Consumption of flavonoids and flavonoid-rich foods and risk of death in patients with Parkinson's disease: a prospective cohort study

DOI: https: //doi.org/10.1212/WNL.00000000013275

Commentary

Because flavonoids may exert neuroprotective effects, there is hope for their role in improving survival in patients with Parkinson's disease (PD), but evidence is lacking.

This study was a prospective investigation of the association between pre-diagnosis and post-diagnosis flavonoid intake and mortality risk in PD patients identified from two large ongoing cohorts of men and women in the United States.

A total of 599 women in the Nurses' Health Study and 652 men in the Health Professionals Follow-up Study who were newly diagnosed with PD during follow-up were also included. Dietary intake of these subclasses, along with major flavonoid-rich foods (tea, apples, berries, oranges and orange juice, and red wine), was repeatedly assessed based on a food frequency questionnaire validated every 4 years.

Mortality was ascertained by the National Mortality Index and state vital statistics records.

As a result, 944 deaths were reported during 32-34 years of follow-up, with higher total flavonoid intake prior to PD diagnosis associated with lower future risk of all-cause mortality in men. After adjusting for age, smoking status, total energy intake, and other covariates. The pooled HR comparing the extreme quartiles was 0.70 (95% CI: 0.40, 1.22; p-trend = 0.25), with significant heterogeneity (p = 0.01).

For the flavonoid subclass, the highest quartile of pre-diagnostic anthocyanin, flavone, and flavan-3-ol intake had a lower risk of death compared to the lowest quartile (pooled HRs = 0.66, 0.78, and 0.69, respectively, p < 0.05 for all), and for berries and red wine, participants consumed > = 3 servings/week, compared to <1 serving/month, indicating a lower risk. (Pooled HR = 0.77 (95% CI: 0.58, 1.02))

These results indicate that the higher the intake of subclasses such as total flavonoids, flavonols, anthocyanins, flavan-3-ols, polymers, berries, and red wine after PD diagnosis, the lower the risk of death. (All p < 0.05)