ArticleThe American journal of clinical nutrition2016
Dietary flavonoid intake and incident coronary heart disease: the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.
Article in The American journal of clinical nutrition, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 5 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Dietary intakes of anthocyanins and cardiometabolic health: a systematic review and meta-analysis of randomized trials and prospective cohort studies in healthy participants.The American journal of clinical nutrition · 2026Pooled it
- Relation of Different Fruit and Vegetable Sources With Incident Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.Journal of the American Heart Association · 2020Pooled it
- Dietary intakes of flavan-3-ols and cardiometabolic health: systematic review and meta-analysis of randomized trials and prospective cohort studies.The American journal of clinical nutrition · 2019Pooled it
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- Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies.International journal of epidemiology · 2017Pooled it
- Maternal Dietary Anthocyanidin, Dietary Inflammatory Potential, and Risk of Small-for-Gestational-Age in China.Nutrients · 2025Trial
- Cocoa Flavanols Improve Vascular Responses to Acute Mental Stress in Young Healthy Adults.Nutrients · 2021Trial
- Maternal dietary flavonoid intake and child wheeze and asthma in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025Article
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- Association between dietary intake of anthocyanidins and heart failure among American adults: NHANES (2007-2010 and 2017-2018).Frontiers in nutrition · 2023Article
- Review
- Anthocyanins as Key Phytochemicals Acting for the Prevention of Metabolic Diseases: An Overview.Molecules (Basel, Switzerland) · 2022Review
- Effect of Dietary Phenolic Compounds on Incidence of Cardiovascular Disease in the SUN Project; 10 Years of Follow-Up.Antioxidants (Basel, Switzerland) · 2022Article
- Application of the Database of Flavonoid Values for USDA Food Codes 2007-2010 in Assessing Intake Differences Between the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) Study and What We Eat in America (WWEIA), NHANES.Journal of food composition and analysis : an official publication of the United Nations University, International Network of Food Data Systems · 2021Article
- The Diverse Efficacy of Food-Derived Proanthocyanidins for Middle-Aged and Elderly Women.Nutrients · 2020Review
- Recent Research on the Health Benefits of Blueberries and Their Anthocyanins.Advances in nutrition (Bethesda, Md.) · 2020Review
- Anthocyanins and Their CMolecules (Basel, Switzerland) · 2019Review
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundFlavonoids are dietary polyphenolic compounds with a variety of proposed beneficial cardiovascular effects, but rigorous prospective studies that examine the association between flavonoid intake and incident coronary heart disease (CHD) in geographically and racially diverse US samples are limited.
objectiveWith the use of the new, expanded USDA flavonoid database, we assessed the association between total flavonoid and flavonoid subclass intakes with incident CHD in a biracial and geographically diverse cohort, as well as effect modification by age, sex, race, and region of residence.
designParticipants were 16,678 black and white men and women enrolled in the REGARDS (REasons for Geographic and Racial Differences in Stroke) study, a national prospective cohort study. All participants were without CHD at baseline, and all completed a Block98 food-frequency questionnaire. Flavonoid intakes were estimated from USDA flavonoid databases, which were recently improved to address missing values for cooked foods and to adjust for flavonoid losses due to processing. Incident CHD events were participant reported and adjudicated by experts. Quintiles of flavonoid intake were examined as predictors of incident CHD by using Cox proportional hazards regression to obtain HRs. Tests for trend used the quintile medians.
resultsOver a mean ± SD follow-up of 6.0 ± 1.9 y, 589 CHD events occurred. High flavonoid intake was associated with self-identified white race, exercise, not smoking, more education, and higher income. In models that adjusted for sociodemographic, health behavior, and dietary factors, there was an inverse association between anthocyanidin and proanthocyanidin intakes and incident CHD (HRs for quintile 5 compared with quintile 1-anthocyanidins: 0.71; 95% CI: 0.52, 0.98; P-trend = 0.04; proanthocyanidins: 0.63; 95% CI: 0.47, 0.84; P-trend = 0.02). There was no association between total flavonoid or other flavonoid subclass intakes and incident CHD.
conclusionsReported anthocyanidin and proanthocyanidin intakes were inversely associated with incident CHD. There was no significant effect modification by age, sex, race, or region of residence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.