Relation between intake of flavonoids and risk for coronary heart disease in male health professionals

Objective: Flavonols and flavones are subgroups of flavonoids and are found in tea, vegetables, fruits, and red wine. Because they have antioxidant properties, we investigated whether intake of these dietary compounds is associated with a lower risk for fatal and nonfatal coronary heart disease. Design: Prospective cohort study. Setting: United States. Patients: 34 789 male health professionals, 40 to 75 years of age, who responded to a questionnaire in 1986. Measurements: In 1986 and 1990, detailed, 131-item questionnaires were used to assess dietary intake of flavonols and flavones. Results: Between 1986 and 1992, 496 patients received a new diagnosis of nonfatal myocardial infarction. The relative risk for nonfatal myocardial infarction was 1.08 (95% Cl, 0.81 to 1.43) for the highest (median, 40.0 mg/d) compared with the lowest (median, 7.1 mg/d) quintiles for intake of flavonols and flavones after adjustment for age, obesity, smoking, intake of vitamin E, intake of alcohol, diabetes, hypertension, hypercholesterolemia, and family history of coronary heart disease. Among the 4814 men who reported that they had previously had coronary heart disease, we found a modest but nonsignificant inverse association between in-take of flavonols and flavones and subsequent coronary mortality rates (relative risk, 0.63 [Cl, 0.33 to 1.20] for the highest compared with the lowest quintile for intake of flavonoids). Conclusion: The data do not support a strong inverse association between intake of flavonoids and total coronary heart disease, but they do not exclude the possibility that flavonoids have a protective effect in men with established coronary heart disease.