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Flavonoid-Rich Foods, Dementia Risk, and Interactions With Genetic Risk, Hypertension, and Depression
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The findings from this large prospective cohort study of more than 120 000 UK Biobank participants suggest that consuming 6 additional servings per day of flavonoid-rich foods, specifically tea, red wine, and berries, was associated with a lower risk of dementia, with the strongest associations observed for tea. We were also able to show, for the first time in our knowledge, that these associations were evident in participants at high genetic risk of dementia and those with modifiable risk factors, including depression and hypertension, but not in those without.
evidence from cohort studies has shown that modifiable risk factors, such as diet, play an important role in prevention. Higher adherence to plant-based diets has been associated with a 21% lower risk of developing cognitive disorders and a 40% lower risk of Alzheimer disease,3 with diets rich in healthy plant-based foods showing the strongest associations with lower dementia risk.4
Flavonoids, a group of polyphenolic compounds found in plant-derived foods and beverages, such as fruits, vegetables, tea, red wine, and dark chocolate, have also been associated with a lower risk of dementia.5,6 There is evidence that higher intakes of berries and tea specifically are associated with a lower risk of dementia and cognitive decline.7-9 Mechanisms proposed for the neuroprotective influence of dietary flavonoids and their downstream metabolites include reducing neuroinflammation10; improving cerebrovascular blood flow, with many flavonoid metabolites able to permeate the blood-brain barrier and mediate the microbiome-gut-brain axis11; and modulating major neuronal signal transduction pathways associated with synaptic plasticity.12 Flavonoids have also been associated with risk factors for dementia, including hypertension and depression. Studies have reported inverse associations between flavonol, flavone, and flavanone intakes and depression risk.13 Furthermore, higher intakes of anthocyanins, polymers, and, specifically, the proanthocyanidin component of the flavan-3-ol polymer class have been associated with lower blood pressure.14
Another key finding of this study was that the association between flavonoid-rich food consumption and dementia risk was observed in participants with depressive symptoms at baseline.
Conclusions
In this cohort study, higher flavonoid-rich diet scores were associated with a lower risk of dementia, with reductions most pronounced in individuals with a high genetic risk, hypertension, and depressive symptoms. Our results suggest that inclusion of flavonoid-rich foods into the daily diet may lower dementia risk, especially in populations at high risk.
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