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Free Radic Biol Med. 2015 Jul;84:1-10. doi: 10.1016/j.freeradbiomed.2015.03.005. Epub 2015 Mar 17.

Associations between flavan-3-ol intake and CVD risk in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk).

Author information

1
Department of Food & Nutritional Sciences, University of Reading, UK.
2
Department of Public Health and Primary Care, University of Cambridge, UK.
3
Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Düsseldorf, Germany.
4
Mars, Inc., McLean, VA 22101, USA.
5
Department of Public Health and Primary Care, University of Cambridge, UK; University of Cambridge, School of Clinical Medicine, Clinical Gerontology Unit, Cambridge, UK.
6
Department of Food & Nutritional Sciences, University of Reading, UK; Department of Public Health and Primary Care, University of Cambridge, UK. Electronic address: g.g.kuhnle@reading.ac.uk.

Abstract

Dietary intervention studies suggest that flavan-3-ol intake can improve vascular function and reduce the risk of cardiovascular diseases (CVD). However, results from prospective studies failed to show a consistent beneficial effect. Associations between flavan-3-ol intake and CVD risk in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) were investigated. Data were available from 24,885 (11,252 men; 13,633 women) participants, recruited between 1993 and 1997 into the EPIC-Norfolk study. Flavan-3-ol intake was assessed using 7-day food diaries and the FLAVIOLA Flavanol Food Composition database. Missing data for plasma cholesterol and vitamin C were imputed using multiple imputation. Associations between flavan-3-ol intake and blood pressure at baseline were determined using linear regression models. Associations with CVD risk were estimated using Cox regression analyses. Median intake of total flavan-3-ols was 1034mg/d (range: 0-8531mg/d) for men and 970mg/d (0-6695mg/d) for women, median intake of flavan-3-ol monomers was 233mg/d (0-3248mg/d) for men and 217 (0-2712mg/d) for women. There were no consistent associations between flavan-3-ol monomer intake and baseline systolic and diastolic blood pressure (BP). After 286,147 person-years of follow-up, there were 8463 cardiovascular events and 1987 CVD related deaths; no consistent association between flavan-3-ol intake and CVD risk (HR 0.93, 95% CI: 0.87; 1.00; Q1 vs Q5) or mortality was observed (HR 0.93, 95% CI: 0.84; 1.04). Flavan-3-ol intake in EPIC-Norfolk is not sufficient to achieve a statistically significant reduction in CVD risk.

KEYWORDS:

Cardio-vascular diseases; EPIC Norfolk; Flavan-3-ols; Nutritional epidemiology

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