Change in habitual intakes of flavonoid-rich foods and mortality in US males and females

Nicola P Bondonno , Yan Lydia Liu, Yan Zheng, Kerry Ivey, Walter C Willett, Meir J Stampfer, Eric B Rimm , Aedín Cassidy
BMC Med. 2023 May 12;21(1):181. doi: 10.1186/s12916-023-02873-z.


Background: Higher baseline intakes of flavonoid-rich foods and beverages are associated with a lower risk of chronic disease and mortality in observational studies. However, associations between changes in intakes and mortality remain unclear. We aimed to evaluate associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a composite measure (termed the ‘flavodiet’) of foods and beverages that are known to be main contributors to flavonoid intake and subsequent total and cause-specific mortality.

Methods: We evaluated associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a novel ‘flavodiet’ score and total and cause-specific mortality. We included 55,786 females from the Nurses’ Health Study (NHS) and 29,800 males from the Health Professionals Follow-up Study (HPFS), without chronic disease at baseline in our analyses. Using multivariable-adjusted Cox proportional hazard models, we examined associations of 8-year changes in intakes of (1) flavonoid-rich foods and (2) the flavodiet score with subsequent 2-year lagged 6-year risk of mortality adjusting for baseline intakes. Data were pooled using fixed-effects meta-analyses.

Results: We documented 15,293 deaths in the NHS and 8988 deaths in HPFS between 1986 and 2018. For blueberries, red wine and peppers, a 5%, 4% and 9% lower risk of mortality, respectively, was seen for each 3.5 servings/week increase in intakes while for tea, a 3% lower risk was seen for each 7 servings/week increase [Pooled HR (95% CI) for blueberries; 0.95 (0.91, 0.99); red wine: 0.96 (0.93, 0.99); peppers: 0.91 (0.88, 0.95); and tea: 0.97 (0.95, 0.98)]. Conversely, a 3.5 servings/week increase in intakes of onions and grapefruit plus grapefruit juice was associated with a 5% and 6% higher risk of total mortality, respectively. An increase of 3 servings per day in the flavodiet score was associated with an 8% lower risk of total mortality [Pooled HR: 0.92 (0.89, 0.96)], and a 13% lower risk of neurological mortality [Pooled HR: 0.87 (0.79, 0.97)], after multivariable adjustments.

Conclusions: Encouraging an increased intake of specific flavonoid-rich foods and beverages, namely tea, blueberries, red wine, and peppers, even in middle age, may lower early mortality risk.

Latest General

The state of the science on the health benefits of blueberries: a perspective

April J. Stull, Aedín Cassidy, Luc Djousse, Sarah A. Johnson, Robert Krikorian, Johanna W. Lampe, Kenneth J. Mukamal, David C. Nieman, Kathryn N. Porter Starr, Heather Rasmussen, Eric B. Rimm, Kim S. Stote, Christy Tangney
Read More

Recent Research on the Health Benefits of Blueberries and Their Anthocyanins

Wilhelmina Kalt, Aedin Cassidy, Luke R Howard, Robert Krikorian, April J Stull, Francois Tremblay, Raul Zamora-Ros
Adv Nutr. 2020 Mar 1;11(2):224–236.
Read More