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Association between flavonoid intake and risk of hypertension in two cohorts of Australian women: a longitudinal study

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Abstract

Purpose

Epidemiological evidence suggests higher dietary flavonoid intake is associated with lower risk of several chronic diseases. This study aimed to investigate the association between intake of flavonoids and their subclasses, and incidence of hypertension among Australian women in two age cohorts.

Methods

This population-based study included 6599 middle-aged (52.5 ± 1.5 years) and 6099 reproductive-aged (27.5 ± 1.5 years) women from the Australian Longitudinal Study on Women’s Health. Food frequency questionnaires were used to quantify intake of flavonoids by cross‐referencing with the Phenol-Explorer food composition database. Generalised Estimating Equation analyses investigated associations with incident hypertension, adjusting for demographic and dietary variables and hypertension risk factors.

Results

There were 1645 cases (24.9%) of hypertension during 15 years follow-up in the middle-aged cohort and 336 cases (5.5%) during 12 years follow-up in the reproductive-aged cohort. Higher intakes of flavones [adjusted relative risk (ARR) for quintile 5 vs. 1: 0.82, 95% CI 0.70–0.97], isoflavones (0.86, 0.75–0.99) and flavanones (0.83, 0.69–1.00) were associated with a lower risk of hypertension in the middle-aged cohort. In the reproductive-aged cohort, higher intakes of flavanols (0.70, 0.49–0.99) were associated with a lower risk of hypertension. Key foods that provided these flavonoids were oranges, orange juice, apples, red wine and soy milk.

Conclusion

Higher intakes of total flavonoids and subclasses were associated with a lower risk of hypertension in Australian women. These findings can be used in nutrition messaging and policies for improved cardiovascular health of women.

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Availability of data and materials

Data are available from the Australian Longitudinal Study on Women’s Health (contact ALSWH Data and Analytic Services at www.alswh.org.au) for researchers who meet the criteria for access to confidential data.

Code availability

Available upon request.

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Acknowledgements

The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women’s Health by the University of Queensland and the University of Newcastle. We are grateful to the Australian Government Department of Health for funding this study and to the women who provided the survey data. The authors thank Professor Graham Giles of the Cancer Epidemiology Centre of Cancer Council Victoria, for permission to use the Dietary Questionnaire for Epidemiological Studies (Version 2), Melbourne: Cancer Council Victoria, 1996.

Funding

The authors declare that no funding was received for this analytical work.

Author information

Authors and Affiliations

  1. School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia

    Vinicius A. do Rosario, Danielle A. J. M. Schoenaker, Katrina Weston-Green & Karen Charlton

  2. Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia

    Danielle A. J. M. Schoenaker & Katrina Weston-Green

  3. Centre of Rural Health, School of Health Sciences, University of Tasmania, Launceston , TAS, 7248, Australia

    Katherine Kent

  4. Molecular Horizons, University of Wollongong, Wollongong, NSW, 2522, Australia

    Katrina Weston-Green

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  1. Vinicius A. do Rosario
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Contributions

VAR, DAJMS, KK and KC were involved in the conception and design of the study. All authors contributed to the interpretation and critical revision of manuscript. The statistical analyses were conducted by VAR and DAJMS.

Corresponding author

Correspondence to Vinicius A. do Rosario.

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Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.

Ethics approval

The Australian Longitudinal Study on Women’s Health received ethical approval from the University of Newcastle Ethics Committee (H-076-0795) and the University of Queensland Medical Research Ethics Committee (200400224).

Consent to participate

All participants gave their informed consent prior to their inclusion in the study.

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Not applicable.

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do Rosario, V.A., Schoenaker, D.A.J.M., Kent, K. et al. Association between flavonoid intake and risk of hypertension in two cohorts of Australian women: a longitudinal study. Eur J Nutr 60, 2507–2519 (2021). https://doi.org/10.1007/s00394-020-02424-9

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  • DOI: https://doi.org/10.1007/s00394-020-02424-9

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