Sandra Helinski

Lamuela-Raventos RM1,2,Tresserra-Rimbau 1,2,Rimm EB3;; Estruch R2,4

1Department of Nutrition, Food Science and Gastronomy , , XaRTA, INSA-UB, School of Pharmacy and Food Science, University of Barcelona, Avda. Joan XXIII, s/n, Barcelona, Spain. *Telephone: +34-934034843, e-mail: lamuela@ub.edu
2CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Spain.
3Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, and Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA
4Internal Medicine Department, Hospital Clínic, Institut d’Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.

The effect of dietary polyphenols on cardiovascular risk parameters has been demonstrated in epidemiological and intervention nutritional trials with foods rich in polyphenols such as extra virgin olive oil, cocoa, berries, and wine. Based on this evidence, two health claims have been approved by the European Food Safety Authority (EFSA) about the effect of polyphenols on cardiovascular risk factors.
In the PREDIMED cohort, we assessed the hypothesis that polyphenol intake was associated with a lower risk of total mortality and cardiovascular death or event with 7447 participants at highcardiovascular risk, aged 55 to 80 years)
Cumulative polyphenol intake was calculated by matching food consumption data from yearly FFQ with the Phenol-Explorer database on polyphenol content in foods. We used Time-dependent Cox proportional hazards regression to estimate the Hazard Risk (HR) to relate polyphenol consumption and risk of cardiovascular event or death using the lowest quintile as the referent group. All intakes were calories adjusted.
Over an average of 4.3 years of follow-up, 273 confirmed cases of CVD and 327 deaths were reported among the 7172 participants (96.3%) who completed the FFQ. After multivariate adjustment and comparing Q5 vs. Q1 of total polyphenol intake, we observed a 46% reduction in risk of CVD and 37% reduction for all-cause death. Among the polyphenol subclasses,
stilbenes and lignans were significantly associated with reduced all-cause mortality with no significant associations apparent in the rest (flavonoids or phenolic acids). The polyphenols with the strongest inverse associations with cardiovascular events were flavanols, lignans and hydroxybenzoic acids
Greater intake of polyphenols was associated with a lower risk of CVD and death for any cause. Clinical trials are needed to confirm this effect and establish accurate dietary recommendations.
Clinical Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN of London, England) 35739639.