Table 3.
Hazard ratio (HR) and 95% confidence intervals (CI) of confirmed cardiovascular disease cases according to quintiles of total (poly)phenol intake and (poly)phenol subclasses.
| Energy-Adjusted Quintiles of Total (Poly)Phenol Intake | Low Intake vs. Medium–High Intake | ||||||
|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | p For Trend | ||
| n = 3230 | n = 3229 | n = 3230 | n = 3229 | n = 3229 | Q1 vs. Q2–Q5 | ||
| Total (poly)phenol intake | |||||||
| Median intake (mg/d) | 432.1 | 600.4 | 729.7 | 883.4 | 1171.1 | ||
| Cases | 27 | 16 | 18 | 26 | 36 | ||
| Person-years | 37038 | 37880 | 37610 | 36657 | 36468 | ||
| Age-sex adjusted HR (95% CI) | 1 (ref.) | 0.42 (0.22–0.78) ** | 0.43 (0.24–0.79) ** | 0.52 (0.30–0.9) * | 0.56 (0.33–0.93) * | 0.29 | 2.04 (1.32–3.15) ** |
| Multivariable adjusted model 1 | 1 (ref.) | 0.33 (0.15–0.71) ** | 0.47 (0.23–0.95) * | 0.55 (0.29–1.05) | 0.52 (0.28–0.96) * | 0.29 | 2.12 (1.27–3.57) ** |
| Model 1 restricted to >40 years | 1 (ref.) | 0.55 (0.27–1.14) | 0.66 (0.33–1.32) | 0.64 (0.33–1.24) | 0.66 (0.35–1.24) | 0.34 | 1.58 (0.94–2.64) |
| Repeated Measurements adjusted model 1 | 1 (ref.) | 0.39 (0.18–0.89) * | 0.57 (0.28–1.14) | 0.63 (0.33–1.21) | 0.56 (0.30–1.05) | 0.30 | 1.85 (1.09–3.16) * |
| Model 1 restricted to >40 years | 1 (ref.) | 0.56 (0.27–1.16) | 0.67 (0.34–1.31) | 0.68 (0.34–1.20) | 0.64 (0.34–1.20) | 0.35 | 1.56 (0.93–2.60) |
| Flavonoids intake | |||||||
| Median intake (mg/d) | 190.7 | 300.3 | 385.7 | 496.2 | 720.4 | ||
| Cases | 27 | 13 | 29 | 24 | 30 | ||
| Person-years | 37701 | 37642 | 37449 | 36618 | 36243 | ||
| Age-sex adjusted HR (95% CI) | 1 (ref.) | 0.35 (0.18–0.69) ** | 0.70 (0.41–1.19) | 0.54 (0.31–0.94) * | 0.54 (0.32–0.92) * | 0.19 | 1.86 (1.20–2.87) ** |
| Multivariable adjusted model 1 | 1 (ref.) | 0.32 (0.14–0.71) ** | 1.01 (0.54–1.89) | 0.59 (0.31–1.15) | 0.51 (0.26–1.00) * | 0.13 | 1.73 (1.03–2.90) * |
| Model 1 restricted to >40 years | 1 (ref.) | 0.27 (0.12–0.63) ** | 1.11 (0.60–2.04) | 0.52 (0.26–1.03) | 0.48 (0.24–0.94) * | 0.10 | 2.27 (1.33–3.88) ** |
| Repeated Measurements adjusted model 1 | 1 (ref.) | 0.27 (0.11–0.63) ** | 0.88 (0.47–1.65) | 0.64 (0.33–1.22) | 0.44 (0.22–0.88) * | 0.08 | 1.88 (1.11–3.17) * |
| Model 1 restricted to >40 years | 1 (ref.) | 0.28 (0.14–0.64) ** | 0.85 (0.46–1.58) | 0.51 (0.26–1.00) | 0.44 (0.22–0.87) * | 0.06 | 1.97 (1.19–3.27) ** |
| Lignans intake | |||||||
| Median intake (mg/d) | 1.2 | 1.7 | 2.1 | 2.5 | 3.3 | ||
| Cases | 26 | 32 | 21 | 23 | 26 | ||
| Person-years | 38692 | 38276 | 37372 | 36279 | 35034 | ||
| Age-sex adjusted HR (95% CI) | 1 (ref.) | 1.10 (0.63–1.92) | 0.73 (0.40–1.35) | 0.66 (0.36–1.21) | 0.61 (0.33–1.11) | 0.03 | 1.29 (0.78–2.09) |
| Multivariable adjusted model 1 | 1 (ref.) | 1.12 (0.60–2.09) | 0.72 (0.35–1.45) | 0.75 (0.37–1.52) | 0.51 (0.25–1.04) | 0.02 | 1.26 (0.73–2.19) |
| Model 1 restricted to >40 years | 1 (ref.) | 0.95 (0.51–1.78) | 0.79 (0.38–1.50) | 0.65 (0.32–1.31) | 0.42 (0.20–0.87) * | <0.01 | 1.83 (1.03–3.25) * |
| Repeated Measurements adjusted model 1 | 1 (ref.) | 1.41 (0.74–2.68) | 0.80 (0.39–1.64) | 0.87 (0.42–1.82) | 0.61 (0.30–1.29) | 0.04 | 1.06 (0.59–1.90) |
| Model 1 restricted to >40 years | 1 (ref.) | 1.40 (0.74–2.60) | 0.87 (0.43–1.73) | 0.72 (0.33–1.53) | 0.58 (0.28–1.24) | 0.03 | 1.08 (0.62–1.89) |
| Phenolic acids intake | |||||||
| Median intake (mg/d) | 146.3 | 220.7 | 285.1 | 351.2 | 480.3 | ||
| Cases | 20 | 27 | 19 | 22 | 35 | ||
| Person-years | 36959 | 36959 | 37068 | 37682 | 37486 | ||
| Age-sex adjusted HR (95% CI) | 1 (ref.) | 0.82 (0.46–1.47) | 0.54 (0.29–1.02) | 0.62 (0.33–1.15) | 0.78 (0.44–1.37) | 0.55 | 1.44 (0.89–2.35) |
| Multivariable adjusted model 1 | 1 (ref.) | 0.70 (0.35–1.40) | 0.35 (0.16–0.80) * | 0.57 (0.28–1.15) | 0.67 (0.34–1.29) | 0.48 | 1.74 (0.99–3.09) |
| Model 1 restricted to >40 years | 1 (ref.) | 0.74 (0.38–1.43) * | 0.39 (0.20–0.86) * | 0.62 (0.31–1.24) | 0.78 (0.42–1.44) | 0.53 | 1.97 (1.12–3.45) * |
| Repeated Measurements adjusted model 1 | 1 (ref.) | 0.92 (0.46–1.82) | 0.44 (0.20–0.95) * | 0.60 (0.29–1.25) | 0.77 (0.39–1.52) | 0.50 | 1.47 (0.82–2.62) |
| Model 1 restricted to >40 years | 1 (ref.) | 0.62 (0.32–1.23) | 0.43 (0.20–0.91) * | 0.60 (0.30–1.19) | 0.71 (0.4–1.33) | 0.57 | 1.66 (0.98–2.80) |
| Stilbenes intake | |||||||
| Median intake (mg/d) | −0.01 | 0.1 | 0.4 | 0.8 | 3.5 | ||
| Cases | 16 | 10 | 23 | 22 | 52 | ||
| Person-years | 37629 | 36446 | 36290 | 36961 | 38328 | ||
| Age-sex adjusted HR (95% CI) | 1 (ref.) | 0.61 (0.27–1.34) | 1.05 (0.55–1.99) | 0.8(0 0.42–1.54) | 1.26(0.71–2.24) | 0.05 | 1.01 (0.60–1.72) |
| Multivariable adjusted model 1 | 1 (ref.) | 0.55 (0.22–1.38) | 1.21 (0.55–2.64) | 0.80 (0.36–1.75) | 1.1(0.52–2.27) | 0.44 | 1.11 (0.58–2.10) |
| Model 1 restricted to >40 years | 1 (ref.) | 0.72 (0.32–1.60) | 0.82 (0.36–1.88) | 0.91 (0.43–1.93) | 1.05(0.51–2.19) | 0.52 | 0.94 (0.46–1.90) |
| Repeated Measurements adjusted model 1 | 1 (ref.) | 0.48 (0.19–1.19) | 0.96 (0.44–2.10) | 0.76 (0.35–1.63) | 0.97 (0.47–2.00) | 0.43 | 1.26(0.66–2.36) |
| Model 1 restricted to >40 years | 1 (ref.) | 0.94 (0.44–2.00) | 0.55 (0.22–1.34) | 0.82 (0.39–1.75) | 1.12(0.54–2.32) | 0.60 | 1.13(0.6–2.11) |
| Other (poly)phenols intake | |||||||
| Median intake (mg/d) | 14.2 | 25.4 | 34.0 | 45.2 | 72.1 | ||
| Cases | 30 | 21 | 22 | 21 | 29 | ||
| Person-years | 38332 | 37833 | 36938 | 36155 | 36396 | ||
| Age-sex adjusted HR (95% CI) | 1(ref.) | 0.70 (0.40–1.23) | 0.80 (0.45–1.38) | 0.74 (0.42–1.39) | 0.79 (0.47–1.32) | 0.57 | 1.32 (0.87–2.00) |
| Multivariable adjusted model 1 | 1(ref.) | 0.87 (0.45–1.70) | 0.89 (0.45–1.76) | 0.76 (0.38–1.51) | 0.95 (0.51–1.79) | 0.92 | 1.15 (0.68–1.93) |
| Model 1 restricted to >40 years | 1(ref.) | 0.81 (0.41–1.59) | 0.81 (0.40–1.62) | 0.74 (0.37–1.50) | 0.98 (0.52–1.87) | 0.94 | 1.18 (0.66–2.08) |
| Repeated Measurements adjusted model 1 | 1(ref.) | 0.74 (0.38–1.45) | 0.77 (0.39–1.50) | 0.79 (0.40–1.55) | 0.91 (0.50–1.70) | 0.97 | 1.23 (0.74–2.05) |
| Model 1 restricted to >40 years | 1(ref.) | 0.84 (0.42–1.62) | 0.62 (0.31–1.26) | 0.87 (0.45–1.75) | 0.96 (0.51–1.82) | 0.81 | 1.21 (0.72–2.02) |
* p < 0.05, ** p < 0.01. Abbreviatures: CI, confidence interval; HR, hazard ratio; Q, quintile; ref., reference. All Cox regression models used age as the underlying time variable and were also stratified by age (five-year periods), recruitment period, marital status, and years of university education. Multivariable adjusted model 1: Additionally adjusted for energy intake (kcal/day), smoking status (never smoker, current smoker or former smoker), lifetime tobacco exposure (packs-years), BMI (kg/m2) and the quadratic term, dyslipidemia, hypertension (yes/no), diabetes(yes/no), family history of cardiovascular disease (yes/no), physical activity (metabolic equivalents-h/week), TV watching (hours/day), use of cardiovascular drugs (yes/no), health consciousness (quintiles), energy-adjusted alcohol intake (g/day) and energy-adjusted sodium intake (g/day). Repeated measurements model 1 were adjusted by the same variables on model 1 with updated data at 10 years of follow-up (except physical activity, TV watching, and health consciousness) using cumulative average for dietary variables.