Background and aims: Polyphenols are secondary metabolites present in small quantities in plant-based food and beverages, with antioxidant and anti-inflammatory properties. Main groups of polyphenols include flavonoids, phenolic acids, stilbenes, and lignans, but their association with mortality has barely been examined. We aimed to assess the association between the intake of 23 polyphenol subgroups and all-cause, cardiovascular, and cancer mortality in a representative sample of the Spanish adult population.

Methods: Population-based cohort study conducted with 12,161 individuals aged 18+ recruited in 2008-2010 and followed-up during a mean of 12.5 years. At baseline, food consumption was obtained with a validated dietary history, and the Phenol-Explorer database was used to estimate polyphenol intake. Associations were examined using Cox regression adjusted for main confounders.

Results: During follow-up, 967 all-cause deaths occurred, 219 were cardiovascular, and 277 cancer. Comparing extreme categories of consumption, hazard ratios (95% CI) of total mortality for subgroups were: dihydroflavonols 0.85 (0.72-1.00; p-trend:0.046); flavonols 0.79 (0.63-0.97; p-trend:0.04); methoxyphenols 0.75 (0.59-0.94; p-trend:0.021); tyrosols 0.80 (0.65-0.98; p-trend:0.044); alkylmethoxyphenols 0.74 (0.59-0.93; p-trend:0.007); hydroxycinnamic acids 0.79 (0.64-0.98; p-trend:0.014); and hydroxyphenilacetic acids 0.82 (0.67-0.99; p-trend:0.064). For cardiovascular mortality, hazard ratios were: methoxyphenols 0.58 (0.38-0.89; p-trend:0.010); alkylmethoxyphenols 0.59 (0.39-0.90; p-trend:0.011); hydroxycinnamic acids 0.63 (0.42-0.94; p-trend:0.020); and hydroxyphenilacetic acids 0.69 (0.48-0.99; p-trend:0.044), when comparing extreme tertiles of consumption. No statistically significant associations were observed for cancer. The main food sources for these polyphenol subgroups were red wine, leafy green vegetables, olive oil, green olives, and coffee (the latter being the major contributor of methoxyphenols, alkylmethoxyphenols, and hydroxycinnamic acids).

Conclusions: In the Spanish adult population, intake of specific polyphenol subgroups was prospectively associated with a 20% lower all-cause mortality risk. This decrease was mainly due to a 40% lower cardiovascular mortality risk over time.

Una investigación llevada a cabo en población adulta española evaluó específicamente la relación entre el consumo de 23 subgrupos concretos de polifenoles y la mortalidad por cualquier causa, y específicamente por enfermedad cardiovascular, o por cáncer. Investigaciones previas han relacionado una alimentación rica en este tipo de compuestos con un menor riesgo de mortalidad. En este estudio de cohortes participaron 12.161 adultos residentes en España, a los que se evaluó durante aproximadamente 12,5 años. Se obtuvo el consumo de alimentos con un historial dietético validado y se utilizó la base de datos Phenol-Explorer para estimar la ingesta de polifenoles.

El vino fue uno de los alimentos que se asoció con la reducción del riesgo de mortalidad por todas las causas y debido a enfermedades cardiovasculares. Fue la principal fuente de dihidroflavonoles, un polifenol del grupo de los flavonoides que se asociaba con un riesgo un 15% más bajo de mortalidad por cualquier causa y con una reducción del riesgo de mortalidad cardiovascular del 12%.

Estos resultados tienen que ver con el efecto antiinflamatorio y antioxidante de los polifenoles del vino, y coinciden por los obtenidos en investigaciones previas, que sugieren que el consumo moderado de vino se asocia con un efecto protector a nivel cardiovascular.