High Anthocyanin Intake Is Associated With a Reduced Risk of Myocardial Infarction in Young and Middle-Aged Women

Study Questions:

Do dietary flavonoids lower risk for myocardial infarction (MI) among women?


Data from the Nurses’ Health Study (NHS) II were used for the present analysis. Women, ages 25-42 years, who were apparently healthy at baseline (in 1989), were included. Intake of flavonoid subclasses was calculated from validated food-frequency questionnaires collected every 4 years using an updated and extended US Department of Agriculture database. The primary outcome of interest was myocardial infarction defined by World Health Criteria and confirmed by medical record review.


A total of 93,600 women were included. Over 18 years of follow-up, 405 cases of MI were reported. Mean age of cases at time of diagnosis was 48.9 years (range 33.8-60.8). Women with higher anthocyanin levels smoked less, exercised more, and had lower total fat and energy intakes and higher whole grain and fiber intakes. The flavonoid polymer subclass contributed most to total flavonoid intake (58-643 mg/d), whereas anthocyanin intakes ranged from 2 to 35 mg/d. An inverse association between higher intake of anthocyanins and risk of MI was observed (hazard ratio, 0.68; 95% confidence interval, 0.49-0.96; p = 0.03, highest vs. lowest quintiles) after multivariate adjustment. Combined intake of two anthocyanin-rich foods, blueberries and strawberries, tended to be associated with a decreased risk of MI (hazard ratio, 0.66; 95% confidence interval, 0.40-1.08) in a comparison of those consuming >3 servings a week and those with lower intake. Intakes of other flavonoid subclasses were not significantly associated with MI risk.


The investigators concluded that high intake of anthocyanins may reduce risk for MI in predominately young women.


As the authors point out, this was not a randomized controlled trial. Women who had higher intake of anthocyanins appeared to have other elements of a healthy lifestyle. These data do support the need to encourage patients towards a healthy diet, along with regular exercise. Furthermore, these data suggest that further research related to anthocyanins may add details related to their protective benefits.

Clinical Topics: Prevention, Diet

Keywords: Risk, Myocardial Infarction, Follow-Up Studies, Blueberry Plant, Medical Records, Flavonoids, Polymers, Middle Aged, Cereals, Energy Intake, Fragaria, United States

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