Habitual Flavonoid Intake from Fruit and Vegetables during Adolescence and Serum Lipid Levels in Early Adulthood: A Prospective Analysis

Abstract

Flavonoids have been implicated in the prevention of cardiovascular diseases (CVD). In a prospective approach, we investigated whether habitual flavonoid intake from fruit, vegetables and juices (FlavFVJ) during adolescence is associated with adult levels of serum lipids, one of the main CVD risk factors. This analysis included healthy participants from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study, who had provided a fasting blood sample in adulthood (aged 18–39 years), data on FlavFVJ intake during adolescence (females: 9–15 years, males: 10–16 years)—estimated either from multiple 3-day weighed dietary records (n = 257), or from validated biomarker hippuric acid (uHA) excretion from multiple 24-h urine samples (n = 233)—together with information on relevant covariates. In multivariable linear regression analyses, a higher FlavFVJ intake during adolescence was independently associated with higher serum high-density lipoprotein cholesterol (HDL-C) levels among males (Ptrend = 0.038); however, the inclusion of adult waist circumference attenuated this association (Ptrend = 0.053). FlavFVJ was not associated with triglycerides (TG), total cholesterol (TC) or low-density lipoprotein cholesterol (LDL-C; all Ptrend ≥ 0.1), nor was uHA excretion with any serum lipid outcome among males (all Ptrend ≥ 0.5). Neither FlavFVJ intake nor uHA excretion was associated with serum lipids among women (all Ptrend ≥ 0.1). However, a higher flavonoid intake from fruit and vegetables was independently related to lower LDL-C levels (Ptrend = 0.021), while a higher intake from juices was associated with higher LDL-C levels (Ptrend = 0.016) among females. In conclusion, a higher flavonoid intake from fruit, vegetables and/or juices during adolescence may be linked to cholesterol levels in early adulthood in a sex- and food source-specific manner.

Dietary flavonoids among children and adolescents in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study: intake, food sources and trends from 1985 until 2016

“…Mean total flavonoid intake for adolescents (12•5-17•5 years) in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study was estimated at 120 mg/4184 kJ per d using two non-consecutive 24-h recalls (10) . Since dietary habits develop during childhood and adolescence, they are considered very important for shaping lifelong dietary habits and the prevention of chronic diseases later in life (11,12) . However, the few studies that described flavonoid intake in children and adolescents are limited to cross-sectional analysis (7,8) , a certain age group (9) , girls (9) , or in the case of isoflavones to Asian populations (13) .…”

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

“…The results of the previous observational studies about the association between total flavonoid intake from foods and HDL-cholesterol were inconsistent. In the follow-up study with German, total flavonoid intake from fruit, vegetables, and juices during adolescence was associated with higher HDL-cholesterol levels only in men, not in women [34]. Cross-sectional studies of Iranians, Italians and Americans showed positive relationships between total flavonoid intakes and HDL-cholesterol levels [35][36][37], but no correlation was observed in studies with Chinese and Polish [38,39].…”

Antioxidant-Rich Dietary Intervention Improves Cardiometabolic Profiles and Arterial Stiffness in Elderly Koreans with Metabolic Syndrome

“…There are many large population studies that demonstrated the inverse associations between fruit and vegetable consumption with adiposity, BMI, or waist circumference. 26 27 28 Also, there are various data to support the relationship between antioxidant diet and hyperlipidemia 29 30 or hypertension. 31 32 33 Recent meta-analysis on food groups and risk of hypertension showed an inverse association for the risk of hypertension for 100 g of fruits/d (relative risk: 0.97).…”