Associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort study
Summary: Background: Flavonoids, compounds found in plant-based foods and beverages, might ameliorate vascular damage and atherosclerosis. Therefore, our aim was to assess the association between flavonoid intake and hospital admissions due to atherosclerotic cardiovascular disease. Methods: In thi...
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Elsevier
2019-11-01
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Series: | The Lancet Planetary Health |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2542519619302128 |
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DOAJ |
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English |
format |
Article |
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DOAJ |
author |
Frederik Dalgaard, MD Nicola P Bondonno, PhD Kevin Murray, PhD Catherine P Bondonno, PhD Joshua R Lewis, PhD Kevin D Croft, ProfPhD Cecilie Kyrø, PhD Gunnar Gislason, ProfPhD Augustin Scalbert, PhD Aedin Cassidy, ProfPhD Anne Tjønneland, ProfPhD Kim Overvad, ProfPhD Jonathan M Hodgson, ProfPhD |
spellingShingle |
Frederik Dalgaard, MD Nicola P Bondonno, PhD Kevin Murray, PhD Catherine P Bondonno, PhD Joshua R Lewis, PhD Kevin D Croft, ProfPhD Cecilie Kyrø, PhD Gunnar Gislason, ProfPhD Augustin Scalbert, PhD Aedin Cassidy, ProfPhD Anne Tjønneland, ProfPhD Kim Overvad, ProfPhD Jonathan M Hodgson, ProfPhD Associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort study The Lancet Planetary Health |
author_facet |
Frederik Dalgaard, MD Nicola P Bondonno, PhD Kevin Murray, PhD Catherine P Bondonno, PhD Joshua R Lewis, PhD Kevin D Croft, ProfPhD Cecilie Kyrø, PhD Gunnar Gislason, ProfPhD Augustin Scalbert, PhD Aedin Cassidy, ProfPhD Anne Tjønneland, ProfPhD Kim Overvad, ProfPhD Jonathan M Hodgson, ProfPhD |
author_sort |
Frederik Dalgaard, MD |
title |
Associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort study |
title_short |
Associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort study |
title_full |
Associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort study |
title_fullStr |
Associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort study |
title_full_unstemmed |
Associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort study |
title_sort |
associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort study |
publisher |
Elsevier |
series |
The Lancet Planetary Health |
issn |
2542-5196 |
publishDate |
2019-11-01 |
description |
Summary: Background: Flavonoids, compounds found in plant-based foods and beverages, might ameliorate vascular damage and atherosclerosis. Therefore, our aim was to assess the association between flavonoid intake and hospital admissions due to atherosclerotic cardiovascular disease. Methods: In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study were cross-linked with Danish nationwide registries. Eligible participants were aged 50–65 years, had no previous history of atherosclerotic cardiovascular disease, and had completed a food-frequency questionnaire at baseline. We examined associations between flavonoid intake (calculated from food-frequency questionnaires with use of the Phenol-Explorer database) and hospital admissions for atherosclerotic cardiovascular disease, ischaemic heart disease, ischaemic stroke, or peripheral arterial disease. We obtained hazard ratios (HRs) using restricted cubic splines based on Cox proportional hazards models. Findings: Of the participants recruited to the Danish Diet, Cancer, and Health study between 1993 and 1997, our study population was comprised of 53 552 participants, with a median follow-up of 21 years (IQR 15–22). During follow-up, 8773 participants were admitted to hospital for atherosclerotic cardiovascular disease. We observed non-linear associations between flavonoid intake and hospital admissions, plateauing at total flavonoid intakes of approximately 1000 mg per day. Compared with an intake of 175 mg per day, an intake of 1000 mg per day was associated with a 14% lower risk of atherosclerotic cardiovascular disease (HR 0·86, 95% CI 0·81–0·91). For disease subtypes, we observed a 9% lower risk of ischaemic heart disease (0·91, 0·85–0·98), a non-significant 9% lower risk of ischaemic stroke (0·91, 0·82–1·01), and a 32% lower risk of peripheral artery disease (0·68, 0·60–0·78). The overall associations were stronger in smokers than in non-smokers, as well as stronger in consumers of high (>20 g per day) quantities of alcohol than in those consuming low-to-moderate (≤20 g per day) quantities. Interpretation: Our results suggest that ensuring an adequate consumption of flavonoid-rich foods, particularly in subpopulations at risk of atherosclerosis such as smokers and consumers of high quantities of alcohol might mitigate some of the risk of atherosclerotic cardiovascular disease. More studies are needed to support and validate these data. Funding: Danish Cancer Society. |
url |
http://www.sciencedirect.com/science/article/pii/S2542519619302128 |
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doaj-499ed0e104ce4d5aa83bcc541fe74f5b2020-11-25T01:15:20ZengElsevierThe Lancet Planetary Health2542-51962019-11-01311e450e459Associations between habitual flavonoid intake and hospital admissions for atherosclerotic cardiovascular disease: a prospective cohort studyFrederik Dalgaard, MD0Nicola P Bondonno, PhD1Kevin Murray, PhD2Catherine P Bondonno, PhD3Joshua R Lewis, PhD4Kevin D Croft, ProfPhD5Cecilie Kyrø, PhD6Gunnar Gislason, ProfPhD7Augustin Scalbert, PhD8Aedin Cassidy, ProfPhD9Anne Tjønneland, ProfPhD10Kim Overvad, ProfPhD11Jonathan M Hodgson, ProfPhD12Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, DenmarkSchool of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, Australia; Correspondence to: Dr Nicola P Bondonno, Medical Research Foundation, Perth, WA 6000, AustraliaSchool of Population and Global Health, University of Western Australia, Perth, WA, AustraliaSchool of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, AustraliaSchool of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, AustraliaSchool of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, AustraliaDanish Cancer Society Research Centre, Copenhagen, DenmarkDepartment of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark; National Institute of Public Health, University of Southern Denmark, Odense, Denmark; Danish Heart Foundation, Copenhagen, DenmarkInternational Agency for Research on Cancer, Lyon, FranceInstitute for Global Food Security, Queen's University Belfast, Belfast, UKDanish Cancer Society Research Centre, Copenhagen, DenmarkDepartment of Public Health, Aarhus University, Aarhus, Denmark; Faculty of Medicine, Aalborg University Hospital, Aalborg, DenmarkSchool of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital, Perth, WA, AustraliaSummary: Background: Flavonoids, compounds found in plant-based foods and beverages, might ameliorate vascular damage and atherosclerosis. Therefore, our aim was to assess the association between flavonoid intake and hospital admissions due to atherosclerotic cardiovascular disease. Methods: In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study were cross-linked with Danish nationwide registries. Eligible participants were aged 50–65 years, had no previous history of atherosclerotic cardiovascular disease, and had completed a food-frequency questionnaire at baseline. We examined associations between flavonoid intake (calculated from food-frequency questionnaires with use of the Phenol-Explorer database) and hospital admissions for atherosclerotic cardiovascular disease, ischaemic heart disease, ischaemic stroke, or peripheral arterial disease. We obtained hazard ratios (HRs) using restricted cubic splines based on Cox proportional hazards models. Findings: Of the participants recruited to the Danish Diet, Cancer, and Health study between 1993 and 1997, our study population was comprised of 53 552 participants, with a median follow-up of 21 years (IQR 15–22). During follow-up, 8773 participants were admitted to hospital for atherosclerotic cardiovascular disease. We observed non-linear associations between flavonoid intake and hospital admissions, plateauing at total flavonoid intakes of approximately 1000 mg per day. Compared with an intake of 175 mg per day, an intake of 1000 mg per day was associated with a 14% lower risk of atherosclerotic cardiovascular disease (HR 0·86, 95% CI 0·81–0·91). For disease subtypes, we observed a 9% lower risk of ischaemic heart disease (0·91, 0·85–0·98), a non-significant 9% lower risk of ischaemic stroke (0·91, 0·82–1·01), and a 32% lower risk of peripheral artery disease (0·68, 0·60–0·78). The overall associations were stronger in smokers than in non-smokers, as well as stronger in consumers of high (>20 g per day) quantities of alcohol than in those consuming low-to-moderate (≤20 g per day) quantities. Interpretation: Our results suggest that ensuring an adequate consumption of flavonoid-rich foods, particularly in subpopulations at risk of atherosclerosis such as smokers and consumers of high quantities of alcohol might mitigate some of the risk of atherosclerotic cardiovascular disease. More studies are needed to support and validate these data. Funding: Danish Cancer Society.http://www.sciencedirect.com/science/article/pii/S2542519619302128 |