Association of Total Flavonoid Intake with Hypo-HDL-Cholesterolemia among Korean Adults: Effect Modification by Polyunsaturated Fatty Acid Intake

Abstract

The aim of this study was to examine the independent association between flavonoid intake and hypo-high-density lipoprotein (HDL)-cholesterolemia and the potential modifying effect of polyunsaturated fatty acid (PUFA) intake on this association among Korean adults. This cross-sectional analysis used data from 10,326 subjects who participated in the 2013–2016 Korean National Health and Nutrition Examination Survey. Multiple logistic regression analyses were used to assess the associations of flavonoid and PUFA intakes with hypo-HDL-cholesterolemia prevalence. Proanthocyanidins intake showed an inverse relationship with hypo-HDL-cholesterolemia only in men (Tertile (T) 3 vs. T1: odds ratio (OR) = 0.74, 95% confidence interval (CI) = 0.59–0.92, p-trend = 0.0330). Total flavonoid and PUFA intakes were not associated with hypo-HDL-cholesterolemia in both men and women. However, when stratified by PUFA intake, there was an inverse relationship between total flavonoid intake and hypo-HDL-cholesterolemia prevalence in men with a high n-3 PUFA intake (total flavonoid intakes T3 vs. T1: OR = 0.59, 95% CI = 0.42–0.82, p-trend = 0.0004) or a low n-6/n-3 PUFA intake ratio (T3 vs. T1: OR = 0.67, 95% CI = 0.48–0.93, p-trend = 0.0053), but not in those with a low n-3 PUFA intake (p-interaction = 0.0038) or a high n-6/n-3 PUFA intake ratio (p-interaction = 0.1772). In women, no association was found between total flavonoid intake and hypo-HDL-cholesterolemia, regardless of PUFA intake. These results imply that the intake of proanthocyanidins might have beneficial effects on the HDL-cholesterol level in Korean men. In addition, n-3 PUFA intake might modify the association of total flavonoid intake with the hypo-HDL-cholesterolemia among Korean men.

Analysis of the intricate effects of polyunsaturated fatty acids and polyphenols on inflammatory pathways in health and disease

“…These results are partially in line with a later cross-sectional analysis in the Korean population that suggested beneficial effects exhibited only in men by high amounts of proanthocyanidins or n-3 PUFAs on HDL levels. In addition, n-3 PUFAs intake increased polyphenols uptake (Ahn et al, 2020).…”

“…Just a small number of published studies investigated if n-3 PUFAs may interact with the polyphenols and if a combined diet may have an enhanced beneficial impact. Until now only the beneficial effects on HDL-levels (as a "surrogate" for the anti-inflammatory effect) were identified (Ahn et al, 2020;Annuzzi et al, 2014;Bub et al, 2019).…”

The Microencapsulation of Noni Fruit Extract (Morinda Citrifolia L.) with Maltodextrin and Its Implementation As Feed Additive on Carcass Quality and Histology of Intestinal Sentul Chicken

“…This is because the noni fruit extract contains active flavonoids and alkaloids. Cholesterol levels can be lowered by flavonoids, namely by inhibiting the performance of the activity of Hydroxymethylglutaryl-CoA (HMG-CoA) reductase, flavonoids show great potential to improve blood HDL cholesterol levels due to their antioxidant and antiinflammatory properties [32]. This also follows that HMG-CoA reductase plays a role in converting acetyl-CoA into mevalonate, which causes a reduction in cholesterol synthesis products that occurs when the liver transports cholesterol from the intestine [33].…”

Effect of Active Compounds for Quercus Fruit on Some Biochemical Parameters and Tissue Aorta in Induced Atherosclerosis Rats

“…Also, flavonoids work in the extract. Vegetarians raise the level of HDL-C by increasing the activity of the lecithin cholesterol acyl transferase enzyme LCAT(Rograni & Baluchnejadomojard., 2010;Ahn et al, 2020) Histological examination in animals used for arteriosclerosis with cholesterol at a concentration of (500 mg/kg) dissolved in oil for 15 days, compared with normal tissues, shows in figure (3) the presence of histological changes in the aorta compared with the control group through the presence of thickenings in three layers of the aorta with the existence of many Foam cells in cholesterol-containing macrophages with coagulation of smooth muscle fibers and cholesterol deposition in the artery. -1 (IL-1) in foam cells with artery stenosis due to inflammation and cholesterol accumulation.…”