Flavonoid consumption and esophageal cancer among black and white men in the United States

Abstract

Flavonoids and proanthocyanidins are bioactive polyphenolic components of fruits and vegetables that may account for part of the protective effect of raw fruit and vegetable consumption in esophageal cancer. We studied the relationship between esophageal cancer and dietary proanthocyanidins, flavonoids and flavonoid subclasses (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols and isoflavonoids) using recently developed USDA and Tufts flavonoid and proanthocyanidin databases. The study was a population-based, case-control analysis of 161 white men with esophageal adenocarcinoma (EAC), 114 white and 218 black men with esophageal squamous cell carcinoma (ESCC) and 678 white and 557 black male controls who lived in 3 areas of the United States. Neither total flavonoid nor proanthocyanidin intake was associated with EAC and ESCC in either white or black men. In white men, inverse associations were observed between anthocyanidin intake and EAC (4th vs. 1st quartile odds ratio [OR], 0.47, 95% confidence interval [CI], 0.24-0.91; p trend 5 0.04) and between isoflavonoid intake and ESCC (4th vs. 1st quartile OR, 0.43, 95% CI, 0.20-0.93; p trend 5 0.01). None of the associations remained significant after adjusting for dietary fiber, which is strongly correlated with flavonoid consumption. We conclude that total flavonoids and proanthocyanidins do not have strong protective effects in either EAC or ESCC. Some protective effects were evident in flavonoid subclasses and population subgroups. In white men, foods rich in anthocyanidins may have chemopreventive effects in EAC and those rich in isoflavonoids may do so in ESCC. ' UICCKey words: case-control study; esophageal adenocarcinoma; esophageal squamous cell carcinoma; flavonoids; proanthocyanidins Low raw fruit and vegetable consumption has been associated with increased risk of the 2 primary histological subtypes of esophageal cancer, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), in both case-control and prospective cohort studies. 1 A population-based case-control study of EAC and ESCC among black and white men in the United States also suggested that these effects might differ between histological subtypes, population subgroups and food groups. 2,3 Flavonoids and proanthocyanidins (condensed tannins) are a group of bioactive polyphenols that are present in raw fruits and vegetables such as citrus fruits, apples and legumes as well as in beverages such as tea, citrus fruit juices and wine. 4,5 They might partially account for the protective effect of high raw fruit and vegetable consumption in EAC and ESCC. The plant sources of the 6 major classes of dietary monomeric flavonoids, such as anthocyanidins, flavan-3-ols (catechins), flavanones, flavones, flavonols and isoflavonoids, differ as do those for proanthocyanidins, oligomers and polymers of flavan-3-ol units. 6 Monomeric flavonoids and proanthocyanidins have anticarcinogenic properties, including antioxidative, antimutagenic, antiinflammatory and antiproliferative ef...

A Food Frequency Questionnaire Validated for Estimating Dietary Flavonoid Intake in an Australian Population

“…In particular, flavonones associate with lower risk of esophageal squamous cell carcinoma (3), flavones and flavonols against renal cell carcinoma (4), and increased intakes of anthocyanadins, flavones, and flavonols may lower risk of colorectal cancer (5). More generally, flavonoid intake is associated with lower risk of esophageal adenocarcinoma (6,7) and breast cancer (8). These epidemiological patterns have been guided by in vitro mechanistic studies on immune function, cell proliferation and apoptosis (9,10).…”

Estimation of Daily Proanthocyanidin Intake and Major Food Sources in the U.S. Diet

“…Polyphenols have been documented as one of the major contributors to the antioxidant capacity of the American diet (14). Several studies have reported the intakes of phenolic compounds (13,15,16) and flavanoids (17)(18)(19)(20) and that about two-thirds of the total dietary polyphenols were flavonoids (14). Due to their ubiquity, PA account for a large fraction of the polyphenols consumed (21).…”

Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults

“…Flavonoid values were derived from 3 USDA databases on flavonoids (16), proanthocyanidins (17), and isoflavones (18) and other research publications (22)(23)(24), as described previously (25). For mixed dishes (eg, pizza, coleslaw), we assigned weighted content values based on recipes from standard cookbooks.…”