Dietary Intake of (Poly)phenols and Risk of All-Cause and Cause-Specific Mortality in the Mexican Teachers' Cohort Study

Jazmin Castañeda; Enrique Almanza-Aguilera; Adriana Monge; Susana Lozano-Esparza; Juan Eugenio Hernández-Ávila; Martin Lajous; Raul Zamora-Ros

doi:10.1016/j.tjnut.2024.03.003

Dietary Intake of (Poly)phenols and Risk of All-Cause and Cause-Specific Mortality in the Mexican Teachers' Cohort Study

J Nutr. 2024 Mar 14:S0022-3166(24)00151-2. doi: 10.1016/j.tjnut.2024.03.003. Online ahead of print.

Authors

Jazmin Castañeda¹, Enrique Almanza-Aguilera¹, Adriana Monge², Susana Lozano-Esparza³, Juan Eugenio Hernández-Ávila⁴, Martin Lajous⁵, Raul Zamora-Ros¹

Affiliations

¹ Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
² Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
³ Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, United States.
⁴ Center for Evaluation and Survey Research, National Institute of Public Health, Cuernavaca, Mexico.
⁵ Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States. Electronic address: mlajous@insp.mx.

PMID: 38490534
DOI: 10.1016/j.tjnut.2024.03.003

Abstract

Background: Observational studies have reported that total (poly)phenol intake is associated with a reduction in all-cause and cardiovascular mortality, but mainly from high-income countries, where (poly)phenol intake may differ from that of low- and middle-income countries.

Objectives: Our objective was to evaluate the association between the intake of total, all classes, and subclasses of (poly)phenols and risk of all-cause and cause-specific mortality in a Mexican cohort.

Methods: We used data from the Mexican Teachers' Cohort, which included 95,313 adult females. After a median follow-up of 11.2 y, 1725 deaths were reported, including 674 from cancer and 282 from cardiovascular diseases. (Poly)phenol intake was estimated using a validated food frequency questionnaire and the Phenol-Explorer database. Multivariable Cox models were applied to estimate the association between (poly)phenol intake and all-cause mortality and competitive risk models for cause-specific mortality.

Results: Comparing extreme quartiles, total (poly)phenol intake was associated with lower risk of all-cause [hazard ratio (HR)_Q4vs.Q1: 0.88; 95% CI: 0.76, 0.99; P-trend = 0.01] and cancer mortality (HR_Q4vs.Q1: 0.81; 95% CI: 0.64, 0.99; P-trend = 0.02). Among (poly)phenol classes, phenolic acids, particularly hydroxycinnamic acids from coffee, showed an inverse association with all-cause (HR_Q4vs.Q1: 0.79; 95% CI: 0.69, 0.91; P-trend = 0.002) and cancer mortality (HR_Q4vs.Q1: 0.75; 95% CI: 0.61, 0.94; P-trend = 0.03). No associations were observed with flavonoids or with cardiovascular mortality.

Conclusion: Our study suggests that high (poly)phenol intake, primarily consisting of phenolic acids such as hydroxycinnamic acids, may have a protective effect on overall and cancer mortality. Null associations for flavonoid intake might be due to the potential underestimation of their intake in this population.

Keywords: (poly)phenols; CVD; cancer; diet; flavonoids; mortality; phenolic acids; prospective cohort.