Associations between flavonoid-rich food and flavonoid intakes and incident unhealthy aging outcomes in older United States males and females.

BACKGROUND

Our knowledge of the importance of flavonoid-rich foods in preventing unhealthy aging across its different domains is limited.

OBJECTIVES

This study aimed to examine prospective associations between flavonoid-rich food and flavonoid intakes and indicators of unhealthy aging, namely frailty, impaired physical function, and poor mental health.

METHODS

We followed up 62,743 females and 23,687 males, all aged ≥60 y, from the Nurses' Health Study (1990-2014) and Health Professionals Follow-up Study (2006-2018), respectively. Both time-updated and change in intakes of a flavodiet score (an aggregate of intakes of major flavonoid-rich foods and beverages) and individual flavonoid-rich foods and beverages and time-updated intakes of total flavonoids and flavonoid subclasses were calculated from food frequency questionnaires collected at baseline and every subsequent 4 y. Associations with incident frailty, impaired physical function, and poor mental health, assessed from self-reported questionnaire responses, were examined with multivariable-adjusted Cox proportional hazards models.

RESULTS

In the Nurses' Health Study, participants with the highest flavodiet scores, compared with the lowest, had a 15% lower risk of frailty (HR: 0.85; 95%CI: 0.80, 0.90), a 12% lower risk of impaired physical function (HR: 0.88; 95% CI: 0.84, 0.91), and a 12% lower risk of poor mental health (HR: 0.88; 95% CI: 0.82, 0.94). Increases in flavodiet scores and both higher intakes and increases in intakes of tea, red wine, apples, blueberries, and oranges tended to be associated with lower risks of all outcomes. Higher intakes of total flavonoids and all flavonoid subclasses tended to be associated with a lower risk of each outcome. Although fewer associations were observed among males in the Health Professionals Follow-up Study, those with the highest flavodiet scores had a lower risk of poor mental health.

CONCLUSIONS

High intakes of flavonoid-rich foods may support healthy aging. Further research is needed, including examining sex-specific associations, as incorporating flavonoid-rich foods in the diet may be a simple strategy to support healthy aging.