Intake estimation of total and individual flavan-3-ols, proanthocyanidins and theaflavins, their food sources and determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Epidemiological studies suggest health-protective effects of flavan-3-ols and their derived compounds on chronic diseases. The present study aimed to estimate dietary flavan-3-ol, proanthocyanidin (PA) and theaflavin intakes, their food sources and potential determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration cohort. Dietary data were collected using a standardised 24 h dietary recall software administered to 36 037 subjects aged 35-74 years. Dietary data were linked with a flavanoid food composition database compiled from the latest US Department of Agriculture and Phenol-Explorer databases and expanded to include recipes, estimations and retention factors. Total flavan-3-ol intake was the highest in UK Health-conscious men (453·6 mg/d) and women of UK General population (377·6 mg/d), while the intake was the lowest in Greece (men: 160·5 mg/d; women: 124·8 mg/d). Monomer intake was the highest in UK General population (men: 213·5 mg/d; women: 178·6 mg/d) and the lowest in Greece (men: 26·6 mg/d in men; women: 20·7 mg/d). Theaflavin intake was the highest in UK General population (men: 29·3 mg/d; women: 25·3 mg/d) and close to zero in Greece and Spain. PA intake was the highest in Asturias (men: 455·2 mg/d) and San Sebastian (women: 253 mg/d), while being the lowest in Greece (men: 134·6 mg/d; women: 101·0 mg/d). Except for the UK, non-citrus fruits (apples/pears) were the highest contributors to the total flavan-3-ol intake. Tea was the main contributor of total flavan-3-ols in the UK. Flavan-3-ol, PA and theaflavin intakes were significantly different among all assessed groups. This study showed heterogeneity in flavan-3-ol, PA and theaflavin intake throughout the EPIC countries

Estimation of the intake of anthocyanidins and their food sources in the European prospective investigation into cancer and nutrition (EPIC) study

Anthocyanidins are bioactive flavonoids with potential health-promoting effects. These may vary among single anthocyanidins considering differences in their bioavailability and some of the mechanisms involved. The aim of the present study was to estimate the dietary intake of anthocyanidins, their food sources and the lifestyle factors (sex, age, BMI, smoking status, educational level and physisical activity) involved among twenty-seven centres in ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthocyanidin intake and their food sources for 36 037 subjects, aged between 35 and 74 years, in twenty-seven redefined centres were obtained using standardised 24 h dietary recall software (EPIC-SOFT). An ad hoc food composition database on anthocyanidins (cyanidin, delphinidin, malvidin, pelargonidin, peonidin, petunidin) was compiled using data from the US Department of Agriculture and Phenol-Explorer databases and was expanded by adding recipes, estimated values and cooking factors. For men, the total anthocyanidin mean intake ranged from 19·83 (se 1·53) mg/d (Bilthoven, The Netherlands) to 64·88 (se 1·86) mg/d (Turin, Italy), whereas for women the range was 18·73 (se 2·80) mg/d (Granada, Spain) to 44·08 (se 2·45) mg/d (Turin, Italy). A clear south to north gradient intake was observed. Cyanidins and malvidins were the main anthocynidin contributors depending on the region and sex. Anthocyanidin intake was higher in non-obese older females, non-smokers, and increased with educational level and physical activity. The major food sources were fruits, wine, non-alcoholic beverages and some vegetables. The present study shows differences in both total and individual anthocyanidin intakes and various lifestyle factors throughout Europe, with some geographical variability in their food sources

Antioxidant Intakes and Food Sources in Greek Adults

Antioxidants are compounds physiologically produced or provided through the diet with a potential to inhibit the oxidation of important biological molecules, such as proteins, lipids, and DNA. The contemporary Greek diet is still strongly influenced by Mediterranean dietary traditions. The traditional Mediterranean diet (MD) is a plant-based diet with apparently beneficial health properties, to which a high antioxidant content may contribute. To explore this issue in detail, a database of the content of >200 Greek foods and recipes for a wide spectrum of antioxidant compounds and indices (flavonoids, proanthocyannidins, other antioxidant microcomponents, and total antioxidant capacity) was developed. The database enabled the estimation of antioxidant intakes in Greece using the population-based European Prospective Investigation into Cancer and Nutrition study, in which >28,000 Greeks participate. The results of this work suggest that the contemporary MD in the Greek population is a rich source of a variety of antioxidants. These data can be used in studies about the relationship between antioxidant intake and chronic diseases in the Greek population. J. Nutr. 140: 1274-1279, 2010

Assessment of antioxidants in foods and biological samples: a short critique

Antioxidants can be defined on a biological basis by their ability to inhibit the oxidation of susceptible biomolecules such as proteins, lipids and DNA. There is observational evidence on an inverse association between dietary antioxidant intake and the development of chronic conditions, although randomized trials have not confirmed these results. The antioxidant potential of a biological material can be evaluated by methods categorized into three groups. The first group includes the determination of the individual antioxidants present in the investigated sample. The second focuses on ‘total antioxidant capacity’, which is considered a convenient tool for obtaining an overall estimate of the antioxidant potential of the sample. The third group involves the quantification of in vivo markers of oxidative stress, such as the products of protein, lipid and DNA oxidation. Due to differences between the assays, however, current research suggests the application of a combination of such methods for a more informative assessment of the oxidation status of the organism

Mediterranean diet, antioxidants and coronary heart disease

The aim of the present thesis was the study of antioxidant intake in the context of the Greek Mediterranean diet and the evaluation of the role of adherence to this diet on the occurrence of and mortality from coronary heart disease. We have used data from the Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC). These data refer to the diet, as well as the somatometry and lifestyle of more than 28,000 Greek men and women. We have calculated the antioxidant content of the diet and have estimated the hazard ratios for incidence of and mortality from coronary heart disease per various dietary and non dietary variables. We have found that the diet of the Greeks is rich in a variety of antioxidants. Closer adherence to the traditional Greek Mediterranean diet was inversely associated woth the incidence of and mortality from coronary heart disease.The present thesis illustrates the beneficial role of adherence to the traditional Greek Mediterranean diet on the incidence of and mortality from coronary heart disease and points to a potential contribution of the high antioxidant content of this diet.Σκοπός της παρούσας διατριβής ήταν η μελέτη της πρόσληψης αντιοξειδωτικών ουσιών στο πλαίσιο της Ελληνικής Μεσογειακής διατροφής και η διερεύνηση του ρόλου της Ελληνικής Μεσογειακής διατροφής στην επίπτωση και θνησιμότητα της στεφανιαίας νόσου. Χρησιμοποιήθηκαν δεδομένα του Προγράμματος ΕΠΙΚ στην Ελλάδα που αφορούν τη σωματομετρία, τις διατροφικές συνήθεις και τα χαρακτηριστικά τρόπου ζωής περισσότερων από 28.000 Ελλήνων και Ελληνίδων. Υπολογίστηκε η πρόσληψη αντιοξειδωτικών ουσιών και εφαρμόστηκε η μέθοδος αναλογικού κινδύνου Cox για τον υπολογισμό του σχετικού κινδύνου επίπτωσης και θνησιμότητας από στεφανιαία νόσο για τις διάφορες διατροφικές και μη μεταβλητές. Η μελέτη έδειξε ότι η διατροφή των Ελλήνων είναι πλούσια σε ποικιλία αντιοξειδωτικών ουσιών. Η μεγαλύτερη προσήλωση στη Μεσογειακή διατροφή συσχετίστηκε σημαντικά με χαμηλότερη θνησιμότητα από στεφανιαία νόσο και ασθενέστερα με τη μείωση της επίπτωσης της νόσου.Η παρούσα μελέτη αναδεικνύει το θετικό ρόλο της Μεσογειακής διατροφής στην εμφάνιση της στεφανιαίας νόσου και τη θνησιμότητα από τη νόσο αυτή και παραθέτει στοιχεία για τη δυνητική συμβολή των αντιοξειδωτικών ουσιών στο πλαίσιο αυτό

Differences in dietary intakes, food sources and determinants of total flavonoids between Mediterranean and non-Mediterranean countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

A greater adherence to the traditional Mediterranean (MED) diet is associated with a reduced risk of developing chronic diseases. This dietary pattern is based on higher consumption of plant products that are rich in flavonoids. We compared the total flavonoid dietary intakes, their food sources and various lifestyle factors between MED and non-MED countries participating in the EPIC study. Flavonoid intakes and their food sources for 35,628 subjects, aged 35-74 years and recruited between 1992 and 2000, in twenty-six study centres were estimated using standardised 24 h dietary recall software (EPIC-Soft®). An ad hoc food composition database on flavonoids was compiled using analytical data from the United States Department of Agriculture and Phenol-Explorer databases. Moreover, it was expanded to include using recipes, estimations of missing values and flavonoid retention factors. No significant differences in total flavonoid mean intake between non-MED countries (373·7 mg/d) and MED countries (370·2 mg/d) were observed. In the non-MED region, the main contributors were proanthocyanidins (48·2%) and flavan-3-ol monomers (24·9%) and the principal food sources were tea (25·7%) and fruits (32·8%). In the MED region, proanthocyanidins (59·0%) were by far the most abundant contributor and fruits (55·1%), wines (16·7%) and tea (6·8%) were the main food sources. The present study shows similar results for total dietary flavonoid intakes, but significant differences in flavonoid class intakes, food sources and some characteristics between MED and non-MED countries. These differences should be considered in studies about the relationships between flavonoid intake and chronic diseases