Skip to main content
×
Home

Intake of specific flavonoids and risk of acute myocardial infarction in Italy

  • Alessandra Tavani (a1), Luana Spertini (a1), Cristina Bosetti (a1), Maria Parpinel (a2), Patrizia Gnagnarella (a3), Francesca Bravi (a1), Julie Peterson (a4), Johanna Dwyer (a5), Pagona Lagiou (a6), Eva Negri (a1) and Carlo La Vecchia (a1) (a7)...
Abstract
AbstractObjective

As intake of flavonoids has been associated with reduced risk of coronary heart disease but data on the relation with specific classes of flavonoids are scarce, we assessed the relation between dietary intake of specific classes of flavonoids and the risk of acute myocardial infarction (AMI) in an Italian population.

Design

Case–control study. Dietary information was collected by interviewers on a questionnaire tested for validity and reproducibility. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained by multiple logistic regression models including terms for energy and alcohol intake, as well as sociodemographic factors, tobacco and other major recognised risk factors for AMI.

Setting

Milan, Italy, between 1995 and 2003.

Subjects

Cases were 760 patients, below age 79 years, with a first episode of non-fatal AMI, and controls were 682 patients admitted to hospital for acute conditions unrelated to diet.

Results

A reduced risk of AMI was found for increasing intake of anthocyanidins (OR = 0.45, 95% CI 0.26–0.78 for the highest vs. the lowest quintile, Ptrend = 0.003) and flavonols (OR = 0.65, 95% CI 0.41–1.02, Ptrend = 0.02). A tendency towards reduced risks, although not significant, was observed for flavan-3-ols (OR = 0.73, 95% CI 0.48–1.10) and total flavonoids (OR = 0.74, 95% CI 0.49–1.14). No meaningful heterogeneity was found between the sexes. No association emerged for other flavonoids, including isoflavones, flavanones and flavones.

Conclusions

High intake of anthocyanidins reduced the risk of AMI even after allowance for alcohol, fruit and vegetables, supporting a real inverse association between this class of flavonoids and AMI risk.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Intake of specific flavonoids and risk of acute myocardial infarction in Italy
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Intake of specific flavonoids and risk of acute myocardial infarction in Italy
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Intake of specific flavonoids and risk of acute myocardial infarction in Italy
      Available formats
      ×
Copyright
Corresponding author
*Corresponding author: Email tavani@marionegri.it
References
Hide All
1Peterson J, Dwyer J. Flavonoids: dietary occurrence and biochemical activity. Nutrition Research 1998; 18: 19952018.
2Middleton E Jr, Kandaswami C, Theoharides TC. The effects of plant flavonoids on mammalian cells: implications for inflammation, heart disease, and cancer. Pharmacological Reviews 2000; 52: 673751.
3Mojzisova G, Kuchta M. Dietary flavonoids and risk of coronary heart disease. Physiological Reviews 2001; 50: 529–35.
4Hertog MG, Feskens EJ, Hollman PC, Katan MB, Kromhout D. Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet 1993; 342: 1007–11.
5Hertog MGL, Kromhout D, Aravanis C, Blackburn H, Buzina R, Fidanza F, et al. Flavonoid intake and long-term risk of coronary heart disease and cancer in the Seven Countries Study. Archives of Internal Medicine 1995; 155: 381–6.
6Knekt P, Jarvinen R, Reunanen A, Maatel J. Flavonoid intake and coronary mortality in Finland: a cohort study. British Medical Journal 1996; 312: 478–81.
7Yochum L, Kushi LH, Meyer K, Folsom AR. Dietary flavonoid intake and risk of cardiovascular disease in postmenopausal women. American Journal of Epidemiology 1999; 149: 943–9.
8Hirvonen T, Pietinen P, Virtanen M, Ovaskainen ML, Hakkinen S, Albanes D, et al. Intake of flavonols and flavones and risk of coronary heart disease in male smokers. Epidemiology 2001; 12: 62–7.
9Rimm EB, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Relation between intake of flavonoids and risk for coronary heart disease in male health professionals. Annals of Internal Medicine 1996; 125: 384–9.
10Geleijnse JM, Launer LJ, van der Kuip DAM, Hofman A, Witteman JCM. Inverse association of tea and flavonoid intakes with incident myocardial infarction: the Rotterdam Study. American Journal of Clinical Nutrition 2002; 75: 880–6.
11Hertog MGL, Sweetnam PM, Fehily AM, Elwood PC, Kromhout D. Antioxidant flavonols and ischemic heart disease in a Welsh population of men: the Caerphilly Study. American Journal of Clinical Nutrition 1997; 65: 1489–94.
12Knekt P, Kumpulainen J, Jarvinen R, Rissanen H, Heliovaara M, Reunanen A, et al. Flavonoid intake and risk of chronic diseases. American Journal of Clinical Nutrition 2002; 76: 560–8.
13Sesso HD, Gaziano JM, Liu S, Buring JE. Flavonoid intake and the risk of cardiovascular disease in women. American Journal of Clinical Nutrition 2003; 77: 1400–8.
14Huxley RR, Neil HAW. The relation between dietary flavonol intake and coronary heart disease mortality: a meta-analysis of prospective cohort studies. European Journal of Clinical Nutrition 2003; 57: 904–8.
15Donovan JL. Flavonoids and the risk of cardiovascular disease in women. American Journal of Clinical Nutrition 2004; 79: 522–4.
16Lagiou P, Samoli E, Lagiou A, Tzonou A, Kalandidi A, Peterson J, et al. Intake of specific flavonoid classes and coronary heart disease – a case–control study in Greece. European Journal of Clinical Nutrition 2004; 58: 1643–8.
17US Department of Agriculture (USDA). Iowa State University Database on the Isoflavone Content of Foods, Release 1.3, 2002. Beltsville, MD: USDA, 2002.
18US Department of Agriculture (USDA). USDA Database for the Flavonoid Content of Selected Foods. Beltsville, MD: USDA, 2004.
19Tavani A, Pelucchi C, Negri E, Bertuzzi M, La Vecchia C. n-3 Polyunsaturated fatty acids, fish, and nonfatal acute myocardial infarction. Circulation 2001; 104: 2269–72.
20World Health Organization (WHO). Ischemic Heart Disease Registers. Report of the Fifth Working Group. Copenhagen: WHO, 2004.
21Franceschi S, Barbone F, Negri E, Decarli A, Ferraroni M, Filiberti R, et al. Reproducibility of an Italian food frequency questionnaire for cancer studies. Results for specific nutrients. Annals of Epidemiology 1995; 5: 6975.
22Decarli A, Franceschi S, Ferraroni M, Gnagnarella P, Parpinel MT, La Vecchia C, et al. Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients. Annals of Epidemiology 1996; 6: 110–8.
23Salvini S, Parpinel MT, Gnagnarella P, Maisonneuve P, Turrini A. Banca Dati di Composizione degli Alimenti per Studi Epidemiologici in Italia. Milan: Edizioni Istituto Europeo di Oncologia, 1998.
24Liggins J, Bluck LJ, Runswick S, Atkinson C, Coward WA, Bingham SA. Daidzein and genistein contents of vegetables. British Journal of Nutrition 2000; 84: 717–25.
25Liggins J, Bluck LJ, Runswick S, Atkinson C, Coward WA, Bingham SA. Daidzein and genistein content of fruits and nuts. Journal of Nutritional Biochemistry 2000; 11: 326–31.
26Liggins J, Mulligan A, Runswick S, Bingham SA. Daidzein and genistein content of cereals. European Journal of Clinical Nutrition 2002; 56: 961–6.
27Breslow NE, Day NE. Statistical Methods in Cancer Research. Vol. 1. The Analysis of Case–Control Studies. International Agency for Research on Cancer (IARC) Scientific Publications No. 32. Lyon: IARC, 1980.
28Zhan S, Ho SC. Meta-analysis of the effects of soy protein containing isoflavones on the lipid profile. American Journal of Clinical Nutrition 2005; 81: 397408.
29Mazur W, Adlercreutz H. Overview of naturally occurring endocrine-active substances in the human diet in relation to human health. Nutrition 2000; 16: 654–87.
30van Erp-Baart M-AJ, Brants AMH, Kiely M, Mulligan A, Turrini A, Sermoneta C, et al. Isoflavone intake in four different European countries: the VENUS approach. British Journal of Nutrition 2003; 89(Suppl. 1): S25–30.
31van der Schouw YT, Kreijkamp-Kaspers S, Peeters PHM, Keinan-Boker L, Rimm EB, Grobbee DE. Prospective study on usual dietary phytoestrogen intake and cardiovascular disease risk in Western women. Circulation 2005; 111: 465–71.
32de Whalley CV, Rankin SM, Hoult JR, Jessup W, Leake DS. Flavonoids inhibit the oxidative modification of low density lipoproteins by macrophages. Biochemical Pharmacology 1990; 39: 1743–50.
33Negre-Salvayre A, Salvayre R. Quercetin prevents the cytotoxicity of oxidized LDL on lymphoid cell lines. Free Radical Biology & Medicine 1992; 12: 101–6.
34Monforte MT, Trovato A, Kirjavainen S, Forestieri AM, Galati EM, Lo Curto RB. Biological effects of hesperidin, a citrus flavonoid. (Note II): hypolipidemic activity on experimental hypercholesterolemia in rat. Farmaco 1995; 50: 595–9.
35Weber C, Negrescu E, Erl W, Pietsch A, Frankenberger M, Ziegler-Heitbrock HW, et al. Inhibitors of protein tyrosine kinase suppress TNF-stimulated induction of endothelial cell adhesion molecules. Journal of Immunology 1995; 155: 445–51.
36Steinberg FM, Guthrie NL, Villablanca AC, Kumar K, Murray MJ. Soy protein with isoflavones has favorable effects on endothelial function that are independent of lipid and antioxidant effects in healthy postmenopausal women. American Journal of Clinical Nutrition 2003; 78: 123–30.
37Vita JA. Polyphenols and cardiovascular disease: effects on endothelial and platelet function. American Journal of Clinical Nutrition 2005; 81(Suppl.): 292S–7S.
38Tavani A, Bertuzzi M, Negri E, Sorbara L, La Vecchia C. Alcohol, smoking, coffee and risk of non-fatal acute myocardial infarction in Italy. European Journal of Epidemiology 2001; 17: 1131–7.
39Tavani A, Bertuzzi M, Gallus S, Negri E, La Vecchia C. Diabetes mellitus as a contributor to the risk of acute myocardial infarction. Journal of Clinical Epidemiology 2005; 55: 1082–7.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 1
Total number of PDF views: 65 *
Loading metrics...

Abstract views

Total abstract views: 69 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th November 2017. This data will be updated every 24 hours.