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

Published online by Cambridge University Press:  02 January 2007

Alessandra Tavani ,
Luana Spertini ,
Cristina Bosetti ,
Maria Parpinel ,
Patrizia Gnagnarella ,
Francesca Bravi ,
Julie Peterson ,
Johanna Dwyer ,
Pagona Lagiou  and
Eva Negri
...Show all authors
Alessandra Tavani*
Affiliation:
Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Eritrea 62, I-20157 Milan, Italy
Luana Spertini
Affiliation:
Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Eritrea 62, I-20157 Milan, Italy
Cristina Bosetti
Affiliation:
Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Eritrea 62, I-20157 Milan, Italy
Maria Parpinel
Affiliation:
Istituto di Igiene, Università di Udine, Udine, Italy
Patrizia Gnagnarella
Affiliation:
Divisione di Epidemiologia e Biostatistica, Istituto Europeo di Oncologia, Milan, Italy
Francesca Bravi
Affiliation:
Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Eritrea 62, I-20157 Milan, Italy
Julie Peterson
Affiliation:
Frances Stern Nutrition Center, Tufts–New England Medical Center, Boston, MA, USA
Johanna Dwyer
Affiliation:
Schools of Medicine, Nutrition and the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
Pagona Lagiou
Affiliation:
Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece
Eva Negri
Affiliation:
Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Eritrea 62, I-20157 Milan, Italy
Carlo La Vecchia
Affiliation:
Istituto di Ricerche Farmacologiche ‘Mario Negri’, Via Eritrea 62, I-20157 Milan, Italy Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milan, Italy
*
*Corresponding author: Email [email protected]
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Abstract

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Objective

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.

Keywords

DietFlavonoidsMyocardial infarctionCase–control studiesRisk factors
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 3 , May 2006 , pp. 369 - 374
Copyright
Copyright © The Authors 2006

References

1Peterson, J, Dwyer, J. Flavonoids: dietary occurrence and biochemical activity. Nutrition Research 1998; 18: 1995–2018.CrossRefGoogle Scholar
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: 673–751.Google ScholarPubMed
3Mojzisova, G, Kuchta, M. Dietary flavonoids and risk of coronary heart disease. Physiological Reviews 2001; 50: 529–35.Google ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
15Donovan, JL. Flavonoids and the risk of cardiovascular disease in women. American Journal of Clinical Nutrition 2004; 79: 522–4.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
17US Department of Agriculture (USDA). Iowa State University Database on the Isoflavone Content of Foods, Release 1.3, 2002. Beltsville, MD: USDA, 2002.Google Scholar
18US Department of Agriculture (USDA). USDA Database for the Flavonoid Content of Selected Foods. Beltsville, MD: USDA, 2004.Google Scholar
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.CrossRefGoogle ScholarPubMed
20World Health Organization (WHO). Ischemic Heart Disease Registers. Report of the Fifth Working Group. Copenhagen: WHO, 2004.Google Scholar
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: 69–75.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
26Liggins, J, Mulligan, A, Runswick, S, Bingham, SA. Daidzein and genistein content of cereals. European Journal of Clinical Nutrition 2002; 56: 961–6.CrossRefGoogle ScholarPubMed
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.Google Scholar
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: 397–408.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
33Negre-Salvayre, A, Salvayre, R. Quercetin prevents the cytotoxicity of oxidized LDL on lymphoid cell lines. Free Radical Biology & Medicine 1992; 12: 101–6.CrossRefGoogle ScholarPubMed
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.Google ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
37Vita, JA. Polyphenols and cardiovascular disease: effects on endothelial and platelet function. American Journal of Clinical Nutrition 2005; 81(Suppl.): 292S–7S.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar