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ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1572189
This article is part of the Research Topic Potential Preventive and Therapeutic Effects of Phytochemicals on Metabolic Disorders and Cardiovascular Disease View all articles
Relationship Between Dietary Flavan-3-ols Intake And Mortality In Metabolic Syndrome Population; A Large Cohort Study
Provisionally accepted- 1 The First Hospital of Hunan University of Chinese Medicine, Changsha, China
- 2 Hunan University of Chinese Medicine, Changsha, Anhui Province, China
AbstractBackground：Metabolic syndrome (MetS) is a global health concern linked to increased mortality. Diets rich in plant-derived compounds, such as polyphenols, have shown potential health benefits for MetS. Among these, flavan-3-ols, a class of commonly occurring polyphenolic compounds, are known for their antioxidant and anti-inflammatory properties. Therefore, we hypothesize that flavan-3-ols intake is negatively associated with mortality risk in MetS population.Methods: This study analyzed NHANES data (2007-2008, 2009-2010, 2017-2018). Flavan-3-ol and monomer intake were obtained from the USDA Flavonoid and FNDDS databases. Associations with mortality were assessed using Cox regression, survival differences were compared using Kaplan-Meier curves, and nonlinear trends were examined using restricted cubic splines. Subgroup analyses were conducted to explore potential effect modifications.Results: Over a median follow-up period of 114 months, 1,856 participants survived, while 329 deaths were recorded. In Model 3, participants in the highest tertile (T3) of Flavan-3-ol intake exhibited a 33% lower risk of all-cause mortality compared to those in the lowest tertile (T1) (HR=0.67,95%CI:0.49-0.92). For monomers, the hazard ratios ranged from 0.55 for higher levels of epigallocatechin to 0.71 for higher levels of gallocatechin. Kaplan-Meier curves indicated significant differences in survival status across dietary Flavan-3-ol intake groups. However, no association was found between Flavan-3-ol intake and cardiovascular mortality risk. Additionally, restricted cubic spline (RCS) analysis did not reveal any nonlinear relationship, and no significant interaction effects were observed in the subgroup analysis.Conclusion: Higher dietary intake of flavan-3-ols is negatively associated with mortality risk in MetS population.
Keywords: Flavan-3-ols, metabolic syndrome, Mortality, NHANES, cohort study, Flavan-3-ol monomers
Received: 06 Feb 2025; Accepted: 27 Mar 2025.
Copyright: © 2025 Zhang, Zhou, Yang, Tan, Yi and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhan Yi, Hunan University of Chinese Medicine, Changsha, 410208, Anhui Province, China
Yin Xu, The First Hospital of Hunan University of Chinese Medicine, Changsha, China
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