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dc.contributor.authorVogiatzoglou, Anna
dc.contributor.authorMulligan, Angela A.
dc.contributor.authorBhaniani, Amit
dc.contributor.authorLentjes, Marleen A.H.
dc.contributor.authorMcTaggart, Alison
dc.contributor.authorLuben, Robert N.
dc.contributor.authorHeiss, Christian
dc.contributor.authorKelm, Malte
dc.contributor.authorMerx, Marc W.
dc.contributor.authorSpencer, Jeremy P. E.
dc.contributor.authorSchroeter, Hagen
dc.contributor.authorKhaw, Kay-Tee
dc.contributor.authorKuhnle, Gunter G. C.
dc.date.accessioned2015-05-19T15:44:04Z
dc.date.available2015-05-19T15:44:04Z
dc.date.issued2015-03-17
dc.identifier.citationFree Radical Biology & Medicine 2015 Mar 17;84:1-10. doi: 10.1016/j.freeradbiomed.2015.03.005.en
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/247824
dc.descriptionThis is the final published version. It first appeared at http://www.sciencedirect.com/science/article/pii/S0891584915001173.en
dc.description.abstractDietary intervention studies suggest that flavan-3-ol intake can improve vascular function and reduce the risk of cardiovascular diseases (CVD). However, results from prospective studies failed to show a consistent beneficial effect. Associations between flavan-3-ol intake and CVD risk in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) were investigated. Data were available from 24,885 (11,252 men; 13,633 women) participants, recruited between 1993 and 1997 into the EPIC-Norfolk study. Flavan-3-ol intake was assessed using 7-day food diaries and the FLAVIOLA Flavanol Food Composition database. Missing data for plasma cholesterol and vitamin C were imputed using multiple imputation. Associations between flavan-3-ol intake and blood pressure at baseline were determined using linear regression models. Associations with CVD risk were estimated using Cox regression analyses. Median intake of total flavan-3-ols was 1034mg/d (range: 0-8531mg/d) for men and 970mg/d (0-6695mg/d) for women, median intake of flavan-3-ol monomers was 233mg/d (0-3248mg/d) for men and 217 (0-2712mg/d) for women. There were no consistent associations between flavan-3-ol monomer intake and baseline systolic and diastolic blood pressure (BP). After 286,147 person-years of follow-up, there were 8463 cardiovascular events and 1987 CVD related deaths; no consistent association between flavan-3-ol intake and CVD risk (HR 0.93, 95% CI: 0.87; 1.00; Q1 vs Q5) or mortality was observed (HR 0.93, 95% CI: 0.84; 1.04). Flavan-3-ol intake in EPIC-Norfolk is not sufficient to achieve a statistically significant reduction in CVD risk.en
dc.description.sponsorshipWe thank all EPIC-Norfolk study participants and staff for their contribution to the study. We thank the members of the FLAVIOLA consortium for their critical review of the manuscript. The present study was supported by the EU (Grant 226588, “Flaviola”) and an unrestricted grant from Mars, Inc. Mars, Inc. had no role in the design and analysis of the study or in the writing of this article. EPIC-Norfolk is supported by Cancer Research UK (SP2024-0201 and SP2024-0204) and the Medical Research Council (G9502233). H.S. is employed by MARS, Inc., a member of the FLAVIOLA research consortium and a company engaged in flavanol research and flavanol-related commercial activities. None of the other authors has a conflict of interest to declare.en
dc.language.isoenen
dc.publisherElsevieren
dc.rightsAttribution 2.0 UK: England & Wales*
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/uk/*
dc.subjectFlavan-3-olsen
dc.subjectCardio-vascular diseasesen
dc.subjectNutritional epidemiologyen
dc.subjectEPIC Norfolken
dc.titleAssociations between flavan-3-ol intake and CVD risk in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk)en
dc.typeArticleen
dc.type.versionpublished versionen
prism.endingPage10
prism.publicationDate2015
prism.publicationNameFree Radical Biology & Medicine
prism.startingPage1
prism.volume84
dc.rioxxterms.funderCRUK
dc.rioxxterms.funderMRC
dc.rioxxterms.projectidSP2024-0201
dc.rioxxterms.projectidSP2024-0204
dc.rioxxterms.projectidG9502233
pubs.declined2017-10-11T13:54:32.59+0100
rioxxterms.versionofrecord10.1016/j.freeradbiomed.2015.03.005.


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Attribution 2.0 UK: England & Wales
Except where otherwise noted, this item's licence is described as Attribution 2.0 UK: England & Wales