Higher Flavonoid Intake Associated with Lower Risk of Abdominal Aortic Calcification

by | Feb 1, 2023 | 2022, Cardiovascular Health, Flavonoids

Written by Taylor Woosley, Staff Writer. Subjects in the highest quartile of dietary flavonoid intake had a 37% (OR [95% CI], 0.63 [0.43–0.92]) lower odds of extensive AAC compared to those in the lowest quartile of dietary flavonoid intake. 

cardiovascular health - sliderCardiovascular disease is the leading cause of morbidity and mortality worldwide1. Abdominal aortic calcifications (AAC) are an important independent predictor of future cardiovascular events2. AAC deposition has been recently proposed as a marker of early atherosclerosis3. Besides age, risk factors for AAC include diabetes, body mass index, and hypertension4.

Research has indicated that intake of dietary flavonoids appears to benefit cardiovascular health5. Flavonoids are naturally found in fruits, vegetables, nuts, seeds, coffee, wine, and tea and possess potent antioxidant and anti-inflammatory properties6. Additionally, this diverse group of compounds exerts antihyperglycemic, antihyperlipidemic, nephroprotective, and hepatoprotective activities7.

Parmenter et al. conducted an observational cross-sectional study to investigate associations between habitual intake of total flavonoids, flavonoid subclasses, and specific flavonoid-containing foods with AAC. Data included in the study was from the Perth Longitudinal Study of Ageing Women (PLSAW), a large cohort study of older, White, female adults living in Western Australia. The current analysis used data from the 2003 PLSAW study including 881 subjects. Information regarding medical assessment, questionnaires on food and beverage consumption, physical activity, and socioeconomic was collected from subjects. Additionally, measures of anthropometry, radiographic imaging, and blood samples were obtained by professional staff.

Dietary intake was assessed by a semiquantitative, self-administered food-frequency questionnaire, with an additional questionnaire focused on black tea and coffee consumption. Flavonoid consumption was estimated based on participant’s food intake frequency and further categorized into 7 subclasses of flavonoids. Calcifications of the abdominal aorta were analyzed using radiographic imagery. Blood samples including hs-CRP, eGFR, creatinine, and cystatin C were obtained.

Logistic regression was used to observe associations of flavonoid intake with the odds of AAC. All exposures were entered as continuous variables and odds ratios and 95% CIs were derived from these model coefficients. Furthermore, in exploratory analysis, subjects were stratified by those who drank and did not drink black tea and investigated the association of total non-tea flavonoid intake with the odds of extensive AAC. The cohort of subjects were all ≥75 years old, who had not used hormone-replacement therapy, and around 58% had a BMI within the normal age for older adults. Extensive AAC was present in around 25% of participants. Significant findings of the study are as follows:

  • After adjusting for demographic and lifestyle confounders, subjects with higher (Q4), compared with lower (Q1), intakes of total flavonoids, flavan-3-ols, flavonols, and flavanones, had 37% (OR [95% CI], 0.63 [0.43–0.92]), 38% (0.62 [0.41–0.93]), 40% (0.60 [0.41–0.87]), and 31% (0.69 [0.49–0.97]) lower odds of extensive AAC, respectively.
  • Higher habitual black tea intake was associated with lower odds of extensive AAC after adjusting for demographic and lifestyle factors. In comparison to those consuming zero cups of black tea per day, those consuming 2, 4, and 6 cups per day showed 16% (OR [95% CI], 0.84 [0.71–0.99]), 30% (0.70 [0.50–0.97]), and 42% (0.58 [0.35–0.96]) lower odds respectively of extensive AAC.

Study results show that higher habitual intake of total flavonoids and specific subclasses, such as flavan-3-ols and flavonols, were associated with significantly reduced odds of extensive AAC after demographic, dietary, and lifestyle adjustments. In particular, black tea consumption showed a significant beneficial association with AAC. Study limitations include the inability to confirm causality due to the observational design of the study, the self-reporting nature of dietary intake which may result in recall bias, and the lack of generalizability of results due to the lack of diversity of subjects.

Source: Parmenter, Benjamin H., Catherine P. Bondonno, Kevin Murray, John T. Schousboe, Kevin Croft, Richard L. Prince, Jonathan M. Hodgson, Nicola P. Bondonno, and Joshua R. Lewis. “Higher Habitual Dietary Flavonoid Intake Associates With Less Extensive Abdominal Aortic Calcification in a Cohort of Older Women.” Arteriosclerosis, thrombosis, and vascular biology 42, no. 12 (2022): 1482-1494.

© 2022 American Heart Association, Inc.

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Posted February 1, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

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