Associations between dietary intake of flavonoids and adiposity: cross-sectional findings from the Fenland Study, the United Kingdom.

Abstract

Prospective and experimental evidence supports beneficial effects of flavonoids on weight management and metabolic health, but their impact on specific adiposity parameters remains unclear. We aimed to investigate associations of total and subclasses of dietary flavonoids with adiposity markers, several of which have been linked to metabolic risk. We evaluated cross-sectional data from 11,568 adults recruited to the Fenland Study between 2005 and 2015 in Cambridgeshire, the United Kingdom. Habitual diets were evaluated using food frequency questionnaires. Flavonoid intakes were calculated mainly using the United States Department of Agriculture food composition databases. We examined associations using robust regression adjusted for relevant confounders and corrected for false discovery rate (FDR) for multiple flavonoids and adiposity parameters: body fat (BF) (dual-energy X-ray absorptiometry), visceral fat (VAT), subcutaneous fat (SCAT), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), VAT:SCAT ratio, and a body shape index (ABSI). Median flavonoid intake was 428 mg/d (interquartile range 258.5-568.6). Doubling in total flavonoid intake was inversely associated with BF [beta_log2 -0.54% (95% CI -0.70; -0.40)]; VAT [-0.13 cm (-0.17; -0.08)]; SCAT [-0.05 cm (-0.08; -0.02)]; BMI [-0.33 kg/m² (-0.44; -0.22)]; WC [-0.84 cm (-1.13; -0.55)]; and WHR [-0.004 (-0.006; -0.002)]. Most of flavonoid subclasses showed similar results, except isoflavones that were positively associated with BF, VAT and WC. Intakes of proanthocyanidins and anthocyanidins showed the strongest negative associations independently of BMI. Subgroup analyses resulted in stronger negative associations in women, older adults, and non-smokers. Flavonoids may influence adiposity, a potential pathway for the relationship between flavonoid-rich foods and metabolic risk. Proanthocyanidins and anthocyanidins may affect site-specific fat distribution, particularly visceral adiposity. Further investigation in prospective, interventional, and mechanistic studies is warranted to understand the link between flavonoids and adiposity.