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Consumption of flavonoid-rich fruits and risk of CHD: a prospective cohort study

Published online by Cambridge University Press:  09 June 2020

Yiyi Yang
Affiliation:
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka5650871, Japan
Jia-Yi Dong
Affiliation:
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka5650871, Japan
Renzhe Cui
Affiliation:
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka5650871, Japan
Isao Muraki
Affiliation:
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka5650871, Japan
Kazumasa Yamagishi
Affiliation:
Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba3058575, Japan
Norie Sawada
Affiliation:
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo1040045, Japan
Hiroyasu Iso
Affiliation:
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka5650871, Japan Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba3058575, Japan
Shoichiro Tsugane
Affiliation:
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo1040045, Japan
Corresponding

Abstract

Although the association between fruit consumption and CHD risk has been well studied, few studies have focused on flavonoid-rich fruits (FRF), in particular strawberries and grapes. We aimed to verify the association of total and specific FRF consumption with risk of CHD by a large prospective cohort study. A total of 87 177 men and women aged 44–75 years who were free of CVD and cancer at study baseline were eligible for the present analysis. FRF consumption was assessed using a FFQ. Cox proportional hazards regression models were used to estimate the hazard ratios (HR) of CHD in relation to FRF consumption with adjustment for potential risk factors and confounders. During a mean follow-up of 13·2 years, we identified 1156 incident CHD cases. After full adjustment for covariates including demographics, lifestyles and dietary factors, the HR were 0·93 (95 % CI 0·77, 1·11), 0·91 (95 % CI 0·75, 1·11), 0·84 (95 % CI 0·67, 1·04) and 0·78 (95 % CI 0·62, 0·99) for the second, third, fourth and fifth quintiles compared with the lowest quintile of FRF consumption. Regarding specific fruits, we observed a significant inverse association for citrus fruit consumption and a borderline inverse association for strawberry consumption, while no association was observed for apple/pear or grape consumption. Although the associations appeared to be stronger in women, they were not significantly modified by sex. Higher consumption of FRF, in particular, citrus fruits, may be associated with a lower risk of developing CHD.

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Full Papers
Copyright
© The Author(s), 2020

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References

WHO (2019) Fact sheets of cardiovascular diseases. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (accessed June 2019).Google Scholar
WHO (2019) Deaths from coronary heart disease. https://www.who.int/cardiovascular_diseases/en/cvd_atlas_14_deathHD.pdf?ua=1 (accessed June 2019).Google Scholar
Aune, D, Giovannucci, E, Boffetta, P, et al. (2017) Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol 46, 10291056.CrossRefGoogle ScholarPubMed
Grassi, D, Desideri, G, Di Giosia, P, et al. (2013) Tea, flavonoids, and cardiovascular health: endothelial protection. Am J Clin Nutr 98, 1660s1666s.CrossRefGoogle ScholarPubMed
Heiss, C, Keen, CL & Kelm, M (2010) Flavanols and cardiovascular disease prevention. Eur Heart J 31, 25832592.CrossRefGoogle ScholarPubMed
Hansson, GK (2005) Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 352, 16851695.CrossRefGoogle Scholar
Lozano, R, Naghavi, M, Foreman, K, et al. (2012) Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380, 20952128.CrossRefGoogle ScholarPubMed
McCullough, ML, Peterson, JJ, Patel, R, et al. (2012) Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults. Am J Clin Nutr 95, 454464.CrossRefGoogle Scholar
Manach, C, Scalbert, A, Morand, C, et al. (2004) Polyphenols: food sources and bioavailability. Am J Clin Nutr 79, 727747.CrossRefGoogle ScholarPubMed
Peterson, JJ, Dwyer, JT, Jacques, PF, et al. (2012) Associations between flavonoids and cardiovascular disease incidence or mortality in European and US populations. Nutr Rev 70, 491508.CrossRefGoogle ScholarPubMed
Tsugane, S & Sawada, N (2014) The JPHC study: design and some findings on the typical Japanese diet. Jpn J Clin Oncol 44, 777782.CrossRefGoogle ScholarPubMed
Ishihara, J, Sobue, T, Yamamoto, S, et al. (2003) Validity and reproducibility of a self-administered food frequency questionnaire in the JPHC Study Cohort II: study design, participant profile and results in comparison with Cohort I. J Epidemiol 13, S134147.CrossRefGoogle ScholarPubMed
Sasaki, S, Matsumura, Y, Ishihara, J, et al. (2003) Validity of a self-administered food frequency questionnaire used in the 5-year follow-up survey of the JPHC Study Cohort I to assess dietary fiber intake: comparison with dietary records. J Epidemiol 13, S106S114.CrossRefGoogle ScholarPubMed
Tunstall-Pedoe, H, Kuulasmaa, K, Amouyel, P, et al. (1994) Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 90, 583612.CrossRefGoogle ScholarPubMed
Vita, JA & Keaney, JF Jr. (2002) Endothelial function: a barometer for cardiovascular risk? Circulation 106, 640642.CrossRefGoogle ScholarPubMed
Hanasaki, Y, Ogawa, S & Fukui, S (1994) The correlation between active oxygens scavenging and antioxidative effects of flavonoids. Free Radic Biol Med 16, 845850.CrossRefGoogle ScholarPubMed
Mansuri, ML, Parihar, P, Solanki, I, et al. (2014) Flavonoids in modulation of cell survival signalling pathways. Genes Nutr 9, 400.CrossRefGoogle ScholarPubMed
Korkina, LG & Afanas’ev, IB (1997) Antioxidant and chelating properties of flavonoids. Adv Pharmacol 38, 151163.CrossRefGoogle ScholarPubMed
Kerry, NL & Abbey, M (1997) Red wine and fractionated phenolic compounds prepared from red wine inhibit low density lipoprotein oxidation in vitro. Atherosclerosis 135, 93102.CrossRefGoogle ScholarPubMed
Shutenko, Z, Henry, Y, Pinard, E, et al. (1999) Influence of the antioxidant quercetin in vivo on the level of nitric oxide determined by electron paramagnetic resonance in rat brain during global ischemia and reperfusion. Biochem Pharmacol 57, 199208.CrossRefGoogle ScholarPubMed
Duarte, J, Francisco, V & Perez-Vizcaino, F (2014) Modulation of nitric oxide by flavonoids. Food Funct 5, 16531668.CrossRefGoogle ScholarPubMed
Leiherer, A, Mundlein, A & Drexel, H (2013) Phytochemicals and their impact on adipose tissue inflammation and diabetes. Vasc Pharmacol 58, 320.CrossRefGoogle ScholarPubMed
Holmes-McNary, M & Baldwin, AS Jr. (2000) Chemopreventive properties of trans-resveratrol are associated with inhibition of activation of the IkappaB kinase. Cancer Res 60, 34773483.Google ScholarPubMed
Ruiz, PA & Haller, D (2006) Functional diversity of flavonoids in the inhibition of the proinflammatory NF-kappaB, IRF, and Akt signaling pathways in murine intestinal epithelial cells. J Nutr 136, 664671.CrossRefGoogle ScholarPubMed
Yamamoto, Y & Gaynor, RB (2001) Therapeutic potential of inhibition of the NF-kappaB pathway in the treatment of inflammation and cancer. J Clin Invest 107, 135142.CrossRefGoogle ScholarPubMed
Retsky, KL, Freeman, MW & Frei, B (1993) Ascorbic acid oxidation product(s) protect human low density lipoprotein against atherogenic modification. Anti- rather than prooxidant activity of vitamin C in the presence of transition metal ions. J Biol Chem 268, 13041309.Google ScholarPubMed
Siow, RC, Richards, JP, Pedley, KC, et al. (1999) Vitamin C protects human vascular smooth muscle cells against apoptosis induced by moderately oxidized LDL containing high levels of lipid hydroperoxides. Arterioscler Thromb Vasc Biol 19, 23872394.CrossRefGoogle ScholarPubMed
Jackson, TS, Xu, A, Vita, JA, et al. (1998) Ascorbate prevents the interaction of superoxide and nitric oxide only at very high physiological concentrations. Circ Res 83, 916922.CrossRefGoogle ScholarPubMed
US Department of Agriculture (2019) USDA Food Composition Databases. https://ndb.nal.usda.gov/ndb/ (accessed June 2019).Google Scholar
Vieira, FG, Borges Gda, S, Copetti, C, et al. (2009) Activity and contents of polyphenolic antioxidants in the whole fruit, flesh and peel of three apple cultivars. Arch Latinoam Nutr 59, 101106.Google ScholarPubMed
Gonzalez, J, Donoso, W, Sandoval, N, et al. (2015) Apple peel supplemented diet reduces parameters of metabolic syndrome and atherogenic progression in ApoE-/- mice. Evid Based Complement Alternat Med 2015, 918384.CrossRefGoogle Scholar
Tian, J, Wu, X, Zhang, M, et al. (2018) Comparative study on the effects of apple peel polyphenols and apple flesh polyphenols on cardiovascular risk factors in mice. Clin Exp Hypertens 40, 6572.10.1080/10641963.2017.1313851CrossRefGoogle ScholarPubMed
Mink, PJ, Scrafford, CG, Barraj, LM, et al. (2007) Flavonoid intake and cardiovascular disease mortality: a prospective study in postmenopausal women. Am J Clin Nutr 85, 895909.CrossRefGoogle ScholarPubMed
Giampieri, F, Alvarez-Suarez, JM & Battino, M (2014) Strawberry and human health: effects beyond antioxidant activity. J Agric Food Chem 62, 38673876.CrossRefGoogle ScholarPubMed
Giampieri, F, Forbes-Hernandez, TY, Gasparrini, M, et al. (2017) The healthy effects of strawberry bioactive compounds on molecular pathways related to chronic diseases. Ann NY Acad Sci 1398, 6271.CrossRefGoogle ScholarPubMed
Sesso, HD, Gaziano, JM, Jenkins, DJ, et al. (2007) Strawberry intake, lipids, C-reactive protein, and the risk of cardiovascular disease in women. J Am Coll Nutr 26, 303310.10.1080/07315724.2007.10719615CrossRefGoogle ScholarPubMed
Cassidy, A, Mukamal, KJ, Liu, L, et al. (2013) High anthocyanin intake is associated with a reduced risk of myocardial infarction in young and middle-aged women. Circulation 127, 188196.CrossRefGoogle Scholar
Lai, HT, Threapleton, DE, Day, AJ, et al. (2015) Fruit intake and cardiovascular disease mortality in the UK Women’s Cohort Study. Eur J Epidemiol 30, 10351048.CrossRefGoogle ScholarPubMed
Lin, J, Rexrode, KM, Hu, F, et al. (2007) Dietary intakes of flavonols and flavones and coronary heart disease in US women. Am J Epidemiol 165, 13051313.CrossRefGoogle ScholarPubMed
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