TABLE 3.
Multivariable-adjusted risk of glioma in women's (NHS, NHSII), men's (HPFS), and pooled (NHS, NHSII, HPFS) cohorts by flavan-3-ol and polymeric flavonoid (polymer) intake, with additional adjustments for total caffeine and total tea intake1
| Hazard ratio (95% CI) | ||||||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | P-trend2 | |
| Flavan-3-ols | ||||||
| Women (325 cases) | ||||||
| Long-term intake,3 adjusted for tea | 1 (Reference) | 0.86 (0.61–1.19) | 0.86 (0.61–1.21) | 0.86 (0.58–1.27) | 1.02 (0.55–1.92) | 0.81 |
| Long-term intake, adjusted for caffeine | 1 (Reference) | 0.85 (0.61–1.18) | 0.82 (0.59–1.15) | 0.74 (0.53–1.05) | 0.69 (0.48–0.99) | 0.08 |
| Men (211 cases) | ||||||
| Long-term intake, adjusted for tea | 1 (Reference) | 1.17 (0.76–1.81) | 1.32 (0.86–2.02) | 1.07 (0.66–1.72) | 1.33 (0.67–2.64) | 0.55 |
| Long-term intake, adjusted for caffeine | 1 (Reference) | 1.15 (0.75–1.78) | 1.27 (0.83–1.95) | 0.96 (0.61–1.52) | 0.93 (0.59–1.47) | 0.35 |
| Pooled4 (536 cases) | ||||||
| Long-term intake, adjusted for tea | 1 (Reference) | 0.96 (0.74–1.25) | 1.01 (0.78–1.33) | 0.94 (0.69–1.27) | 1.16 (0.73–1.84) | 0.58 |
| Long-term intake, adjusted for caffeine | 1 (Reference) | 0.95 (0.73–1.24) | 0.97 (0.74–1.26) | 0.82 (0.62–1.07) | 0.77 (0.58–1.02) | 0.05 |
| Polymers | ||||||
| Women (325 cases) | ||||||
| Long-term intake, adjusted for tea | 1 (Reference) | 0.90 (0.64–1.27) | 1.06 (0.76–1.49) | 0.87 (0.59–1.28) | 1.09 (0.61–1.95) | 0.72 |
| Long-term intake, adjusted for caffeine | 1 (Reference) | 0.88 (0.62–1.24) | 1.00 (0.72–1.40) | 0.76 (0.53–1.08) | 0.74 (0.52–1.07) | 0.09 |
| Men (211 cases) | ||||||
| Long-term intake, adjusted for tea | 1 (Reference) | 1.37 (0.89–2.10) | 1.13 (0.71–1.79) | 1.15 (0.71–1.85) | 1.34 (0.72–2.49) | 0.59 |
| Long-term intake, adjusted for caffeine | 1 (Reference) | 1.32 (0.86–2.03) | 1.07 (0.67–1.69) | 1.02 (0.65–1.62) | 0.96 (0.60–1.53) | 0.38 |
| Pooled (536 cases) | ||||||
| Long-term intake, adjusted for tea | 1 (Reference) | 1.06 (0.81–1.38) | 1.09 (0.83–1.43) | 0.97 (0.72–1.31) | 1.20 (0.79–1.83) | 0.54 |
| Long-term intake, adjusted for caffeine | 1 (Reference) | 1.03 (0.79–1.35) | 1.02 (0.78–1.34) | 0.85 (0.64–1.12) | 0.82 (0.61–1.09) | 0.06 |
Cox proportional hazards models using energy-adjusted flavonoid intake and adjusted for age, total caloric intake (quintile), BMI (<25 kg/m2, 25–29.9 kg/m2, or ≥30 kg/m2), smoking status (never, past, or current), hyperlipidemia (ever diagnosed compared with never diagnosed), and either total caffeine or total tea intake. HPFS, Health Professionals Follow-Up Study; NHS, Nurses’ Health Study; NHSII, Nurses’ Health Study II; Q, quintile.
P trends were calculated using quintile median values in Cox proportional hazards regression models to estimate linear trends.
Long-term flavonoid intake was calculated as the average of reported intake in all years (up to 30) prior to diagnosis or the end of follow-up.
The pooled analysis includes data from women (NHS, NHSII) and men (HPFS), combined by a meta-analysis using fixed-effects models.