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Nutrients 2017, 9(2), 117; doi:10.3390/nu9020117

Impact of Flavonols on Cardiometabolic Biomarkers: A Meta‐Analysis of Randomized Controlled Human Trials to Explore the Role of Inter‐Individual Variability

1
BET/ITQB, Molecular Nutrition & Health Laboratory, 2780‐157 Oeiras, Portugal
2
Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 9NH, UK
3
FAME Laboratory, School of Exercise Science, University of Thessaly, 42100 Volos, Greece
4
CEBAS‐CSIC, E‐30100 Murcia, Spain
5
Unilever R&D, 3133AT Vlaardingen, The Netherlands
6
University of Nicosia, CY1700 Engomi, Cyprus
7
Biomarkers and Nutrimetabolomic Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Campus Torribera, Faculty of Pharmacy and Food Sciences, University of Barcelona, CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 08028 Barcelona, Spain
8
INRA, UMR 1019, UNH, CRNH Auvergne, F‐63000 Clermont‐Ferrand, Clermont Université, Université d’Auvergne, Unité de Nutrition Humaine, BP 10448, F‐63000 Clermont‐Ferrand, France
9
University College Dublin, D4 Dublin, Ireland
10
Université Lille, INSERM, Institut Pasteur de Lille, U1167—RID‐AGE—Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, F‐59000 Lille, France
11
Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6AP, UK
12
Human Nutrition, University of Glasgow, Glasgow G31 2ER, UK
13
Goce Delcev University, 2000 Stip, Macedonia
14
Polytechnic Institute of Santarem, ESA, Department of Food Technology, Biotechnology and Nutrition, 2001‐904 Santarém, Portugal
*
Author to whom correspondence should be addressed.
Received: 30 December 2016 / Accepted: 3 February 2017 / Published: 9 February 2017
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Abstract

Several epidemiological studies have linked flavonols with decreased risk of cardiovascular disease (CVD). However, some heterogeneity in the individual physiological responses to the consumption of these compounds has been identified. This meta‐analysis aimed to study the effect of flavonol supplementation on biomarkers of CVD risk such as, blood lipids, blood pressure and plasma glucose, as well as factors affecting their inter‐individual variability. Data from 18 human randomized controlled trials were pooled and the effect was estimated using fixed or random effects meta‐analysis model and reported as difference in means (DM). Variability in the response of blood lipids to supplementation with flavonols was assessed by stratifying various population subgroups: age, sex, country, and health status. Results showed significant reductions in total cholesterol (DM = −0.10 mmol/L; 95% CI: −0.20, −0.01), LDL cholesterol (DM = −0.14 mmol/L; Nutrients 2017, 9, 117 2 of 21 95% CI: −0.21, 0.07), and triacylglycerol (DM = −0.10 mmol/L; 95% CI: −0.18, 0.03), and a significant increase in HDL cholesterol (DM = 0.05 mmol/L; 95% CI: 0.02, 0.07). A significant reduction was also observed in fasting plasma glucose (DM = −0.18 mmol/L; 95%CI: −0.29, −0.08), and in blood pressure (SBP: DM = −4.84 mmHg; 95% CI: −5.64, −4.04; DBP: DM = −3.32 mmHg; 95% CI: -4.09, -2.55). Subgroup analysis showed a more pronounced effect of flavonol intake in participants from Asian countries and in participants with diagnosed disease or dyslipidemia, compared to healthy and normal baseline values. In conclusion, flavonol consumption improved biomarkers of CVD risk, however, country of origin and health status may influence the effect of flavonol intake on blood lipid levels View Full-Text
Keywords: flavonols;  quercetin;  cardiovascular  disease;  meta‐analysis;  systematic  review;  Interindividual variability; blood lipids; blood pressure; glucose flavonols;  quercetin;  cardiovascular  disease;  meta‐analysis;  systematic  review;  Interindividual variability; blood lipids; blood pressure; glucose
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MDPI and ACS Style

Menezes, R.; Rodriguez‐Mateos, A.; Kaltsatou, A.; González‐Sarrías, A.; Greyling, A.; Giannaki, C.; Andres‐Lacueva, C.; Milenkovic, D.; Gibney, E.R.; Dumont, J.; Schär, M.; Garcia‐Aloy, M.; Palma‐Duran, S.A.; Ruskovska, T.; Maksimova, V.; Combet, E.; Pinto, P. Impact of Flavonols on Cardiometabolic Biomarkers: A Meta‐Analysis of Randomized Controlled Human Trials to Explore the Role of Inter‐Individual Variability. Nutrients 2017, 9, 117.

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