Skip to main content
ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #307394
Title: Higher dietary flavonol intake is associated with lower incidence of Type 2 Diabetes

Author
item JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item CASSIDY, AEDIN - University Of East Anglia
item ROGERS, GAIL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item PETERSON, JULIA - Tufts University
item MEIGS, JAMES - Massachusetts General Hospital
item DWYER, JOHANNA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/3/2013
Publication Date: 7/31/2013
Citation: Jacques, P.F., Cassidy, A., Rogers, G., Peterson, J.J., Meigs, J.B., Dwyer, J.T. 2013. Higher dietary flavonol intake is associated with lower incidence of Type 2 Diabetes. Journal of Nutrition. 143(9):1474-1480.

Interpretive Summary: Type 2 diabetes (T2D) is a largely preventable condition with serious health consequences, including a greater risk of heart disease, stroke, peripheral neuropathy, renal disease, and vision loss. Over the past 2 decades, the prevalence of T2D has increased dramatically worldwide due largely to an increase in obesity. Global estimates predict a continued growth in worldwide diabetes prevalence for the foreseeable future. It is well established that diet, even independent of body weight, can influence the risk of T2D. Diets high in plant foods, mainly vegetable and fruit intake, are associated with lower T2D risk. Plant foods are not only good sources for nutrients associated with lower T2D risk, such as fiber, potassium, and magnesium, but they also provide a large array of other bioactive compounds, such as polyphenols. Growing evidence from preliminary research suggests that flavonoids, a class of polyphenols, may improve glucose and insulin levels. Individuals with T2D have high blood glucose due to the fact that their cells fail to respond to insulin, which helps to regulate glucose, a form of sugar in the blood. Few studies have examined the potential association between flavonoids and T2D in humans. The aim of this study was to examine if higher intakes of individual flavonoid classes are associated with a lower incidence of T2D. We followed 2,915 members of the Framingham Heart Study cohort who were free of T2D at the start of the study for, on average, 12 years. Study participants completed physical examinations, health questionnaires, and dietary intake questionnaires. From the dietary questionnaires, we determined individuals’ intakes of total flavonoids and 6 specific flavonoid classes. Our results indicated that each 2.5-fold increase in flavonol intake was associated with a 26% lower incidence of T2D, and each 2.5-fold increase in flavan-3-ol intake was marginally associated with an 11% lower incidence of T2D. Thus, our observations support a possible beneficial relationship between flavonol intake and T2D risk.

Technical Abstract: Substantial experimental evidence suggests that several flavonoid classes are involved in glucose metabolism, but few clinical or epidemiologic studies exist that provide supporting human evidence for this relationship. The objective of this study was to determine if habitual intakes of specific flavonoid classes are related to incidence of type 2 diabetes (T2D). We followed 2915 members of the Framingham Offspring cohort who were free of T2D at baseline from 1991 to 2008. Diabetes was defined by either elevated fasting glucose (greater than or equal to 7.0 mmol/L) or initiation of hypoglycemic medication during follow-up. Dietary intakes of 6 flavonoid classes and total flavonoids were assessed using a validated, semiquantitative food frequency questionnaire. We observed 308 incident cases of T2D during a mean follow-up period of 11.9 y (range 2.5–16.8 y). After multivariable adjusted, time-dependent analyses, which accounted for long-term flavonoid intake during follow-up, each 2.5-fold increase in flavonol intake was associated with a 26% lower incidence of T2D [HR = 0.74 (95% CI: 0.61, 0.90); P-trend = 0.003] and each 2.5-fold increase in flavan-3-ol intake was marginally associated with an 11% lower incidence of T2D [HR = 0.89 (95% CI: 0.80, 1.00); P-trend = 0.06]. No other associations between flavonoid classes and risk of T2D were observed. Our observations support previous experimental evidence of a possible beneficial relationship between increased flavonol intake and risk of T2D.