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Relation between Intake of Flavonoids and Risk for Coronary Heart Disease in Male Health Professionals

Eric B. Rimm, ScD; Martijn B. Katan, PhD; Alberto Ascherio, MD; Meir J. Stampfer, MD; and Walter C. Willett, MD
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From Harvard School of Public Health, Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts; and Agricultural University, Wageningen, the Netherlands. Acknowledgments: The authors thank the participants of the Health Professionals Follow-up Study for their continued cooperation and participation; Jeanne de Vries and Peter Hollman for food analyses; Al Wing, Laura Sampson, Susan Woo, Mira Kaufman, and Steve Stuart for computer assistance; and Jill Arnold, Betsy Frost-Hawes, Kerry Pillsworth, and Mitzi Wolff for assistance with data compilation and manuscript preparation. Requests for Reprints: Eric Rimm, ScD, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115. Current Author Addresses: Drs. Rimm, Ascherio, and Willett: Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1996;125(5):384-389. doi:10.7326/0003-4819-125-5-199609010-00005
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Objective: Flavonols and flavones are subgroups of flavonoids and are found in tea, vegetables, fruits, and red wine. Because they have antioxidant properties, we investigated whether intake of these dietary compounds is associated with a lower risk for fatal and nonfatal coronary heart disease.

Design: Prospective cohort study.

Setting: United States.

Patients: 34 789 male health professionals, 40 to 75 years of age, who responded to a questionnaire in 1986.

Measurements: In 1986 and 1990, detailed, 131-item questionnaires were used to assess dietary intake of flavonols and flavones.

Results: Between 1986 and 1992, 496 patients received a new diagnosis of nonfatal myocardial infarction. The relative risk for nonfatal myocardial infarction was 1.08 (95% CI, 0.81 to 1.43) for the highest (median, 40.0 mg/d) compared with the lowest (median, 7.1 mg/d) quintiles for intake of flavonols and flavones after adjustment for age, obesity, smoking, intake of vitamin E, intake of alcohol, diabetes, hypertension, hypercholesterolemia, and family history of coronary heart disease. Among the 4814 men who reported that they had previously had coronary heart disease, we found a modest but nonsignificant inverse association between intake of flavonols and flavones and subsequent coronary mortality rates (relative risk, 0.63 [CI, 0.33 to 1.20] for the highest compared with the lowest quintile for intake of flavonoids).

Conclusion: The data do not support a strong inverse association between intake of flavonoids and total coronary heart disease, but they do not exclude the possibility that flavonoids have a protective effect in men with established coronary heart disease.





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