In a recent study published in NutrientsIn this study, researchers assessed the risk of developing colorectal cancer (CRC) while taking flavonoids.
Flavonoids, found in plant foods, are a group of polyphenols divided into six subcategories – isoflavones, flavanols, flavones, anthocyanidins, flavanones, and flavonols. Flavonoids act in pathways involving cellular transformation, reproduction, and apoptosis. Several epidemiological studies have reported an inverse relationship between CRC risk and dietary flavonoids.
In this study, researchers analyzed the association of flavonoid intake with CRC risk and bacterial DNA proliferation. They used data from an Italian case-control study conducted in two hospitals during 2017-19. Subjects between the ages of 20 and 85 years scheduled for colonoscopy were eligible for inclusion in the review.
Excluded individuals are those with immunodeficiency, previous cancer, recent colonoscopy/hospitalization, dietary changes in the past month, liver/heart/renal failure, or specific inflammatory diseases. One hundred CRC cases and 200 observational cases were included. Among the group of controls, 100 had gastrointestinal adenoma (IA), while the rest were free of CRC or IA.
Controls were repeatedly matched for CRC cases by age, gender, and study center. Blind interviewers conducted questionnaires to obtain educational data, sociodemographic and anthropometric characteristics, and lifestyle habits. The Food Frequency Questionnaire (FFQ), which included 75 items on food, food groups, typical Italian recipes, and six items on alcohol consumption, was used to obtain data on each patient’s usual diet prior to colonoscopy.
Participants indicated their average weekly frequency of consuming each food item. A customized food composition database was developed using available information on the content of flavonoids in food products. The average daily intake of flavonoids was estimated using nutritional information from the FFQ. Total energy intake was similarly measured using the Italian Food Ingredients Database.
Blood samples were obtained prior to colonoscopy and used for metagenomic analyses. 16S rRNA abundance was estimated using quantitative polymerase chain reaction (qPCR). Triple intake of total flavonoids and each class of flavonoids was calculated. Logistic regression was used to calculate odds ratios for CRC and 95% confidence intervals using the lowest amount of tertile as a reference.
In addition, ORs for colorectal cancer were calculated separately. Distributions of 16S rRNA copies, indices of alpha diversity and relative abundance of operational taxonomic units (OTUs) between subjects in the first two and third intakes of flavanones and anthocyanidins were compared with the two-tailed Mann-Whitney test.
Most participants (62%) out of 300 were male; The mean age was 67 for the CRC subjects and 66 for the control group. Controls were more likely to be educated with lower alcohol consumption than CRC cases. Total flavonoid intake was not associated with CRC risk. However, there was a significant inverse relationship with CRC risk with regard to intake of flavanones and anthocyanidins.
The ORs for colon cancer for anthocyanidins were 0.32 and 0.22 for flavanones, while for rectal cancer, the ORs were 0.16 for anthocyanidins and 0.12 for flavanones. The associations between flavonoids and CRC risk remained consistent across age, gender and alcohol consumption strata. There were no significant differences in 16S rRNA gene transcription between tertiles of flavanones and anthocyanidin intake.
Similarly, no differences in the observed alpha and chow diversity indices were observed according to the trio of flavanone and anthocyanidin intake. In contrast, subjects in the highest anthocyanidin intake had inverse Shannon and Simpson indices lower than those in the lowest thirty.
Participants in the three times higher anthocyanidin/flavanone intake had a lower prevalence and relative abundance of OTUs than flavobacterium And the Legionella Species of those in the first two tertile.
Subjects in the highest amount of anthocyanidins tertile had a lower relative abundance of OTUs than Escherichia–Shigella taxonomic group. Those in the third quartile of flavanone intake showed a lower prevalence of OTUs of the family Diplorickettsiaceae, Pelomonas genus, the higher the prevalence of OTUs than Brevundimonas sex.
The results indicate that increased dietary flavanones and anthocyanidins reduce the risk of CRC. These subclasses of flavonoids have been associated with different compositions of bacteria. Specifically, they were inversely related to the OTUs of Legionella And the flavobacterium species and are positively correlated with OTUs from Brevundimonas sex. Overall, the results confirm the effect of taking anthocyanidins in preventing CRC and demonstrate that flavanones also reduce CRC risks.
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