syndrome (MetS), partly due to their high polyphenol content.
This study examined the association between dietary polyphenol intake, MetS risk, and cardiometabolic factors in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
A total of 6387 participants (mean age 49.8 y, 65% female) were included. Food intake was assessed via a semiquantitative Food Frequency Questionnaire with polyphenol content from the Phenol-Explorer database. MetS was defined using the Joint Interim Statement. Logistic regressions assessed associations between polyphenol intake tertiles and cardiometabolic risk factors, as well as the odds of MetS during the follow-up period.
During a median of 8.19 y follow-up, 2031 cases of MetS occurred. The second and third tertiles of total polyphenol intake were associated with 22% and 23% lower odds of MetS, respectively, after adjusting for sociodemographic, lifestyle, and dietary factors (T2 vs. T1, odds ratio [OR] 0.78 [95% confidence interval {CI}: 0.68, 0.90]; T3 vs. T1, OR 0.77 [0.66, 0.90]). Inverse associations were also found between phenolic acids, lignans, stilbenes, other polyphenols, and the odds of MetS. Although no significant link was observed for total flavonoids, flavan-3-ols showed inverse associations with MetS (monomers: T3 vs. T1, OR 0.92 [0.80, 0.94]; dimers to polymers: T3 vs. T1, OR 0.82 [0.70, 0.96]). Total polyphenol intake was also inversely associated with waist-hip ratio, diastolic blood pressure, systolic blood pressure, HOMA-IR, triglycerides, and C-reactive protein, and positively associated with total cholesterol, LDL cholesterol, and HDL cholesterol.
Higher intakes of dietary polyphenols, particularly phenolic acids, lignans, stilbenes, other polyphenols, and flavan-3-ols, were inversely associated with the odds of MetS and its components. These findings suggest that promoting polyphenol-rich diets could be a valuable strategy in reducing cardiometabolic risk and preventing MetS in the population, potentially informing dietary guidelines and public health interventions.
富含水果和蔬菜的饮食可能预防代谢综合征（MetS），部分原因是其高多酚含量。
本研究在巴西成人健康纵向研究（ELSA - Brasil）中检验了膳食多酚摄入量、MetS风险和心脏代谢因素之间的关联。
共纳入6387名参与者（平均年龄49.8岁，65%为女性）。通过半定量食物频率问卷评估食物摄入量，并根据酚类物质探索者数据库获取多酚含量。MetS采用联合临时声明进行定义。逻辑回归分析评估多酚摄入量三分位数与心脏代谢危险因素之间的关联，以及随访期间患MetS的几率。
在中位随访8.19年期间，发生了2031例MetS病例。在调整社会人口学、生活方式和饮食因素后，总多酚摄入量的第二和第三三分位数分别与MetS几率降低22%和23%相关（T2与T1相比，比值比[OR]0.78[95%置信区间{CI}：0.68，0.90]；T3与T1相比，OR 0.77[0.66，0.90]）。酚酸、木脂素、芪类、其他多酚与MetS几率之间也存在负相关。虽然总黄酮未观察到显著关联，但黄烷 - 3 - 醇与MetS存在负相关（单体：T3与T1相比，OR 0.92[0.80，0.94]；二聚体至聚合物：T3与T1相比，OR 0.82[0.70，0.96]）。总多酚摄入量还与腰臀比、舒张压、收缩压、HOMA - IR、甘油三酯和C反应蛋白呈负相关，与总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇呈正相关。
较高的膳食多酚摄入量，特别是酚酸、木脂素、芪类、其他多酚和黄烷 - 3 - 醇，与MetS及其组分的几率呈负相关。这些发现表明，推广富含多酚的饮食可能是降低人群心脏代谢风险和预防MetS的一项有价值策略，可能为饮食指南和公共卫生干预提供参考。
