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Open AccessArticle

Association of Total Flavonoid Intake with Hypo-HDL-Cholesterolemia among Korean Adults: Effect Modification by Polyunsaturated Fatty Acid Intake

1
Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
2
Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
3
Institute of Health and Environment, Seoul National University, 08826 Seoul, Korea
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(1), 195; https://doi.org/10.3390/nu12010195
Received: 18 November 2019 / Revised: 29 December 2019 / Accepted: 8 January 2020 / Published: 10 January 2020
(This article belongs to the Section Nutritional Epidemiology)
The aim of this study was to examine the independent association between flavonoid intake and hypo-high-density lipoprotein (HDL)-cholesterolemia and the potential modifying effect of polyunsaturated fatty acid (PUFA) intake on this association among Korean adults. This cross-sectional analysis used data from 10,326 subjects who participated in the 2013–2016 Korean National Health and Nutrition Examination Survey. Multiple logistic regression analyses were used to assess the associations of flavonoid and PUFA intakes with hypo-HDL-cholesterolemia prevalence. Proanthocyanidins intake showed an inverse relationship with hypo-HDL-cholesterolemia only in men (Tertile (T) 3 vs. T1: odds ratio (OR) = 0.74, 95% confidence interval (CI) = 0.59–0.92, p-trend = 0.0330). Total flavonoid and PUFA intakes were not associated with hypo-HDL-cholesterolemia in both men and women. However, when stratified by PUFA intake, there was an inverse relationship between total flavonoid intake and hypo-HDL-cholesterolemia prevalence in men with a high n-3 PUFA intake (total flavonoid intakes T3 vs. T1: OR = 0.59, 95% CI = 0.42–0.82, p-trend = 0.0004) or a low n-6/n-3 PUFA intake ratio (T3 vs. T1: OR = 0.67, 95% CI = 0.48–0.93, p-trend = 0.0053), but not in those with a low n-3 PUFA intake (p-interaction = 0.0038) or a high n-6/n-3 PUFA intake ratio (p-interaction = 0.1772). In women, no association was found between total flavonoid intake and hypo-HDL-cholesterolemia, regardless of PUFA intake. These results imply that the intake of proanthocyanidins might have beneficial effects on the HDL-cholesterol level in Korean men. In addition, n-3 PUFA intake might modify the association of total flavonoid intake with the hypo-HDL-cholesterolemia among Korean men. View Full-Text
Keywords: flavonoids; polyunsaturated fatty acids; HDL-cholesterol; Korea National Health and Nutrition Examination Survey flavonoids; polyunsaturated fatty acids; HDL-cholesterol; Korea National Health and Nutrition Examination Survey
MDPI and ACS Style

Ahn, S.; Jun, S.; Joung, H. Association of Total Flavonoid Intake with Hypo-HDL-Cholesterolemia among Korean Adults: Effect Modification by Polyunsaturated Fatty Acid Intake. Nutrients 2020, 12, 195.

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