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Intake of specific flavonoid classes and coronary heart disease—a case–control study in Greece

European Journal of Clinical Nutrition volume 58, pages 1643–1648 (2004)Cite this article

Abstract

Objective: Dietary intake of flavonoids has been reported to protect against coronary heart disease (CHD) risk, but associations of specific classes of flavonoids with CHD have not been adequately studied.

Design: Hospital-based case–control study relying on interviewer administered questionnaires.

Setting: Cardiology Department of the University of Athens Medical School in the Hippokrateion General Hospital (1990–1991).

Subjects: Cases were 329 patients with electrocardiographically confirmed first coronary infarct or a first positive coronary arteriogram, or both (participation fraction 93%). Controls were 570 patients admitted to the same hospital for minor conditions unrelated to nutrition (participation fraction 95%). All cases and controls were interviewed in the hospital wards by experienced interviewers, and a 110-item food frequency questionnaire was administered.

Results: There was statistically significant evidence (P∼0.03) for an inverse association between intake of flavan-3-ols and CHD risk, an increase of about 21 mg per day corresponding to a 24% decrease in CHD risk. The inverse association between flavan-3-ols and CHD risk was largely accounted for by the intake of wine and to a lesser extent tea. For none of the other flavonoid classes was there statistically significant evidence of an association.

Conclusion: Flavan-3-ols, which are largely found in wine and tea, are inversely associated with, and may be protective against, coronary heart disease.

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Acknowledgements

This study was partially supported by the University of Athens and a grant to Harvard University by the Samourkas Foundation. The project was also funded in part with Federal funds from the US Department of Agriculture Research Service under contract number 58-1950-9-001. The contents of this publication do not necessarily reflect the views or policies of the US Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government. Partial support was also provided by the State of Florida, Department of Citrus.

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Authors and Affiliations

  1. Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Athens, Greece

    P Lagiou, E Samoli, A Lagiou, A Tzonou, A Kalandidi & D Trichopoulos

  2. Faculty of Health Professions, Athens Technological Institute (TEI), Akadimia Platonos, Greece

    A Lagiou

  3. Schools of Nutrition and Medicine, Boston, MA, USA

    J Peterson & J Dwyer

  4. Jean Mayer USDA Human Nutrition Research Centre on Aging at Tufts University, Boston, MA, USA

    J Peterson & J Dwyer

  5. Frances Stern Nutrition Centre Tufts-New England Medical Centre, Boston, MA, USA

    J Peterson & J Dwyer

  6. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    D Trichopoulos

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  1. P Lagiou
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  2. E Samoli
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  3. A Lagiou
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  6. J Peterson
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  7. J Dwyer
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  8. D Trichopoulos
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Contributions

Guarantor: D Trichopoulos.

Contributors: PL: lead investigator, supervisor of all activities and manuscript developer. ES: Statistical analysis. AL: Epidemiologist and contributor in manuscript drafting. AT: Statistical analysis. AK: Design of the original study and supervision of data collection. JP: Contribution in development and application of flavonoid content data. JD: Contribution in development and application of flavonoid content data. DT: Design of the original study; senior epidemiologist.

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Correspondence to P Lagiou.

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Lagiou, P., Samoli, E., Lagiou, A. et al. Intake of specific flavonoid classes and coronary heart disease—a case–control study in Greece. Eur J Clin Nutr 58, 1643–1648 (2004). https://doi.org/10.1038/sj.ejcn.1602022

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