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      Dietary Polyphenol Intake is Associated with HDL-Cholesterol and A Better Profile of other Components of the Metabolic Syndrome: A PREDIMED-Plus Sub-Study

      research-article
      1 , 2 , 2 , 3 , 4 , 5 , 6 , 1 , 2 , 2 , 3 , 4 , 5 , 6 , 7 , 6 , 2 , 8 , 9 , 2 , 10 , 2 , 11 , 2 , 12 , 7 , 13 , 2 , 14 , 2 , 15 , 2 , 16 , 17 , 2 , 18 , 2 , 19 , 2 , 20 , 2 , 21 , 2 , 12 , 22 , 23 , 7 , 24 , 13 , 25 , 26 , 17 , 27 , 28 , 2 , 29 , 2 , 30 , 8 , 2 , 3 , 4 , 5 , 2 , 10 , 2 , 11 , 2 , 12 , 7 , 13 , 2 , 14 , 2 , 15 , 2 , 16 , 17 , 2 , 18 , 1 , 2 , 2 , 19 , 2 , 20 , 21 , 2 , 12 , 22 , 2 , 8 , 2 , 3 , 4 , 5 , 31 , 2 , 10 , 2 , 11 , 2 , 12 , 32 , 2 , 14 , 2 , 8 , 2 , 3 , 4 , 5 , 1 , 2 , 2 , 33 , 1 , 2 , 34 , *
      Nutrients
      MDPI
      polyphenols, metabolic syndrome, Mediterranean diet, glignans, stilbenes, HDL-cholesterol

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          Abstract

          Dietary polyphenol intake is associated with improvement of metabolic disturbances. The aims of the present study are to describe dietary polyphenol intake in a population with metabolic syndrome (MetS) and to examine the association between polyphenol intake and the components of MetS. This cross-sectional analysis involved 6633 men and women included in the PREDIMED (PREvención con DIeta MEDiterranea-Plus) study. The polyphenol content of foods was estimated from the Phenol-Explorer 3.6 database. The mean of total polyphenol intake was 846 ± 318 mg/day. Except for stilbenes, women had higher polyphenol intake than men. Total polyphenol intake was higher in older participants (>70 years of age) compared to their younger counterparts. Participants with body mass index (BMI) >35 kg/m 2 reported lower total polyphenol, flavonoid, and stilbene intake than those with lower BMI. Total polyphenol intake was not associated with a better profile concerning MetS components, except for high-density lipoprotein cholesterol (HDL-c), although stilbenes, lignans, and other polyphenols showed an inverse association with blood pressure, fasting plasma glucose, and triglycerides. A direct association with HDL-c was found for all subclasses except lignans and phenolic acids. To conclude, in participants with MetS, higher intake of several polyphenol subclasses was associated with a better profile of MetS components, especially HDL-c.

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          Most cited references20

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          Flavanones: Citrus phytochemical with health-promoting properties.

          Citrus fruit and juices represent one of the main sources of compounds with a high potential for health promoting properties. Among these compounds, flavanones (such as hesperetin, naringenin, eriodictyol, isosakuranetin, and their respective glycosides), which occur in quantities ranging from ∼180 to 740 mg/L (depending on the Citrus species and cultivar) are responsible for many biological activities. These compounds support and enhance the body's defenses against oxidative stress and help the organism in the prevention of cardiovascular diseases, atherosclerosis, and cancer. Moreover, among other properties, they also show anti-inflammatory, antiviral, and antimicrobial activities. This review analyzes the biochemistry, pharmacology, and biology of Citrus flavanones, emphasizing the occurrence in Citrus fruits and juices and their bioavailability, structure-function correlations and ability to modulate signal cascades both in vitro and in vivo. © 2017 BioFactors, 2017.
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            Dietary intake and major food sources of polyphenols in Finnish adults.

            Phenolic acids, flavonoids, proanthocyanidins, and ellagitannins are polyphenols that may have beneficial effects on human health and provide protection against chronic diseases. To date, limited data exist on quantitative intake of polyphenols. The aims of this study were to estimate the quantitative intakes of polyphenols by using analyzed concentrations together with individual food consumption records and to determine major dietary sources. Analyzed concentrations of phenolic acids, anthocyanidins, and other flavonoids, proanthocyanidins, and ellagitannins (44 total polyphenol compounds) were entered into the national food composition database, Fineli. The absolute intakes of the polyphenols and the corresponding food sources were calculated on the basis of 48-h dietary recalls of 2007 Finnish adults. The mean total intake of polyphenols was 863 +/- 415 mg/d. Phenolic acids comprised the dominant group of polyphenols (75% of total intake) followed by proanthocyanidins (14%) and anthocyanidins and other flavonoids (10%). Due to their high consumption and high concentrations of phenolic acids, coffee and cereals were the main contributors to total polyphenol intake. Berries and berry products were the main source for anthocyanidins, ellagitannins, and proanthocyanidins, and fruits were the main source for flavonols, flavones, and flavanones. The results give additional support to the recommendations for a varied diet with fruits, berries, cereals, and vegetables.
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              Adherence to the Mediterranean diet is inversely associated with metabolic syndrome occurrence: a meta-analysis of observational studies.

              Diet plays a role in the onset and progression of metabolic disorders, including metabolic syndrome (MetS). We aimed to systematically review and conduct a quantitative meta-analysis of results from observational cross-sectional and prospective cohort studies on adherence to the Mediterranean dietary pattern and risk of MetS. Literature databases including PubMed, SCOPUS and EMBASE were searched from the beginning to May 2016. Eight cross-sectional and four prospective studies were included in this meta-analysis, accounting for a total of 33,847 individuals and 6342 cases of MetS. High adherence to the Mediterranean diet was associated with a risk of MetS (RR: 0.81, 95%CI: 0.71, 0.92). Regarding individual components of the MetS, the inverse associations were significant for waist circumference, blood pressure and low HDL-C levels. In conclusion, adoption of a Mediterranean dietary pattern was associated with lower risk of the MetS and it can be proposed for the primary prevention of the MetS.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                04 March 2020
                March 2020
                : 12
                : 3
                : 689
                Affiliations
                [1 ]Department of Medicine, Faculty of Medicine and Life Sciences, University of Barcelona, Barcelona, Spain. Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain; sara.castro@ 123456ub.edu (S.C.-B.); mdomen@ 123456clinic.cat (M.D.); rcasas1@ 123456clinic.cat (R.C.); alvaro.hernaez1@ 123456gmail.com (Á.H.)
                [2 ]Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain jordi.salas@ 123456urv.cat (J.S.-S.); pilarbuilc@ 123456gmail.com (P.B.-C.); dolores.corella@ 123456uv.es (D.C.); mfito@ 123456imim.es (M.F.); mariaadoracion.romaguera@ 123456ssib.es (D.R.); angelmaria.alonsogomez@ 123456osakidetza.eus (Á.M.A.-G.); jwarnberg@ 123456uma.es (J.W.); jalfmtz@ 123456unav.es (J.A.M.); lluis.serra@ 123456ulpgc.es (L.S.-M.); fjtinahones@ 123456uma.es (F.J.T.); jose.lapetra.sspa@ 123456juntadeandalucia.es (J.L.); xpinto@ 123456bellvitgehospital.cat (X.P.); pep.tur@ 123456uib.es (J.A.T.); clotilde.vazquez@ 123456fjd.es (C.V.); mcofan@ 123456clinic.cat (M.C.); nerea.becerra@ 123456urv.cat (N.B.-T.); rocio.barragan@ 123456uv.es (R.B.); ocastaner@ 123456imim.es (O.C.); jadwiga.konieczna@ 123456ssib.es (J.K.); daisysorto2@ 123456yahoo.com (C.S.-S.); jessicaperezlopez@ 123456uma.es (J.P.-L.); mazulet@ 123456unav.es (M.A.Z.); inmaculada.bautista@ 123456ulpgc.es (I.B.-C.); anamgp86@ 123456gmail.com (A.M.G.-P.); josem.santos.lozano.sspa@ 123456juntadeandalucia.es (J.M.S.-L.); alicia.julibert@ 123456uib.es (A.J.); nmartincalvo@ 123456unav.es (N.M.-C.); pablo1280@ 123456gmail.com (P.H.-A.); Sorli@ 123456uv.es (J.V.S.); albertsanllorente@ 123456gmail.com (A.S.); aina.galmes@ 123456uib.es (A.M.G.-P.); leiregoiko@ 123456gmail.com (L.G.-G.); mcanela@ 123456unav.es (M.R.-C.); nancy.babio@ 123456urv.cat (N.B.); lamuela@ 123456ub.edu (R.M.L.-R.)
                [3 ]Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, 43204 Reus, Spain
                [4 ]University Hospital of Sant Joan de Reus, Nutrition Unit, 43201 Reus, Spain
                [5 ]Institut d’Investigació Sanitària Pere Virgili (IISPV), 43201 Reus, Spain
                [6 ]Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain; fvits@ 123456unileon.es (F.V.-S.); vicente.martin@ 123456unileon.es (V.M.-S.); mrubig02@ 123456estudiantes.unileon.es (M.R.-G.)
                [7 ]CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; vioque@ 123456umh.es (J.V.); lgarmol@ 123456ugr.es (L.G.-M.); sandra.gonzalezp@ 123456umh.es (S.G.-P.)
                [8 ]University of Navarra, Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; aromanos@ 123456unav.es
                [9 ]Servicio Navarro de Salud-Osasunbidea-Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
                [10 ]Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
                [11 ]Cardiovascular Risk and Nutrition Research group, Institut Hospital del Mar de Investigaciones Médicas (IMIM), 08007 Barcelona, Spain
                [12 ]Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (Research Unit), 07120 Palma de Mallorca, Spain
                [13 ]Miguel Hernandez University, ISABIAL-FISABIO, 03010 Alicante, Spain; mdelgado@ 123456ujaen.es
                [14 ]Bioaraba Health Research Institute; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
                [15 ]Department of Nursing. University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
                [16 ]Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
                [17 ]Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; lidia.daimiel@ 123456imdea.org
                [18 ]Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35016 Las Palmas de Gran Canaria, Spain
                [19 ]Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, 29010 Málaga, Spain
                [20 ]Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41010 Sevilla, Spain
                [21 ]Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, IDIBELL, Hospitalet de Llobregat, 08908 Barcelona, Spain; mrodriguezsa@ 123456bellvitgehospital.cat
                [22 ]Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain
                [23 ]Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain; angarios2004@ 123456yahoo.es
                [24 ]Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain
                [25 ]Division of Preventive Medicine, Faculty of Medicine, University of Jaén, 23071 Jaén, Spain
                [26 ]Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; mmatia@ 123456ucm.es
                [27 ]CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; jovidal@ 123456clinic.cat
                [28 ]Department of Endocrinology, Institut d’Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
                [29 ]Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD. University Autonoma, 28040 Madrid, Spain
                [30 ]Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, 08036 Barcelona, Spain
                [31 ]Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
                [32 ]Centro de Salud Raval, 03203 Alicante, Spain; ecases@ 123456coma.es
                [33 ]Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, School of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
                [34 ]Department of Internal Medicine, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
                Author notes
                [* ]Correspondence: restruch@ 123456clinic.cat ; Tel.: +34-932-279-935
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-6876-5443
                https://orcid.org/0000-0002-7022-9041
                https://orcid.org/0000-0003-2700-7459
                https://orcid.org/0000-0002-8586-577X
                https://orcid.org/0000-0002-2366-4104
                https://orcid.org/0000-0002-5762-8558
                https://orcid.org/0000-0002-2284-148X
                https://orcid.org/0000-0003-2945-7509
                https://orcid.org/0000-0002-8408-316X
                https://orcid.org/0000-0001-5218-6941
                https://orcid.org/0000-0002-9658-9061
                https://orcid.org/0000-0002-6940-0761
                https://orcid.org/0000-0001-9898-6629
                https://orcid.org/0000-0002-1895-5644
                https://orcid.org/0000-0002-9694-7607
                https://orcid.org/0000-0001-8072-3791
                https://orcid.org/0000-0003-3169-997X
                https://orcid.org/0000-0003-3358-472X
                https://orcid.org/0000-0003-2579-716X
                https://orcid.org/0000-0002-3926-0892
                https://orcid.org/0000-0002-0211-9166
                https://orcid.org/0000-0002-2874-5894
                https://orcid.org/0000-0001-7549-1455
                https://orcid.org/0000-0002-9977-8976
                https://orcid.org/0000-0002-0130-2006
                https://orcid.org/0000-0001-6977-9874
                https://orcid.org/0000-0002-7684-2787
                https://orcid.org/0000-0003-3527-5277
                https://orcid.org/0000-0001-8593-1477
                https://orcid.org/0000-0002-1287-4560
                https://orcid.org/0000-0003-1260-4445
                Article
                nutrients-12-00689
                10.3390/nu12030689
                7146338
                32143308
                fec800e7-0469-4fe8-bc2c-78b4c67721fb
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 07 February 2020
                : 29 February 2020
                Categories
                Article

                Nutrition & Dietetics
                polyphenols,metabolic syndrome,mediterranean diet,glignans,stilbenes,hdl-cholesterol

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