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Original Research Communication |
1 From the Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, Netherlands (JMG, LJL, DAMVDK, AH, and JCMW); the Division of Human Nutrition and Epidemiology, Wageningen University, Netherlands (JMG); and the National Institute of Aging, Bethesda, MD (LJL).
Background: Dietary flavonoids may protect against cardiovascular disease, but evidence is still conflicting. Tea is the major source of flavonoids in Western populations.
Objective: The association of tea and flavonoid intake with incident myocardial infarction was examined in the general Dutch population.
Design: A longitudinal analysis was performed with the use of data from the Rotterdam Study—a population-based study of men and women aged 
55 y. Diet was assessed at baseline (1990–1993) with a validated semiquantitative food-frequency questionnaire. The analysis included 4807 subjects with no history of myocardial infarction, who were followed until 31 December 1997. Data were analyzed in a Cox regression model, with adjustment for age, sex, body mass index, smoking status, pack-years of cigarette smoking, education level, and daily intakes of alcohol, coffee, polyunsaturated fat, saturated fat, fiber, vitamin E, and total energy.
Results: During 5.6 y of follow-up, a total of 146 first myocardial infarctions occurred, 30 of which were fatal. The relative risk (RR) of incident myocardial infarction was lower in tea drinkers with a daily intake >375 mL (RR: 0.57; 95% CI: 0.33, 0.98) than in nontea drinkers. The inverse association with tea drinking was stronger for fatal events (0.30; 0.09, 0.94) than for nonfatal events (0.68; 0.37, 1.26). The intake of dietary flavonoids (quercetin + kaempferol + myricetin) was significantly inversely associated only with fatal myocardial infarction (0.35; 0.13, 0.98) in upper compared with lower tertiles of intake.
Conclusions: An increased intake of tea and flavonoids may contribute to the primary prevention of ischemic heart disease.
Key Words: Tea • flavonoids • myocardial infarction • ischemic heart disease • population-based study • the Rotterdam Study • Netherlands
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