Dietary Intake of Flavonoids and Ventilatory Function in European Adults: A GA²LEN Study

Vanessa Garcia-Larsen, N Thawer, D Charles, A Cassidy, Thibaut Van Zele, Trine Thilsing, Matti Ahlström, Tari Haahtela, T Keil, Paolo Maria Matricardi, G Brozek, Marek L Kowalski, Joanna Makowska, Ewa Nizankowska-Mogilnicka, Barbara Rymarczyk, C Loureiro, A Todo-Bom, C Bachert, Bertil Forsberg, Christer JansonKjell Torén, James F. Potts, Peter G J Burney

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Background: Flavonoids exert anti-inflammatory properties and modulate oxidative stress in vitro, suggesting a protective effect on lung function, but epidemiological studies examining this association are scarce. Methods: A stratified random sample was drawn from the GA 2LEN screening survey, in which 55,000 adults aged 15 to 75 answered a questionnaire on respiratory symptoms. Post-bronchodilator spirometry was obtained from 2850 subjects. Forced vital capacity (FVC), the ratio between the forced exhaled volume in 1 second (FEV 1) and FVC (FEV 1/FVC), FVC below lower limit of normal (FVC < LLN), and FEV 1/FVC < LLN were calculated. Intake of the six main subclasses of flavonoids was estimated using the GA 2LEN Food Frequency Questionnaire. Adjusted associations between outcomes and each subclass of flavonoids were examined with multivariate regressions. Simes’ procedure was used to test for multiple comparisons. Results: A total of 2599 subjects had valid lung function and dietary data. A lower prevalence of FVC < LLN (airway restriction) was observed in those with higher total flavonoid (adjusted odds ratio (aOR), higher vs. lowest quintile intake 0.58, 95% Confidence Interval (CI) 0.36, 0.94), and pro-anthocyanidin intakes (aOR 0.47, 95% CI 0.27, 0.81). A higher FEV 1/FVC was associated with higher intakes of total flavonoids and pro-anthocyanidins (adjusted correlation coefficient (a β-coeff 0.33, 0.10, 0.57 and a β-coeff 0.44, 95% CI 0.19, 0.69, respectively). After Simes’ procedure, the statistical significance of each of these associations was attenuated but remained below 0.05, with the exception of total flavonoids and airway restriction. Conclusions: This population-based study in European adults provides cross-sectional evidence of a positive association of total flavonoid intake and pro-anthocyanidins and ventilatory function, and a negative association with spirometric restriction in European adults.

Original languageEnglish
Article number95
Issue number1
Number of pages13
Publication statusPublished - 15. Jan 2018


  • Flavonoids
  • GA2LEN
  • Lung function
  • Pro-anthocyanidins
  • Spirometry
  • Prevalence
  • Follow-Up Studies
  • Pulmonary Ventilation
  • Anthropometry
  • Humans
  • Middle Aged
  • Male
  • Nutrition Assessment
  • Oxidative Stress/drug effects
  • Young Adult
  • Adult
  • Female
  • Surveys and Questionnaires
  • Lung/metabolism
  • Anthocyanins/administration & dosage
  • Cross-Sectional Studies
  • Flavonoids/administration & dosage
  • European Continental Ancestry Group
  • Vital Capacity
  • Diet
  • Adolescent
  • Aged


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