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. Clinical trial registry: International Standard Randomized Controlled Trial Number (ISRCTN of London, England)
35739639.
Keywords
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Article info
Publication history
Published online: February 18, 2014
Accepted:
December 30,
2013
Received in revised form:
December 19,
2013
Received:
November 6,
2013
Identification
Copyright
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
