Intake of specific flavonoid classes and coronary heart disease - a case-control study in Greece

Objective: Dietary intake of flavonoids has been reported to protect against coronary heart disease (CHD) risk, but associations of specific classes of flavonoids with CHD have not been adequately studied. Design: Hospital-based case-control study relying on interviewer administered questionnaires. Setting: Cardiology Department of the University of Athens Medical School in the Hippokrateion General Hospital (1990 - 1991). Subjects: Cases were 329 patients with electrocardiographically confirmed first coronary infarct or a first positive coronary arteriogram, or both ( participation fraction 93%). Controls were 570 patients admitted to the same hospital for minor conditions unrelated to nutrition ( participation fraction 95%). All cases and controls were interviewed in the hospital wards by experienced interviewers, and a 110-item food frequency questionnaire was administered. Results: There was statistically significant evidence (Psimilar to0.03) for an inverse association between intake of flavan-3-ols and CHD risk, an increase of about 21 mg per day corresponding to a 24% decrease in CHD risk. The inverse association between flavan-3-ols and CHD risk was largely accounted for by the intake of wine and to a lesser extent tea. For none of the other flavonoid classes was there statistically significant evidence of an association. Conclusion: Flavan-3-ols, which are largely found in wine and tea, are inversely associated with, and may be protective against, coronary heart disease.