RESUMEN
Data from dietary intervention studies suggest that intake of (-)-epicatechin mediates beneficial vascular effects in humans. However, population-based investigations are required to evaluate associations between habitual intake and health and these studies rely on accurate estimates of intake, which nutritional biomarkers can provide. Here, we evaluate a series of structurally related (-)-epicatechin metabolites (SREM), particularly (-)-epicatechin-3'-glucuronide, (-)-epicatechin-3'-sulfate and 3'-O-methyl-(-)-epicatechin-5-sulfate (SREMB), as flavan-3-ol and (-)-epicatechin intake. SREMB in urine proved to be a specific indicator of (-)-epicatechin intake, showing also a strong correlation with the amount of (-)-epicatechin ingested (R2: 0.86 (95% CI 0.8l; 0.92). The median recovery of (-)-epicatechin as SREMB in 24 h urine was 10% (IQR 7-13%) and we found SREMB in the majority of participants of EPIC Norfolk (83% of 24,341) with a mean concentration of 2.4 ± 3.2 µmol/L. Our results show that SREMB are suitable as biomarker of (-)-epicatechin intake. According to evaluation criteria from IARC and the Institute of Medicine, the results obtained support use of SREMB as a recovery biomarker to estimate actual intake of (-)-epicatechin.
Asunto(s)
Catequina/metabolismo , Dieta , Flavonoides/farmacología , Adulto , Biomarcadores/metabolismo , Estudios de Cohortes , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Flavonoids are a group of phenolic secondary plant metabolites that are ubiquitous in plant-based diets. Data from anthropological, observational and intervention studies have shown that many flavonoids are bioactive. For this reason, there is an increasing interest in investigating the potential health effects of these compounds. The translation of these findings into the context of the health of the general public requires detailed information on habitual dietary intake. However, only limited data are currently available for European populations. OBJECTIVE: The objective of this study is to determine the habitual intake and main sources of anthocyanidins, flavanols, flavanones, flavones, flavonols, proanthocyanidins, theaflavins and thearubigins in the European Union. DESIGN: We use food consumption data from the European Food Safety Authority (EFSA) and the FLAVIOLA Food Composition Database to estimate intake of flavonoids. RESULTS: Mean (±SEM) intake of total flavonoids in Europe was 428±49 mg/d, of which 136±14 mg/d were monomeric compounds. Gallated flavan-3-ols (53±12 mg/d) were the main contributor. The lowest flavonoid intake was observed in Mediterranean countries (monomeric compounds: 95±11 mg/d). The distribution of intake was skewed in many countries, especially in Germany (monomeric flavonoids; mean intake: 181 mg/d; median intake: 3 mg/d). CONCLUSIONS: The habitual intake of flavonoids in Europe is below the amounts found to have a significant health effect.
Asunto(s)
Flavonoides/administración & dosificación , Flavonoides/análisis , Adulto , Dieta , Europa (Continente) , Humanos , Persona de Mediana Edad , Adulto JovenRESUMEN
Dietary intervention studies suggest that flavan-3-ol intake can improve vascular function and reduce the risk of cardiovascular diseases (CVD). However, results from prospective studies failed to show a consistent beneficial effect. Associations between flavan-3-ol intake and CVD risk in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) were investigated. Data were available from 24,885 (11,252 men; 13,633 women) participants, recruited between 1993 and 1997 into the EPIC-Norfolk study. Flavan-3-ol intake was assessed using 7-day food diaries and the FLAVIOLA Flavanol Food Composition database. Missing data for plasma cholesterol and vitamin C were imputed using multiple imputation. Associations between flavan-3-ol intake and blood pressure at baseline were determined using linear regression models. Associations with CVD risk were estimated using Cox regression analyses. Median intake of total flavan-3-ols was 1034mg/d (range: 0-8531mg/d) for men and 970mg/d (0-6695mg/d) for women, median intake of flavan-3-ol monomers was 233mg/d (0-3248mg/d) for men and 217 (0-2712mg/d) for women. There were no consistent associations between flavan-3-ol monomer intake and baseline systolic and diastolic blood pressure (BP). After 286,147 person-years of follow-up, there were 8463 cardiovascular events and 1987 CVD related deaths; no consistent association between flavan-3-ol intake and CVD risk (HR 0.93, 95% CI: 0.87; 1.00; Q1 vs Q5) or mortality was observed (HR 0.93, 95% CI: 0.84; 1.04). Flavan-3-ol intake in EPIC-Norfolk is not sufficient to achieve a statistically significant reduction in CVD risk.
Asunto(s)
Fármacos Cardiovasculares/administración & dosificación , Enfermedades Cardiovasculares/prevención & control , Flavonoides/administración & dosificación , Adulto , Anciano , Enfermedades Cardiovasculares/mortalidad , Dieta , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/prevención & control , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de RiesgoRESUMEN
Dietary interventions with flavan-3-ols have shown beneficial effects on vascular function. The translation of these findings into the context of the health of the general public requires detailed information on habitual dietary intake. However, only limited data are currently available for European populations. Therefore, in the present study, we assessed the habitual intake of flavan-3-ol monomers, proanthocyanidins (PA) and theaflavins in the European Union (EU) and determined their main food sources using the EFSA (European Food Safety Authority) Comprehensive European Food Consumption Database. Data for adults aged 18-64 years were available from fourteen European countries, and intake was determined using the FLAVIOLA Flavanol Food Composition Database, developed for the present study and based on the latest US Department of Agriculture and Phenol-Explorer databases. The mean habitual intake of flavan-3-ol monomers, theaflavins and PA ranged from 181 mg/d (Czech Republic) to 793 mg/d (Ireland). The highest intakes of flavan-3-ol monomers and theaflavins were observed in Ireland (191/505 mg/d) and the lowest intakes in Spain (24/9 mg/d). In contrast, the daily intake of PA was highest in Spain (175 mg/d) and lowest in The Netherlands (96 mg/d). Main sources were tea (62%), pome fruits (11%), berries (3%) and cocoa products (3%). Tea was the major single contributor to monomer intake (75%), followed by pome fruits (6%). Pome fruits were also the main source of PA (28%). The present study provides important data on the population-based intake of flavanols in the EU and demonstrates that dietary intake amounts for flavan-3-ol monomers, PA and theaflavins vary significantly across European countries. The average habitual intake of flavan-3-ols is considerably below the amounts used in most dietary intervention studies.
Asunto(s)
Biflavonoides/administración & dosificación , Catequina/administración & dosificación , Dieta , Ingestión de Energía , Conducta Alimentaria , Flavonoides/administración & dosificación , Proantocianidinas/administración & dosificación , Adolescente , Adulto , Unión Europea , Humanos , Persona de Mediana Edad , Adulto JovenRESUMEN
BACKGROUND/OBJECTIVES: Data from intervention studies suggest a beneficial effect of flavanols on vascular health. However, insufficient data on their intake have delayed the assessment of their health benefits. The aim of this study was to estimate intake of flavanols and their main sources among people living in Germany. SUBJECTS/METHODS: Data from diet history interviews of the German National Nutrition Survey II for 15,371 people across Germany aged 14-80 years were analyzed. The FLAVIOLA Flavanol Food Composition Database was compiled using the latest US Department of Agriculture and Phenol-Explorer Databases and expanded to include recipes and retention factors. RESULTS: Mean intake of total flavanols, flavan-3-ol monomers, proanthocyanidins (PA), and theaflavins in Germany was 386, 120, 196, and 70 mg/day, respectively. Women had higher intakes of total flavanols (399 mg/day) than men (372 mg/day) in all age groups, with the exception of the elderly. Similar results were observed for monomers (108 mg/day for men, 131 mg/day for women) and PA (190 mg/day; 203 mg/day), although intake of theaflavins was higher in men (74 mg/day; 66 mg/day). There was an age gradient with an increase in total flavanols, monomers, and theaflavins across the age groups. The major contributor of total flavanols in all subjects was pome fruits (27%) followed by black tea (25%). CONCLUSIONS: This study demonstrated age- and sex-related variations in the intake and sources of dietary flavanols in Germany. The current analysis will provide a valuable tool in clarifying and confirming the potential health benefits of flavanols.
Asunto(s)
Dieta , Flavonoides/administración & dosificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biflavonoides/administración & dosificación , Catequina/administración & dosificación , Catequina/análogos & derivados , Femenino , Frutas , Alemania , Humanos , Masculino , Persona de Mediana Edad , Política Nutricional , Encuestas Nutricionales , Estado Nutricional , Proantocianidinas/administración & dosificación , TéRESUMEN
OBJECTIVE: To investigate the cross-sectional relation between metabolic markers of vitamin B(12) status and cognitive performance, and possible effect modification by the presence of depression and apolipoprotein E (ApoE) ε4. METHODS: This is a population-based study of 1935 participants, aged 71 to 74 years, from Norway. Participants were administered a cognitive test battery, and vitamin B(12) status was assessed by measurements of plasma vitamin B(12), holotranscobalamin (holoTC), methylmalonic acid (MMA), and total homocysteine. RESULTS: The geometric mean (95% confidence interval) for vitamin B(12) was 348 pM (341-354), whereas 5.9% of participants had vitamin B(12) levels lower than 200 pM. In linear regression analyses, holoTC (p = .039) and the holoTC/vitamin B(12) ratio (p = .013) were positively related, whereas MMA (p = .010) was inversely related, to global cognition, after adjustment for sex, education, ApoE status, plasma creatinine, and history of diabetes, cardiovascular disease, hypertension, and depression. Among those positive for ApoE ε4, but not among those without the ε4 allele, plasma vitamin B(12) was positively associated with global cognition (p = .015), whereas MMA was inversely related to global cognition (p = .036) and executive function (p = .014). In participants with depression, MMA was inversely associated with global cognition (p < .001) and episodic memory (p = .001). CONCLUSIONS: Among the well-nourished elderly, low vitamin B(12) status is associated with cognitive deficit, particularly in those with the ApoE ε4 allele or with depression.
Asunto(s)
Apolipoproteína E4/sangre , Trastornos del Conocimiento/fisiopatología , Cognición/fisiología , Depresión/fisiopatología , Vitamina B 12/sangre , Anciano , Trastornos del Conocimiento/sangre , Trastornos del Conocimiento/complicaciones , Estudios Transversales , Depresión/sangre , Depresión/psicología , Femenino , Homocisteína/sangre , Humanos , Modelos Lineales , Masculino , Ácido Metilmalónico/sangre , Pruebas Neuropsicológicas , Noruega , Análisis de Regresión , Transcobalaminas/análisis , Deficiencia de Vitamina B 12/sangre , Deficiencia de Vitamina B 12/complicaciones , Deficiencia de Vitamina B 12/fisiopatologíaRESUMEN
Phyto-oestrogens have been associated with a decreased risk for osteoporosis, but results from intervention and observational studies in Western countries have been inconsistent. In the present study, we investigated the association between habitual phyto-oestrogen intake and broadband ultrasound attenuation (BUA) of the calcanaeum as a marker of bone density. We collected 7 d records of diet, medical history and demographic and anthropometric data from participants (aged 45-75 years) in the European Prospective Investigation into Cancer-Norfolk study. Phyto-oestrogen (biochanin A, daidzein, formononetin; genistein, glycitein; matairesinol; secoisolariciresinol; enterolactone; equol) intake was determined using a newly developed food composition database. Bone density was assessed using BUA of the calcanaeum. Associations between bone density and phyto-oestrogen intake were investigated in 2580 postmenopausal women who were not on hormone replacement therapy and 4973 men. Median intake of total phyto-oestrogens was 876 (interquartile range 412) µg/d in postmenopausal women and 1212 (interquartile range 604) µg/d in men. The non-soya isoflavones formononetin and biochanin A were marginally significant or significantly associated with BUA in postmenopausal women (ß = 1·2; P < 0·1) and men (ß = 1·2; P < 0·05), respectively; enterolignans and equol were positively associated with bone density in postmenopausal women, but this association became non-significant when dietary Ca was added to the model. In the lowest quintile of Ca intake, soya isoflavones were positively associated with bone density in postmenopausal women (ß = 1·4; P < 0·1). The present results therefore suggest that non-soya isoflavones are associated with bone density independent of Ca, whereas the association with soya or soya isoflavones is affected by dietary Ca.
Asunto(s)
Densidad Ósea/efectos de los fármacos , Dieta , Fitoestrógenos/farmacología , Posmenopausia , Anciano , Calcio de la Dieta , Conducta Alimentaria , Femenino , Análisis de los Alimentos , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Methylmalonic acid (MMA) in plasma or serum is widely used for assessment of vitamin B(12) status. However, data are sparse regarding factors, besides renal function, that may influence MMA concentrations. We searched for important determinants of plasma MMA in the general population. METHODS: In 6946 middle-aged (47-49 years) and elderly (71-74 years) individuals from the Hordaland Homocysteine Study in Norway, we collected anthropometric measurements, lifestyle data, and plasma MMA, vitamin B(12), and creatinine measurements. For 5820 individuals, we also collected dietary data. RESULTS: Age and plasma creatinine were positively associated with plasma MMA, whereas plasma vitamin B(12) was negatively associated. These variables together with sex were the strongest determinants of plasma MMA, accounting for 16% of the variation (R(2) = 0.16). Addition of anthropometric measures and lifestyle and dietary factors only gave slight improvement (total R(2) = 0.167). Increased plasma MMA was seen when plasma vitamin B(12) was <400 pmol/L. In individuals with vitamin B(12) >or =400 micromol/L (vitamin B(12)-replete), the 2.5th-97.5th percentile reference limits for MMA were 0.10-0.28 micromol/L (middle-aged) and 0.10-0.36 micromol/L (elderly). When plotted against creatinine (nomograms), the 97.5th percentile of MMA was similar in men and women but approximately 0.15 micromol/L higher in elderly than middle-aged individuals. Vitamin B(12)-replete participants had MMA upper limits approximately 0.1 micromol/L (elderly) and 0.04 micromol/L (middle-aged) below those of the unselected population at all creatinine concentrations. CONCLUSIONS: Identified determinants accounted for <17% of the overall variation in plasma MMA. The difference in MMA between middle-aged and elderly individuals is only partly explained by creatinine and vitamin B(12) concentrations.
Asunto(s)
Ácido Metilmalónico/sangre , Vitamina B 12/sangre , Factores de Edad , Anciano , Análisis de Varianza , Índice de Masa Corporal , Creatinina/sangre , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores SexualesRESUMEN
BACKGROUND: Limited information is available on the association between vitamin B-12 status and intake from different dietary sources. OBJECTIVE: We investigated the relation of dietary intake of different food items with plasma vitamin B-12 concentrations in the general population. DESIGN: A cross-sectional, population-based study of 5937 subjects in 2 age groups (47-49 and 71-74 y) from the Hordaland Homocysteine Study in Norway was conducted by using a food-frequency questionnaire and measurements of plasma vitamin B-12 concentrations. RESULTS: A significant difference in plasma vitamin B-12 concentrations was observed with increasing total vitamin B-12 intake. A plateau was reached at an intake of approximately 10 microg/d. Plasma vitamin B-12 was associated with intakes of increasing amounts of vitamin B-12 from dairy products or fish (P for trend <0.001 for both) but not with intakes of vitamin B-12 from meat or eggs. For the same content of vitamin B-12, intake from dairy products led to the greatest increase in plasma vitamin B-12. Total intake of vitamin B-12, particularly from milk and fish, decreased the risk of vitamin B-12 concentrations <200 pmol/L and impaired vitamin B-12 function (vitamin B-12 <200 pmol/L and methylmalonic acid >0.27 micromol/L) in the total group and in 71-74-y-old subjects. CONCLUSIONS: Dietary intake of dairy products and fish are significant contributors to plasma vitamin B-12 and may improve plasma vitamin B-12 status. Vitamin B-12 appears to be more bioavailable from dairy products; guidelines for improving vitamin B-12 status should take this into consideration.