Flavonoids, flavonoid-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials.
By L. Hooper, P. Kroon, E. Rimm, J. Cohn, I. Harvey, K. A. Le Cornu, Jonathan J. Ryder, W. Hall, A. Cassidy. American Journal of Clinical Nutrition, 2008
1,093 citations recorded by the source corpus.
BACKGROUND The beneficial effects of flavonoid consumption on cardiovascular risk are supported by mechanistic and epidemiologic evidence. OBJECTIVE We aimed to systematically review the effectiveness of different flavonoid subclasses and flavonoid-rich food sources on cardiovascular disease (CVD) and risk factors--ie, lipoproteins, blood pressure, and flow-mediated dilatation (FMD). DESIGN Methods included a structured search strategy on MEDLINE, EMBASE, and Cochrane databases; formal inclusion or exclusion, data extraction, and validity assessment; and meta-analysis. RESULTS One hundred thirty-three trials were included. No randomized controlled trial studied effects on CVD morbidity or mortality. Significant heterogeneity confirmed differential effects between flavonoid subclasses and foods. Chocolate increased FMD after acute (3.99%; 95% CI: 2.86, 5.12; 6 studies) and chronic (1.45%; 0.62, 2.28; 2 studies) intake and reduced systolic (-5.88 mm Hg; -9.55, -2.21; 5 studies) and diastolic (-3.30 mm Hg; -5.77, -0.83; 4 studies) blood pressure. Soy protein isolate (but not other soy products or components) significantly reduced diastolic blood pressure (-1.99 mm Hg; -2.86, -1.12; 9 studies) and LDL cholesterol (-0.19 mmol/L; -0.24, -0.14; 39 studies). Acute black tea consumption increased systolic (5.69 mm Hg; 1.52, 9.86; 4 studies) and diastolic (2.56 mm Hg; 1.03, 4.10; 4 studies) blood pressure. Green tea reduced LDL (-0.23 mmol/L; -0.34, -0.12; 4 studies). For many of the other flavonoids, there was insufficient evidence to draw conclusions about efficacy. CONCLUSIONS To date, the effects of flavonoids from soy and cocoa have been the main focus of attention. Future studies should focus on other commonly consumed subclasses (eg, anthocyanins and flavanones), examine dose-response effects, and be of long enough duration to allow assessment of clinically relevant endpoints.
Subfields: Biochemistry, Pathology and Forensic Medicine
View Paper: https://www.semanticscholar.org/paper/acd3567c60e11728cd7570926d181a36b1dc62c1
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Citations in the corpus
- Natural polyphenols: An overview (2017, background): “Flavonoids found in cocoa and soy present favorable outcomes on cardiovascular disease,([26]) and others are not as efficient.”
- The Immunomodulatory and Anti-Inflammatory Role of Polyphenols (2018, positive): “Soy and cocoa flavonoids contribute to the prevention of CVD as per meta-analysis of randomized controls trial [159].”
- Flavonoids as anti-inflammatory agents: implications in cancer and cardiovascular disease (2009, background): “concluded that although some flavonoid-rich foods may have some clinically relevant effects on CVD risk factors, there are limited data from intervention trials for other flavonoid subclasses consumed as part of a normal diet [181].”
- Dietary (Poly)phenolics in Human Health: Structures, Bioavailability, and Evidence of Protective Effects Against Chronic Diseases (2013, positive): “(211) indicates that black tea consumption significantly increases the FMD response after acute ( + 1.”
- Polyphenols and Human Health: Prevention of Disease and Mechanisms of Action (2010, background): “In support of these findings, three recent meta-analyses have confirmed the blood pressure lowering capacity of flavanol-rich cocoa [98,106,110].”
- Oxidative Stress and Inflammation: What Polyphenols Can Do for Us? (2016, background): “Moreover, the meta-analysis studies suggested that higher intake of three cups of tea per day suppress risks by 11% [64] whereas adequate intake of red wine is related to 32% lower risk of cardiovascular disease (CVD) [65].”