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Nutr Metab Cardiovasc Dis. 2014 Jun;24(6):639-47. doi: 10.1016/j.numecd.2013.12.014. Epub 2014 Jan 22.

Inverse association between habitual polyphenol intake and incidence of cardiovascular events in the PREDIMED study.

Author information

1
Department of Nutrition and Food Science, XaRTA, INSA, Pharmacy School, University of Barcelona (UB), Barcelona, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain.
2
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA.
3
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.
4
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Cardiovascular Epidemiology Unit, Municipal Institute for Medical Research, Barcelona, Spain.
5
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Epidemiology, Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain.
6
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Human Nutrition Unit, School of Medicine, IISPV, University Rovira i Virgili, Reus, Spain.
7
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Epidemiology, School of Medicine, University of Malaga, Málaga, Spain.
8
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain.
9
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Cardiology, University Hospital of Alava, Vitoria, Spain.
10
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Institut Universitari d'Investigació en Ciències de la Salut, Palma de Mallorca, Spain.
11
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain.
12
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Palmas de Gran Canaria, Spain.
13
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Lipid Unit, Department of Internal Medicine, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, FIPEC, Barcelona, Spain.
14
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Biochemistry, School of Medicine, University of Valencia, Valencia, Spain.
15
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Primary Care Division, Catalan Institute of Health, Institut d'Investigació en Atenció Primària Jordi Gol, Reus, Spain.
16
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Valencian Institute of Health, Valencia, Spain.
17
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Nutrition and Food Sciences, Physiology and Toxicology, University of Navarra, Pamplona, Spain.
18
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; La Mina Primary Care Center, UB, Barcelona, Spain.
19
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Nutrition and Lipids Metabolism, Instituto de la Grasa, Consejo Superior de Investigaciones Científicas, Sevilla, Spain.
20
CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Internal Medicine, Hospital Clínic, IDIBAPS, UB, Barcelona, Spain.
21
Department of Nutrition and Food Science, XaRTA, INSA, Pharmacy School, University of Barcelona (UB), Barcelona, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain. Electronic address: lamuela@ub.edu.

Abstract

BACKGROUND AND AIMS:

Epidemiologic and biological evidence supports an inverse association between polyphenol consumption and the risk of cardiovascular disease (CVD). However, no previous studies have prospectively evaluated the relationship between polyphenol intake and the incidence of CVD in such a comprehensive way. The aim was to evaluate the association between intakes of total polyphenol and polyphenol subgroups, and the risk of major cardiovascular events (myocardial infarction, stroke or death from cardiovascular causes) in the PREDIMED study.

METHODS AND RESULTS:

The present work is an observational study within the PREDIMED trial. Over an average of 4.3 years of follow-up, there were 273 confirmed cases of CVD among the 7172 participants (96.3%) who completed a validated 137-item food frequency questionnaire (FFQ) at baseline. Polyphenol consumption was calculated by matching food consumption data from the FFQ with the Phenol-Explorer database on polyphenol content of each reported food. After multivariate adjustment, a 46% reduction in risk of CVD risk was observed comparing Q5 vs. Q1 of total polyphenol intake (HR = 0.54; 95% confidence interval [CI] = 0.33-0.91; P-trend = 0.04). The polyphenols with the strongest inverse associations were flavanols (HR = 0.40; CI 0.23-0.72; P-trend = 0.003), lignans (HR = 0.51; CI 0.30-0.86; P-trend = 0.007), and hydroxybenzoic acids (HR = 0.47; CI 0.26-0.86; P-trend 0.02).

CONCLUSION:

Greater intake of polyphenols, especially from lignans, flavanols, and hydroxybenzoic acids, was associated with decreased CVD risk. Clinical trials are needed to confirm this effect and establish accurate dietary recommendations.

KEYWORDS:

Cardiovascular diseases; Diet; Epidemiology; Polyphenols

PMID:
24552647
DOI:
10.1016/j.numecd.2013.12.014
[Indexed for MEDLINE]

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