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      Flavonoid intake is inversely associated with obesity and C-reactive protein, a marker for inflammation, in US adults

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      Author(s): 1 , 2 , 3 , * , 3
      Publication date (Electronic):
      Journal: Nutrition & Diabetes
      Publisher: Nature Publishing Group

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          Abstract

          Recent studies have demonstrated the importance of flavonoid intake and disease risk, however the association between flavonoid intake and obesity has not been evaluated in a nationally representative sample of US adults. The objective of the study was to evaluate the association between flavonoid consumption and established risk factors for obesity and obesity-related inflammation. Data from a nationally representative sample of 9551 adults who participated in the 2005–2008 National Health and Nutrition Examination Survey (NHANES) were analyzed. Flavonoid consumption was inversely associated with obesity in both men and women in multivariate models. Adults in the highest quartile of flavonoid intake had significantly lower body mass index and waist circumference than those in the lowest quartile of flavonoid intake ( P<0.03 and P<0.04, respectively), and flavonoid intake was inversely related to C-reactive protein levels in women (p-trend, 0.01). These findings support a growing body of laboratory evidence that flavonoid consumption may be beneficial for disease prevention.

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          Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults.

          Marjorie L. McCullough, Julia Peterson, Roshni Patel … (2012)
          Flavonoids are plant-based phytochemicals with cardiovascular protective properties. Few studies have comprehensively examined flavonoid classes in relation to cardiovascular disease mortality. We examined the association between flavonoid intake and cardiovascular disease (CVD) mortality among participants in a large, prospective US cohort. In 1999, a total of 38,180 men and 60,289 women in the Cancer Prevention Study II Nutrition Cohort with a mean age of 70 and 69 y, respectively, completed questionnaires on medical history and lifestyle behaviors, including a 152-item food-frequency questionnaire. Cox proportional hazards modeling was used to calculate multivariate-adjusted hazard RRs and 95% CIs for associations between total flavonoids, 7 flavonoid classes, and CVD mortality. During 7 y of follow-up, 1589 CVD deaths in men and 1182 CVD deaths in women occurred. Men and women with total flavonoid intakes in the top (compared with the bottom) quintile had a lower risk of fatal CVD (RR: 0.82; 95% CI: 0.73, 0.92; P-trend = 0.01). Five flavonoid classes-anthocyanidins, flavan-3-ols, flavones, flavonols, and proanthocyanidins-were individually associated with lower risk of fatal CVD (all P-trend < 0.05). In men, total flavonoid intakes were more strongly associated with stroke mortality (RR: 0.63; 95% CI: 0.44, 0.89; P-trend = 0.04) than with ischemic heart disease (RR: 0.90; 95% CI: 0.72, 1.13). Many associations appeared to be nonlinear, with lower risk at intakes above the referent category. Flavonoid consumption was associated with lower risk of death from CVD. Most inverse associations appeared with intermediate intakes, suggesting that even relatively small amounts of flavonoid-rich foods may be beneficial.
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            Increasing consumption of sugar-sweetened beverages among US adults: 1988-1994 to 1999-2004.

            Steven L Gortmaker, Sara Bleich, Yanping Wang … (2008)
            Consumption of sugar-sweetened beverages (SSBs) has been linked to obesity and type 2 diabetes. We examined national trends in SSB consumption among US adults by sociodemographic characteristics, body weight status, and weight-loss intention. We analyzed 24-h dietary recall data to estimate beverage consumption among adults (aged > or = 20 y) obtained from the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994; n = 15,979) and NHANES 1999-2004 (n = 13,431). From 1988-1994 to 1999-2004 on the survey day, the percentage of adult SSB drinkers increased from 58% to 63% (P < 0.001), per capita consumption of SSB increased by 46 kcal/d (P = 0.001), and daily SSB consumption among drinkers increased by 6 oz (P < 0.001). In both survey periods, per capita SSB consumption was highest among young adults (231-289 kcal/d) and lowest among the elderly (68-83 kcal/d). Young blacks had the highest percentage of SSB drinkers and the highest per capita consumption compared with white and Mexican American adults (P < 0.05). Overweight-obese adults with weight-loss intention (compared with those without) were significantly less likely to drink SSB, but they still consumed a considerable amount in 1999-2004 (278 kcal/d). Among young adults, 20% of SSB calories were consumed at work. Over the past decade, US adult SSB consumption has increased. SSB comprises a considerable source of total daily intake and is the largest source of beverage calories. SSB consumption is highest among subgroups also at greatest risk of obesity and type 2 diabetes.
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              Dietary flavonoid intake and weight maintenance: three prospective cohorts of 124 086 US men and women followed for up to 24 years

              Monica L Bertoia, Eric Rimm, Kenneth Mukamal … (2016)
              Objective To examine whether dietary intake of specific flavonoid subclasses (including flavonols, flavones, flavanones, flavan-3-ols, anthocyanins, and flavonoid polymers) is associated with weight change over time. Design Three prospective cohort studies. Setting Health professionals in the United States. Participants 124 086 men and women participating in the Health Professionals Follow-up Study (HPFS), Nurses’ Health Study (NHS), and Nurses’ Health Study II (NHS II). Main outcome measure Self reported change in weight over multiple four year time intervals between 1986 and 2011. Results Increased consumption of most flavonoid subclasses, including flavonols, flavan-3-ols, anthocyanins, and flavonoid polymers, was inversely associated with weight change over four year time intervals, after adjustment for simultaneous changes in other lifestyle factors including other aspects of diet, smoking status, and physical activity. In the pooled results, the greatest magnitude of association was observed for anthocyanins (−0.23 (95% confidence interval −0.30 to −0.15) lbs per additional standard deviation/day, 10 mg), flavonoid polymers (−0.18 (−0.28 to −0.08) lbs per additional SD/day, 138 mg), and flavonols (−0.16 (−0.26 to −0.06) lbs per additional SD/day, 7 mg). After additional adjustment for fiber intake, associations remained significant for anthocyanins, proanthocyanidins, and total flavonoid polymers but were attenuated and no longer statistically significant for other subclasses. Conclusions Higher intake of foods rich in flavonols, flavan-3-ols, anthocyanins, and flavonoid polymers may contribute to weight maintenance in adulthood and may help to refine dietary recommendations for the prevention of obesity and its potential consequences.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Nutr Diabetes
                Journal ID (iso-abbrev): Nutr Diabetes
                Title: Nutrition & Diabetes
                Publisher: Nature Publishing Group
                ISSN (Electronic): 2044-4052
                Publication date (Print): May 2017
                Publication date (Electronic): 15 May 2017
                Publication date PMC-release: 1 May 2017
                Volume: 7
                Issue: 5
                Page: e276
                Affiliations
                [1 ]Department of Biology, Fairfield University , Fairfield, CT, USA
                [2 ]Marion Egan Peckham School of Nursing and Health Studies, Fairfield University , Fairfield, CT, USA
                [3 ]Department of Food Science, The Pennsylvania State University, University Park , PA, USA
                Author notes
                [* ]Department of Biology, Fairfield University , 1073 North Benson Road, Fairfield, CT 06824, USA. E-mail: jvernarelli@ 123456fairfield.edu
                Article
                Publisher Item ID: nutd201722
                DOI: 10.1038/nutd.2017.22
                PMC ID: 5518804
                PubMed ID: 28504712
                SO-VID: 82ff471f-50ee-4805-bf67-deb61fce7f99
                Copyright © Copyright © 2017 The Author(s)
                License:

                This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

                History
                Date received : 06 July 2016
                Date revision received : 12 October 2016
                Date accepted : 16 October 2016
                Categories
                Subject: Short Communication

                ScienceOpen disciplines: Endocrinology & Diabetes
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes

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