Background: Epidemiological and experimental evidence support a protective effect of dietary polyphenols on chronic diseases, but high quality longitudinal data are needed, including details on categories of polyphenols. Our objective was to investigate the prospective association between total and individual classes and subclasses of dietary polyphenols and the risk of major cardiovascular disease in the NutriNet-Santé cohort. Methods: A total of 84,158 participants, who completed at least three 24 h dietary records, were included between May 2009 and June 2017. Individual polyphenols intakes were obtained by matching food consumption data from the 24 h dietary records with the Phenol-Explorer polyphenol composition database. Multivariable Cox proportional hazards models were used to characterize the associations between dietary polyphenols and the incidence of cardiovascular diseases, comparing tertile T3 vs. T1 of classes and subclasses of polyphenols. Results: Over a median of 4.9 years of follow-up, 602 major cardiovascular events were diagnosed. Intakes of anthocyanins, catechins, and flavonols were strongly inversely associated with cardiovascular disease risk (anthocyanins: Hazard Ratio (HR)for a 1-point increment of 10 mg/day = 0.98 (0.96–0.99, p = 0.03, HRT3vs.T1 = 0.66 (0.52–0.83), ptrend = 0.0003; catechins: HRfor a 1-point increment of 10 mg/day = 0.98 (0.96–0.99), p = 0.02, HRT3vs.T1 = 0.74 (0.60–0.91), ptrend = 0.004; flavonols: HRfor a 1-point increment of 10 mg/day = 0.94 (0.90–0.99), p = 0.02, HRT3vs.T1 = 0.75 (0.61–0.94), ptrend = 0.006). Intakes of dihydrochalcones, proanthocyaninidins, dihydroflavonols, hydroxybenzoic acids, and stilbenes were also associated with a decrease (13%, 19%, 24%, 24%, and 27%, respectively) in cardiovascular disease risk, when comparing tertile T3 to T1. Conclusions: Higher intakes of polyphenols, especially of anthocyanins, catechins, and flavonols, were associated with a statistically significant decreased cardiovascular disease risk.
BackgroundSnacking raises concern since it may lead to an additional energy intake and poor nutrient quality. A snacking occasion can be defined as any eating occasion apart from main meals, regardless of the amount or type of foods consumed. We described the frequency of snacking occasions according to daily timing in French adults, and compared them between each other, and with the main meals, in terms of energy intake, energy and nutrient density, and food content.MethodsThis cross-sectional analysis included 104,265 adults from the NutriNet-Santé cohort. Food intake was estimated using 24-h records of weekdays. For each eating occasion, nutrient density and energy content and density were computed.ResultsAfter weighting, 47.6% of our sample were men and mean age was 45.6 (15.3). Overall, 68% of participants ate at least one snack during the reported record, mainly in the morning or afternoon. Overall snack had a lower nutrient density [22.8 (SD = 278.3)] than main meals [25.8 (36.9) to 30.0 (30.4)]; but higher energy density [222.2 (163.3) kcal/100 g] than meals [133.9 (57.3) to 175.9 (99.6) kcal/100 g]. Morning snack was the snacking occasion with the lowest energy density [211 kcal/100 g], the lowest energy intake [104.1 kcal] and the highest nutrient density [60.1]. Afternoon and evening snacks had the highest energy loads [192.4 kcal and 207.6 kcal], but low nutrient scores [16 and 13, respectively]. The main food groups contributing to energy intake from snacks were fatty-sweet and sugary foods, fruit, hot beverages, and bread.ConclusionsOur findings highlight the frequency of snacking and the varying nutritional quality of snacks over the day. The morning snack was shown to be healthier than afternoon and evening snacks.Trial registrationThis study was conducted according to guidelines laid down in the Declaration of Helsinki, and all procedures were approved by the Institutional Review Board of the French Institute for Health and Medical Research (IRB Inserm No. 0000388FWA00005831) and the French Data Protection Authority (Commission Nationale Informatique et Libertés No. 908450 and No. 909216). Electronic informed consent was obtained from all participants (Clinical Trial no. NCT03335644).Electronic supplementary materialThe online version of this article (10.1186/s12937-018-0336-z) contains supplementary material, which is available to authorized users.
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