Background: Diet is one of the leading factors contributing to the prevalence of non-communicable diseases, including neurodegenerative disorders. Dietary polyphenols, antioxidant components and anti-inflammatory agents of plant-based foods rich diets have been shown to modulate neuro-inflammation, adult neurogenesis and brain signaling, all of which are linked to cognitive function. As epidemiological evidence is limited and the results are contradictory, the aim of this study is to explore the association between dietary flavonoid intake and cognitive health among the adult population living in the Mediterranean area. Methods: The demographic and dietary habits of 808 adults living in southern Italy were analyzed. Food frequency questionnaires (FFQs) were used to assess dietary intake. Data on the polyphenol content in foods were estimated using the Phenol-Explorer database. The Short Portable Mental Status Questionnaire was used as a screening tool for cognitive status. Multivariate logistic regression analyses were used to assess the associations. Results: A significant inverse association between higher dietary intake of total flavonoids (Q4 vs. Q1: OR = 0.39, 95% CI: 0.15, 1.00) and impaired cognitive status was found. Among individual subclasses of flavonoids, flavan-3-ols (Q3 vs. Q1: OR = 0.30, 95% CI: 0.11, 0.76), catechins (Q4 vs. Q1: OR = 0.24, 95% CI: 0.08, 0.72), anthocyanins (Q4 vs. Q1: OR = 0.38, 95% CI: 0.14, 1.00) and flavonols (Q3 vs. Q1: OR = 0.30, 95% CI: 0.11, 0.76) were associated with cognitive health. Among individual polyphenols, only quercetin was associated with cognitive health (Q4 vs. Q1: OR = 0.30, 95% CI: 0.10, 0.91). Conclusions: The results of this study suggest that higher dietary intake of flavonoids may be associated with better cognitive health among adult individuals.
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