Dietary Intake of (poly)phenols and the Risk of All-Cause and Specific-Cause Mortality in the Mexican Teachers’ Cohort Study.

BackgroundObservational studies have reported that total (poly)phenol intake is associated with a reduction in all-cause and cardiovascular mortality, but mainly from high-income countries, where (poly)phenol intake may differ from low- and middle-income countries.ObjectiveOur objective was to evaluate the association between the intake of total, all classes and subclasses of (poly)phenols and the risk of all-cause and cause-specific mortality in a Mexican cohort.MethodsWe used data from the Mexican Teachers' Cohort, which included 95,313 adult women. After a median follow-up of 11.2 years, 1,725 deaths were reported, including 674 from cancer and 282 from cardiovascular diseases. (Poly)phenol intake was estimated using a validated food frequency questionnaire and the Phenol-Explorer database. Multivariable Cox models were applied to estimate the association between (poly)phenol intake and all-cause mortality and competitive risk models for cause-specific mortality.ResultsComparing extreme quartiles, total (poly)phenol intake was associated with lower risk of all-cause (HRQ4vs.Q1 0.88, 95% CI: 0.76-0.99, p trend=0.01) and cancer mortality (HRQ4vs.Q1 0.81, 95% CI: 0.64-0.99, p trend=0.02). Among (poly)phenol classes, phenolic acids, particularly hydroxycinnamic acids from coffee, showed an inverse association with all-cause (HRQ4vs.Q1 0.79, 95% CI: 0.69-0.91, p trend = 0.002) and cancer mortality (HRQ4vs.Q1 0.75, 95% CI: 0.61-0.94, p trend = 0.03). No associations were observed with flavonoids or with cardiovascular mortality.ConclusionOur study suggests that high (poly)phenol intake, primarily consisting of phenolic acids such as hydroxycinnamic acids, may have a protective effect on overall and cancer-mortality. Null associations for flavonoid intake might be due to the potential underestimation of their intake in this population.