Dietary intakes of flavonoids and carotenoids and the risk of developing an unhealthy metabolic phenotype.

This study was designed to investigate prospective associations between dietary habitual intakes of flavonoids and carotenoids and the development of an unhealthy metabolic phenotype. In this study 1114 adults, who had a healthy metabolic phenotype in the third examination cycle (2005-2008) participated. Dietary intakes of flavonoids and carotenoids were estimated using valid food frequency questionnaires evaluated during the study. Joint Scientific Statement criteria were used to define a metabolic unhealthy phenotype as meeting at least two criteria. During a median follow-up of 5.4 years, one standard deviation increase in total flavonoids reduced the risk of developing an unhealthy phenotype by 50% (95% CIs: 0.42-0.59), and inverse associations were observed for individual classes except anthocyanins, being the strongest for flavan-3-ols. Among carotenoid classes, a significant inverse association was only observed between lutein + zeaxanthin (HRs: 0.87, 95% CIs: 0.77-0.98) and the occurrence of an unhealthy phenotype. When data were stratified by baseline BMI, total flavonoids and individual classes of flavan-3-ols, flavonols, and flavones among both normal weight and overweight/obese individuals, isoflavones in those with excess weight and anthocyanins in normal weight individuals were inversely associated with the development of an unhealthy phenotype. Total carotenoids, β-carotene and lutein + zeaxanthin were significantly associated with the lower likelihood of the occurrence of an unhealthy phenotype, only among normal weight individuals. Higher intakes of flavonoids and their individual classes may contribute to the lower risk of a metabolic unhealthy phenotype in both normal weight and overweight/obese adults. Flavonoids may have more favorable metabolic health effects than carotenoids.