An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk
Authors
Benjamin H. Parmenter
Kevin D. Croft
Jonathan M. Hodgson, Edith Cowan UniversityFollow
Frederik Dalgaard
Catherine P. Bondonno, Edith Cowan UniversityFollow
Joshua R. Lewis, Edith Cowan UniversityFollow
Aedín Cassidy
Augustin Scalbert
Nicola P. Bondonno, Edith Cowan UniversityFollow
Author Identifier
Jonathan Hodgson
https://orcid.org/0000-0001-6184-7764
Catherine Bondonno
https://orcid.org/0000-0001-8509-439X
Joshua Lewis
https://orcid.org/0000-0003-1003-8443
Nicola Bondonno
Document Type
Journal Article
Publication Title
Food & Function
Volume
11
Issue
8
First Page
6777
Last Page
6806
PubMed ID
32725042
Publisher
Royal Society of Chemistry
School
School of Medical and Health Sciences
RAS ID
32037
Funders
National Health and Medical Research Council of Australia
Grant Number
NHMRC Number : APP1159914
Abstract
There is an accumulating body of literature reporting on dietary flavonoid intake and the risk of cardiovascular disease (CVD) in prospective cohort studies. This makes apparent the need for an overview and update on the current state of the science. To date, at least 27 prospective cohorts (in 44 publications) have evaluated the association between estimated habitual flavonoid intake and CVD risk. At this time, the totality of evidence suggests long-term consumption of flavonoid-rich foods may be associated with a lower risk of fatal and non-fatal ischemic heart disease (IHD), cerebrovascular disease, and total CVD; disease outcomes which are principally, though not exclusively, composed of cases of atherosclerotic CVD (ASCVD). To date, few studies have investigated outcome specific ASCVD, such as peripheral artery disease (PAD) or ischemic stroke. Of the flavonoid subclasses investigated, evidence more often implicates diets rich in anthocyanins, flavan-3-ols, and flavonols in lowering the risk of CVD. Although inferences are restricted by confounding and other inherent limitations of observational studies, causality appears possible based on biological plausibility, temporality, and the relative consistency of the reported associations. However, whether the associations observed represent a benefit of the isolated bioactives per se, or are a signal of the bioactives acting in concert with the co-occurring nutrient matrix within flavonoid-bearing foods, are issues of consideration. Thus, the simple interpretation, and the one most relevant for dietary advice, is that consumption of flavonoid-rich foods or diets higher in flavonoids, appear nutritionally beneficial in the prevention of CVD.
DOI
10.1039/d0fo01118e
Access Rights
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Comments
Parmenter, B. H., Croft, K. D., Hodgson, J. M., Dalgaard, F., Bondonno, C. P., Lewis, J. R., ... & Bondonno, N. P. (2020). An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk. Food & Function, 11(8), 6777-6806. https://doi.org/10.1039/d0fo01118e