Cited by 1,916Phytochemicals and Antioxidant ActivitiesNutritional Studies and DietAntioxidant Activity and Oxidative Stress

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Polyphenols and disease risk in epidemiologic studies

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Arts, Ilja CW, Hollman, Peter CH·2005·The American Journal of Clinical Nutrition

DOI 10.1093/ajcn/81.1.317s

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Abstract

Plant polyphenols, a large group of natural antioxidants, are serious candidates in explanations of the protective effects of vegetables and fruits against cancer and cardiovascular diseases. Epidemiologic studies are useful for evaluation of the human health effects of long-term exposure to physiologic concentrations of polyphenols, but reliable data on polyphenol contents of foods are still scarce. The aim of this review is to summarize available epidemiologic data on the health effects of polyphenols, focusing on the flavonoid subclasses of flavonols, flavones, and catechins and on lignans. Data obtained to date suggest beneficial effects of both flavonoids and lignans on cardiovascular diseases but not on cancer, with the possible exception of lung cancer. There is a need for more research on stroke and lung diseases such as asthma and chronic obstructive pulmonary disease. Most studies to date have included only flavonols and flavones. With data becoming available for other polyphenols, these compounds should be included in future studies. Careful design of prospective studies is important to offset some of the major drawbacks of epidemiologic studies, including residual confounding (by smoking and other dietary factors) and exposure assessment.

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Effect of cooking on total vitamin C contents and antioxidant activity of sweet chestnuts (Castanea sativa Mill.)
Barros, A., Nunes, F. M., Gonçalves, B. C., Bennett, R. N., & Silva, A. P. (2011) · Food Chemistry · doi:10.1016/j.foodchem.2011.03.013 · Cited by 137
“Epidemiological studies indicate that fruits and vegetables have protective effects against degenerative diseases such as cancer and cardiovascular diseases (Arts & Hollman, 2005; Neuhouser, 2004).”
Background
Measuring exposure to the polyphenol metabolome in observational epidemiologic studies: current tools and applications and their limits
Zamora‐Ros, R., Touillaud, M. S., Rothwell, J. A., Romieu, I., & Scalbert, A. (2014) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.077743 · Cited by 141
Functional Components in Peanuts
Francisco, M. L. D. L., & Resurreccion, A. V. A. (2008) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408390701640718 · Cited by 149
“These studies were as follows: the Zutphen Elderly Study, the Finnish Mobile Clinic Health Examination Survey, the Iowa Women’s Health Study, the Alpha Tocopherol, Beta Carotene Cancer Prevention Study, the Dutch Zutphen Elderly Study, and the Rotterdam Study, in the Netherlands (Arts and Hollman, 2005).”
BackgroundMethodInfluential
Nutritional improvement of the endothelial control of vascular tone by polyphenols: role of NO and EDHF
Schini‐Kerth, V. B., Auger, C., Kim, J. H., Étienne-Selloum, N., & Chataigneau, T. (2010) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-010-0806-4 · Cited by 132
Phloridzin reduces blood glucose levels and improves lipids metabolism in streptozotocin-induced diabetic rats
Najafian, M., Jahromi, M. Z., Nowroznejhad, M. J., Khajeaian, P., Kargar, M., Sadeghi, M., & Arasteh, A. (2011) · Molecular Biology Reports · doi:10.1007/s11033-011-1328-7 · Cited by 131
“Intestinal sugar absorption is increased in experimental diabetes [2–4].”
Background
Differences in dietary intakes, food sources and determinants of total flavonoids between Mediterranean and non-Mediterranean countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study
Zamora‐Ros, R., Knaze, V., Luján‐Barroso, L., Romieu, I., Scalbert, A., Slimani, N., Hjartåker, A., Engeset, D., Skeie, G., Overvad, K., et al. (2012) · British Journal Of Nutrition · doi:10.1017/s0007114512003273 · Cited by 141
“Associations between the consumption of total or classes of ﬂavonoids and chronic disease prevention have also been suggested in several case–control and a few cohort studies (12,13) .”
Phytochemical Antioxidants Modulate Mammalian Cellular Epigenome: Implications in Health and Disease
Malireddy, S., Kotha, S. R., Secor, J. D., Gurney, T. O., Abbott, J. L., Maulik, G., Maddipati, K. R., & Parinandi, N. L. (2012) · Antioxidants and Redox Signaling · doi:10.1089/ars.2012.4600 · Cited by 127
“Antioxidant supplementation/ treatment has been adopted for either prevention of or protection against several disorders and pathophysiological states wherein oxidative stress has been established as a causative mechanism (5).”
Background
CYSTUS052, a polyphenol-rich plant extract, exerts anti-influenza virus activity in mice
Droebner, K., Ehrhardt, C., POETTER, A., Ludwig, S., & Planz, O. (2007) · Antiviral Research · doi:10.1016/j.antiviral.2007.04.001 · Cited by 128
“…have een shown to be strong antioxidants with potential health benfits as they are able to protect the heart, support the biological ctivity of vitamin C, protect from premature skin ageing, and ind viruses and bacteria (Urquiaga and Leighton, 2000; Arts nd Hollman, 2005; Halliwell et al., 2005).”
Background
Tiliroside, a glycosidic flavonoid, ameliorates obesity-induced metabolic disorders via activation of adiponectin signaling followed by enhancement of fatty acid oxidation in liver and skeletal muscle in obese–diabetic mice
Goto, T., Teraminami, A., Lee, J.-Y., Ohyama, K., Funakoshi, K., Kim, Y.-I., Hirai, S., Uemura, T., Yu, R., Takahashi, N., et al. (2011) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2011.04.001 · Cited by 130
“Epidemiological studies suggest the health beneficial effects of dietary flavonoids through the reduction of the risk of carcinogenesis, hypertension, inflammation and cardiovascular diseases [9–11].”
Background
Dietary quercetin attenuates oxidant-induced endothelial dysfunction and atherosclerosis in apolipoprotein E knockout mice fed a high-fat diet: A critical role for heme oxygenase-1
Shen, Y., Ward, N. C., Hodgson, J. M., Puddey, I. B., Wang, Y., Zhang, D., Maghzal, G. J., Stocker, R., & Croft, K. D. (2013) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2013.08.185 · Cited by 129
“There is increasing evidence to suggest that quercetin is one of several flavonoids that can contribute to beneficial effects on the cardiovascular system [16].”
Background
Polyphenols Beyond Barriers: A Glimpse into the Brain
Figueira, I., Menezes, R., Macedo, D., Costa, I., & dos Santos, C. N. (2016) · Current Neuropharmacology · doi:10.2174/1570159x14666161026151545 · Cited by 134
“The amount of research that has emerged in the past years in order to better understand polyphenols health benefits discloses a glimpse of the huge potential they may present [73-75].”
Breast Cancer Resistance Protein (Bcrp1/Abcg2) Limits Net Intestinal Uptake of Quercetin in Rats by Facilitating Apical Efflux of Glucuronides
Sesink, A. L. A., Arts, I. C. W., de Boer, V. C. J., Breedveld, P., Schellens, J. H. M., Hollman, P. C. H., & Rüssel, F. G. M. (2005) · Molecular Pharmacology · doi:10.1124/mol.104.009753 · Cited by 128
Adsorption/Desorption Characteristics and Separation of Anthocyanins from Muscadine (Vitis rotundifolia) Juice Pomace by Use of Macroporous Adsorbent Resins
Sandhu, A. K., & Gu, L. (2013) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf3036148 · Cited by 127
Intake of dietary procyanidins does not contribute to the pool of circulating flavanols in humans
Ottaviani, J. I., Kwik-Uribe, C. L., Keen, C. L., & Schroeter, H. (2012) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.028340 · Cited by 127
Polyphenolic Composition of Hazelnut Skin
Rio, D. D., Calani, L., Dall’Asta, M., & Brighenti, F. (2011) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf202449z · Cited by 128
Phenolic sulfates as new and highly abundant metabolites in human plasma after ingestion of a mixed berry fruit purée
Pimpão, R. C., Ventura, M. R., Ferreira, R. B., Williamson, G., & Santos, C. N. (2015) · British Journal of Nutrition · doi:10.1017/s0007114514003511 · Cited by 126
Phenolic contents and bioactive potential of peach fruit extracts
Mokrani, A., Krisa, S., Cluzet, S., Costa, G. D., Temsamani, H., Renouf, E., Mérillon, J., Madani, K., Mesnil, M., Monvoisin, A., et al. (2015) · Food Chemistry · doi:10.1016/j.foodchem.2015.12.026 · Cited by 126
Neuroprotective effect of curcumin as evinced by abrogation of rotenone-induced motor deficits, oxidative and mitochondrial dysfunctions in mouse model of Parkinson's disease
Khatri, D. K., & Juvekar, A. R. (2016) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2016.09.002 · Cited by 129
Higher dietary flavone, flavonol, and catechin intakes are associated with less of an increase in BMI over time in women: a longitudinal analysis from the Netherlands Cohort Study
Hughes, L., Arts, I. C. W., Ambergen, T., Brants, H. A. M., Dagnelie, P. C., Goldbohm, R. A., van den Brandt, P. A., & Weijenberg, M. P. (2008) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2008.26058 · Cited by 123
“Present in foods of plant origin such as fruit, vegetables, tea, wine, seeds, herbs, spices, and whole grains, 6000 naturally occurring flavonoids have been identified and classified into 6 major subgroups: catechins, flavonols, flavones, flavanones, anthocyanins, and isoflavones (25).”
Background
Hypertension, the Kuna, and the Epidemiology of Flavanols
McCullough, M. L., Chevaux, K. A., Jackson, L., Preston, M., Martinez, G., Schmitz, H. H., Coletti, C. M., Campos, H., & Hollenberg, N. K. (2006) · Journal of Cardiovascular Pharmacology · doi:10.1097/00005344-200606001-00003 · Cited by 124
Review: Antioxidant therapeutic advances in COPD
Rahman, I. (2008) · Therapeutic Advances in Respiratory Disease · doi:10.1177/1753465808098224 · Cited by 124
“Polyphenols Several epidemiological studies have established a beneficial link between polyphenol intake and reduced risk of disease, which were attributed to both the antioxidant and anti-inflammatory properties of polyphenols [Arts and Hollman, 2005].”
Background
A Review of the Epidemiological Evidence on Tea, Flavonoids, and Lung Cancer2
Arts, I. C. W. (2008) · Journal of Nutrition · doi:10.1093/jn/138.8.1561s · Cited by 122
“An earlier review on flavonoids and chronic diseases (6) found evidence suggestive of a lower risk of lung cancer with a higher intake of flavonols/flavones.”
Background
Anthocyanin bio-fortified colored wheat: Nutritional and functional characterization
Sharma, S., Chunduri, V., Kumar, A., Kumar, R., Khare, P., Kondepudi, K. K., Bishnoi, M., & Garg, M. (2018) · PLoS ONE · doi:10.1371/journal.pone.0194367 · Cited by 122
Flavonoids and Asthma
Tanaka, T., & Takahashi, R. (2013) · Nutrients · doi:10.3390/nu5062128 · Cited by 128
“In addition, epidemiological evidence of the beneficial role of flavonoid intake in the fight against the risk of chronic diseases is promising [24,25].”
Background
Can the sprouting process applied to wheat improve the contents of vitamins and phenolic compounds and antioxidant capacity of the flour?
Žilić, S., Basić, Z., Šukalović, V. H., Maksimović, V. M., Janković, M., & Filipović, M. (2013) · International Journal of Food Science & Technology · doi:10.1111/ijfs.12397 · Cited by 120
“Common dietary compounds, such as bread, in the form of functional foods, can deliver a high concentration of antioxidants that may play a role in protection from diseases, such as cancer, cardiovascular diseases and degenerative diseases (Arts & Hollman, 2005).”
Background
Recommending flavanols and procyanidins for cardiovascular health: Current knowledge and future needs
Schroeter, H., Heiß, C., Spencer, J. P. E., Keen, C. L., Lupton, J. R., & Schmitz, H. H. (2010) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2010.09.008 · Cited by 120
“Arts and Hollman (2005) evaluated the outcomes of 15 prospective cohort studies that were aimed at investigating the relationship between the intake of polyphenol- and flavonoid-containing foodstuffs and cardiovascular disease risk.”
Background
Dietary flavonoids: effects on endothelial function and blood pressure
Hodgson, J. M., & Croft, K. D. (2006) · Journal of the Science of Food and Agriculture · doi:10.1002/jsfa.2675 · Cited by 121
Dietary flavonoids and nitrate: effects on nitric oxide and vascular function
Bondonno, C. P., Croft, K. D., Ward, N., Considine, M. J., & Hodgson, J. M. (2015) · Nutrition Reviews · doi:10.1093/nutrit/nuu014 · Cited by 150
Recent trends in the development of nanophytobioactive compounds and delivery systems for their possible role in reducing oxidative stress in Parkinson’s disease models
Ganesan, P., Ko, H.-M., Kim, I., & Choi, D. (2015) · International Journal of Nanomedicine · doi:10.2147/ijn.s93918 · Cited by 119
Network medicine framework shows that proximity of polyphenol targets and disease proteins predicts therapeutic effects of polyphenols
do Valle, Í. F., Roweth, H. G., Malloy, M. W., Moco, S., Barron, D., Battinelli, E. M., Loscalzo, J., & Barabási, A.-Ĺ. (2021) · Nature Food · doi:10.1038/s43016-021-00243-7 · Cited by 120
Flavonoid Glycosides Are Not Transported by the Human Na+/Glucose Transporter When Expressed in Xenopus laevis Oocytes, but Effectively Inhibit Electrogenic Glucose Uptake
Kottra, G., & Daniel, H. (2007) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.107.124040 · Cited by 118
Mass spectrometry detection in comprehensive liquid chromatography: Basic concepts, instrumental aspects, applications and trends
Donato, P., Cacciola, F., Tranchida, P. Q., Dugo, P., & Mondello, L. (2012) · Mass Spectrometry Reviews · doi:10.1002/mas.20353 · Cited by 121
Quercetin and its metabolites improve vessel function by inducing eNOS activity via phosphorylation of AMPK
Shen, Y., Croft, K. D., Hodgson, J. M., Kyle, R. A., Lee, I.-L. E., Wang, Y., Stocker, R., & Ward, N. C. (2012) · Biochemical Pharmacology · doi:10.1016/j.bcp.2012.07.016 · Cited by 118
Comparative safety assessment of plant-derived foods
Kok, E. J., Keijer, J., Kleter, G. A., & Kuiper, H. A. (2007) · Regulatory Toxicology and Pharmacology · doi:10.1016/j.yrtph.2007.09.007 · Cited by 116
The effects of chronic tea intake on platelet activation and inflammation: A double-blind placebo controlled trial
Steptoe, A., Gibson, E. L., Vuononvirta, R., Hamer, M., Wardle, J., Rycroft, J. A., Martin, J. F., & Erusalimsky, J. D. (2006) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2006.08.054 · Cited by 116
“An association between tea consumption and reduced risk of coronary heart disease (CHD) and str ke has been demonstrated in cohort and case-control studies [1,2].”
Background
Does a Mediterranean-Type Diet Reduce Cancer Risk?
Schwingshackl, L., & HOFFMANN, G. E. (2015) · Current Nutrition Reports · doi:10.1007/s13668-015-0141-7 · Cited by 119
Estimated dietary intakes of flavonols, flavanones and flavones in the European Prospective Investigation into Cancer and Nutrition (EPIC) 24 hour dietary recall cohort
Zamora‐Ros, R., Knaze, V., Luján‐Barroso, L., Slimani, N., Romieu, I., Fedirko, V., de Magistris, M. S., Ericson, U., Amiano, P., Trichopoulou, A., et al. (2011) · British Journal Of Nutrition · doi:10.1017/s000711451100239x · Cited by 117
Effect of increasing fruit and vegetable intake by dietary intervention on nutritional biomarkers and attitudes to dietary change: a randomised trial
Duthie, S. J., Duthie, G. G., Russell, W. R., Kyle, J. A. M., Macdiarmid, J. I., Rungapamestry, V., Stephen, S., Megías, C., Kaniewska, J., Shaw, L., et al. (2017) · European Journal of Nutrition · doi:10.1007/s00394-017-1469-0 · Cited by 135
Solubility of Flavonoids in Pure Solvents
Ferreira, O., & Pinho, S. P. (2012) · Industrial & Engineering Chemistry Research · doi:10.1021/ie300211e · Cited by 115
You are what you eat, and so are your children: the impact of micronutrients on the epigenetic programming of offspring
Vanhees, K., Vonhögen, I. G. C., van Schooten, F., & Godschalk, R. (2013) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-013-1427-9 · Cited by 121
“This is also the main reason why flavonoids are gaining interest as treatment and prevention options for adult diseases [87, 104–106].”
Background
Metabolism and Bioavailability of Flavonoids in Chemoprevention: Current Analytical Strategies and Future Prospectus
PRASAIN, J. K., & Barnes, S. (2007) · Molecular Pharmaceutics · doi:10.1021/mp700116u · Cited by 114

Authors: Arts, I. C., & Hollman, P. C.
Affiliations: Wageningen University & Research (NL)
Corresponding author: Arts, Ilja CW
ORCID: Arts, Ilja CW
Hollman, Peter CH
Venue: The American Journal of Clinical Nutrition
Publisher: Elsevier BV
Published: 2005-01
Volume: 81
Issue: 1
Pages: 317S-325S
ISSN: 0002-9165 (ISSN-L)
DOI: 10.1093/ajcn/81.1.317s
OpenAlex: W2129133439
Cited by: 1,916
References: 74
Citations by year: 2026: 20 · 2025: 37 · 2024: 72 · 2023: 55 · 2022: 66 · 2021: 82 · 2020: 77 · 2019: 106 · 2018: 107 · 2017: 103 · 2016: 130 · 2015: 119 · 2014: 138 · 2013: 132 · 2012: 114
FWCI: 6.43
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 6628 d)
Locations: American Journal of Clinical Nutrition (publishedVersion)
PubMed (publishedVersion)
Socio-Environmental Systems Modeling (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: ZonMw
Topics: Health Sciences › Medicine › Biochemistry (medical) › Phytochemicals and Antioxidant Activities
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
Keywords: plant polyphenols, flavonoids, flavonols, flavones, catechins, lignans, cardiovascular disease, cancer risk, lung cancer, stroke, asthma, chronic obstructive pulmonary disease, dietary exposure assessment, residual confounding, prospective study design
MeSH terms: Adult, Animals, Antioxidants, Cardiovascular Diseases, Clinical Trials as Topic, Epidemiologic Methods, Female, Flavonoids, Humans, Male, Neoplasms, Phenols, Prospective Studies, Risk Factors, Polyphenols

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Polyphenols and disease risk in epidemiologic studies

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