Polyphenol intake and mortality risk: a re-analysis of the PREDIMED trial

BMC Medicine

Rosa M Lamuela-Raventós⁸  Ramón Estruch⁸  Valentina Ruiz-Gutiérrez⁸  Alfredo Gea⁵  Miguel A Muñoz⁸  Xavier Pintó⁸  Lluis Serra-Majem⁸  Emili Ros⁸  Miquel Fiol⁸  Fernando Arós⁸  José Lapetra³  Enrique Gómez-Gracia¹  Jordi Salas-Salvadó²  Dolores Corella⁷  María I Covas⁴  M Carmen López-Sabater⁸  Miguel A Martínez-González⁵  Alexander Medina-Remón⁸  Eric B Rimm⁶  Anna Tresserra-Rimbau⁸ 

[1] Department of Epidemiology, School of Medicine, University of Malaga, Málaga, Spain;Human Nutrition Unit, School of Medicine, IISPV, University Rovira i Virgili, Reus, Spain;Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain;Cardiovascular Epidemiology Unit, Municipal Institute for Medical Research (IMIM), Barcelona, Spain;Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain;Harvard Medical School and Harvard School of Public Health, Boston, MA, USA;Department of Epidemiology, Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain;CIBER CB06/03 Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Institute of Health “Carlos III”, Government of Spain, Madrid, Spain

关键词: Lignans;    Stilbenes;    Mediterranean diet;    PREDIMED;    All-cause mortality;    Polyphenol intake;   

Others  :  854888
DOI  :  10.1186/1741-7015-12-77

 received in 2014-01-23, accepted in 2014-04-10,  发布年份 2014

【 摘 要 】

Background

Polyphenols may lower the risk of cardiovascular disease (CVD) and other chronic diseases due to their antioxidant and anti-inflammatory properties, as well as their beneficial effects on blood pressure, lipids and insulin resistance. However, no previous epidemiological studies have evaluated the relationship between the intake of total polyphenols intake and polyphenol subclasses with overall mortality. Our aim was to evaluate whether polyphenol intake is associated with all-cause mortality in subjects at high cardiovascular risk.

Methods

We used data from the PREDIMED study, a 7,447-participant, parallel-group, randomized, multicenter, controlled five-year feeding trial aimed at assessing the effects of the Mediterranean Diet in primary prevention of cardiovascular disease. Polyphenol intake was calculated by matching food consumption data from repeated food frequency questionnaires (FFQ) with the Phenol-Explorer database on the polyphenol content of each reported food. Hazard ratios (HR) and 95% confidence intervals (CI) between polyphenol intake and mortality were estimated using time-dependent Cox proportional hazard models.

Results

Over an average of 4.8 years of follow-up, we observed 327 deaths. After multivariate adjustment, we found a 37% relative reduction in all-cause mortality comparing the highest versus the lowest quintiles of total polyphenol intake (hazard ratio (HR) = 0.63; 95% CI 0.41 to 0.97; P for trend = 0.12). Among the polyphenol subclasses, stilbenes and lignans were significantly associated with reduced all-cause mortality (HR =0.48; 95% CI 0.25 to 0.91; P for trend = 0.04 and HR = 0.60; 95% CI 0.37 to 0.97; P for trend = 0.03, respectively), with no significant associations apparent in the rest (flavonoids or phenolic acids).

Conclusions

Among high-risk subjects, those who reported a high polyphenol intake, especially of stilbenes and lignans, showed a reduced risk of overall mortality compared to those with lower intakes. These results may be useful to determine optimal polyphenol intake or specific food sources of polyphenols that may reduce the risk of all-cause mortality.

Clinical trial registration

ISRCTN35739639.

【 授权许可】

   
2014 Tresserra-Rimbau et al.; licensee BioMed Central Ltd.

【 图 表 】

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