FLAVONOID INTAKE AND LONG-TERM RISK OF CORONARY-HEART-DISEASE AND CANCER IN THE 7 COUNTRIES STUDY

Objective: To determine whether flavonoid intake explains differences in mortality rates from chronic diseases between populations. Design: Cross-cultural correlation study. Setting/Participants: Sixteen cohort s of the Seven Countries Study in whom flavonoid intake at baseline ar ound 1960 was estimated by flavonoid analysis of equivalent food compo sites that represented the average diet in the cohorts. Main Outcome M easures: Mortality from coronary heart disease, cancer (various sites) , and all causes in the 16 cohorts after 25 years of follow-up. Result s: Average intake of antioxidant flavonoids was inversely associated w ith mortality from coronary heart disease and explained about 25% of t he variance in coronary heart disease rates in the 16 cohorts. In mult ivariate analysis, intake of saturated fat (73%; P=.0001), flavonoid i ntake (8%; P=.01), and percentage of smokers per cohort (9%; P=.03) ex plained together, independent of intake of alcohol and antioxidant vit amins, 90% of the variance in coronary heart disease rates. Flavonoid intake was not independently associated with mortality from other caus es. Conclusions: Average flavonoid intake may partly contribute to dif ferences in coronary heart disease mortality across populations, but i t does not seem to be an important determinant of cancer mortality.