Sex differences in (poly)phenol intake patterns and cardiovascular risk in Spanish adult population at high risk of cardiovascular disease: Cross-sectional findings

Background Men and women tend to follow different dietary patterns, but this is often disregarded when relating diet to health outcomes. Objective Our aim was to analyze (poly)phenol intake patterns and their association with cardiovascular risk (CVR) according to sex. Methods 6,633 participants were included in this cross-sectional study. The intake of 26 (poly)phenol classes/subclasses was included in the factor analysis obtaining for the total sample, men and women. Linear regression models were performed with the estimation of absolute CVR (Framingham equation) as the dependent variable, and each (poly)phenol pattern categorized into quintiles as the independent variable. Results For the total sample, (poly)phenol pattern three (olives and olive oil) was positively associated with CVR (β Q5vs.Q1 =2.71%, 95%CI=1.45, 3.96), presenting a higher risk of diabetes prevalence, smoked more and consumed more salt. In men, pattern three (olives and olive oil) was also positively associated with CVR (β Q5vs.Q1 =3.17%, 95%CI=1.58, 5.64), exhibiting higher prevalence of diabetes and higher sodium intake. Also in men, pattern four (coffee) was positively associated (β Q5vs.Q1 =1.99 %, 95%CI= 0.26, 3.73) presenting a higher diabetes and current smokers prevalence and higher sugar intake. In women, greater adherence to pattern four (coffee) was associated with higher CVR (β Q5vs.Q1 =2.19%, 95%CI= 1.05, 3.34). Conclusions We found sex differences in (poly)phenol intake patterns and in their associations with CVR. These differences may be explained by the fact that subjects at higher risk at baseline may be motivated to improve their dietary habit (reverse causality). Clinical Trial Registry number The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN89898870).