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

Abstract

BackgroundPolyphenols 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.MethodsWe 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.ResultsOver 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).ConclusionsAmong 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 registrationISRCTN35739639.

Resveratrol metabolite profiling in clinical nutrition research—from diet to uncovering disease risk biomarkers: epidemiological evidence

“…42 However, in the PREDIMED study, high total resveratrol intake decreased 50% all-cause mortality in approximately 7,500 men and women at high cardiovascular risk after a mean followup of 4.8 years. 43 In this study, the dose-response effect was borderline significant, but the only significant results were observed with the highest quintile (>5.75mg/day), while in the InChianti study the resveratrol intake was lower and the results were presented in quartiles.…”

Polyphenols: Food Sources and Health Benefits

“…Among high-risk subjects, those Functional Food -Improve Health through Adequate Foodwith higher polyphenol intake showed a 37% lower mortality risk, compared with those with lower intake. Subgroups of polyphenols with the strongest inverse association were stilbenes and lignans, while lavonoids and phenolic acids had no signiicant efect on mortality reduction [12]. However, the European Prospective Investigation into Cancer and Nutrition (EPIC) reported that higher lavonoid intake in the diet was associated with a 29% reduction in all-cause mortality, in particular for the subclasses of lavanones and lavonols, which decreased the incidence of cardiovascular disease by 40 and 41%, respectively [13].…”

The relationships between alcohol, wine and cardiovascular diseases –A review

“…The types of phenolic compounds found in beer are also different, with different biological activities, to those found in wine. The wine-derived phenolic compounds, that are also present in the fruit and vegetable components of a Mediterranean-style diet, have also been associated with a reduced risk of CVD [189][190][191][192] In the PRED-IMED (Prevención con Dieta Mediterránea) study, the class observed to be strongest associated with a reduced risk of CVD is the flavanol class which includes catechin, epicatechin gallate, epigallocatechin, epigallocatechin gallate and proanthocyanidins [191]. A primary source (32%) of flavanols in the daily diet is wine.…”