Higher dietary flavonoid intakes are associated with lower objectively measured body composition in women: evidence from discordant monozygotic twins

Amy Jennings, Alexander MacGregor, Tim Spector, Aedin Cassidy

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Background: Although dietary flavonoid intake has been associated with less weight gain there are limited data on its impact on fat mass and the contribution of genetic factors to this relationship has not previously been assessed. Objective: To examine associations between flavonoid intakes and fat mass. Design: In a study of 2734 healthy female twins aged 18-83 years from the TwinsUK registry intakes oftotalflavonoids and seven subclasses(flavanones, anthocyanins, flavan-3-ols, flavonols, flavones, polymers and proanthocyanidins) were calculated from food frequency questionnaires. Measures of DXA-derived fat mass included limb-to-trunk fat ratio (FMR), fat mass index and central fat mass index. Results: In cross-sectional multivariable analyses, higher intake of anthocyanins, flavonols and proanthocyanidins were associated with lower FMR, with differences between extreme quintiles of -0.03 (SE 0.02 P-trend = 0.02), -0.03 (SE 0.02 P-trend = 0.03) and -0.05 (SE 0.02 P-trend <0.01), respectively. These associationsremained significant even after further adjustment for fibre and total fruit and vegetable intakes. In monozygotic intake-discordant twin-pairs, those with higher intakes of flavan-3-ols (n= 154, P = 0.03), flavonols (n= 173, P = 0.03) and proanthocyanidins (n= 172, P < 0.01)had significantly lower FMR than their cotwins with within-pair differences of 3-4%. Furthermore, in confirmatory food-based analyses, twins with higher intake of flavonol- (onion, tea and pears, P = 0.01) and proanthocyanidin- (apples and cocoa drinks, P = 0.04) and, in younger participants (< 50 y) only, anthocyanin-rich foods (berries, pears, grapes and wine, P = 0.01) had 3-9% lower FMR than their co-twins. Conclusions: These data suggest that higher habitual intake of a number of flavonoids, including anthocyanins,flavan-3-ols,flavonols and proanthocyanidins, are associated with lower fat massindependent ofshared genetic and common environmental factors. Intervention trials are now needed to further examine the effect of flavonoid-rich foods on body composition.
Original languageEnglish
Pages (from-to)626-634
Number of pages9
JournalThe American Journal of Clinical Nutrition
Issue number3
Early online date18 Jan 2017
Publication statusPublished - Mar 2017


  • Flavonoids
  • diet
  • body composition
  • fat distribution
  • twins

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