(P26-062-25) Dietary Sources and Amounts of Flavan-3-Ols for Cardiovascular Benefit – A Meta-Analysis

Objectives: Intake of flavan-3-ols, a subclass of flavonoids primarily found in cocoa, tea, fruits and vegetables, is associated with blood pressure (BP) reduction and improved vascular function. Current US intake levels of flavan-3-ols are unlikely to produce these health benefits. Recently, the Academy of Nutrition and Dietetics recommended consumption of 400-600 mg/d flavan-3-ols as part of a healthy diet to support cardiometabolic health. To better understand how individual flavan-3-ols dietary sources can contribute to optimized dietary intakes, this meta-analysis evaluated flavan-3-ols dose and effect of flavan-3-ol-rich foods and supplements on BP and vascular function for cardiovascular health.

Methods: PubMed was searched for randomized controlled trials (RCTs) published between 1946 and 2024 on BP and flow-mediated dilation (FMD) after flavan-3-ol-rich food, beverage, or supplement intake. Random-effects meta-analysis of 109 publications (145 RCTs and 5,205 participants) was performed.

Results: Flavan-3-ol interventions included cocoa products (58±30 g chocolate, 16±12 g cocoa), tea (699±268 ml), grape extract, apples (373±154 g) and pure compounds (epicatechin [81±28 mg (mean±SD]), epigallocatechin-gallate [350±260 mg]. Flavan-3-ol interventions significantly decreased office and 24h ambulatory BP after chronic repetitive intake, with larger effects in those with elevated and hypertensive baseline BP. FMD, a measure of vascular function, significantly increased after acute and repetitive consumption independent of BP.

Conclusions: This metanalysis demonstrates sufficient evidence exists to support recommendations that regular consumption of flavan-3-ol rich foods and beverages can lower BP, specifically in clinically relevant populations. Flavan-3-ol-rich foods analyzed demonstrate how individual foods can be included to support cardiometabolic health. Overall flavan-3-ol amounts from each food component used in the studies had large variation, delivering on average ~585±423 mg total flavan-3-ols, which falls within the previously recommended 400-600 mg/d. This evidence further informs recommendations for flavan-3-ols as part of lifestyle interventions for cardiovascular disease prevention and management.

Funding Sources: Funding was provided by an unrestricted research grant by Lipton Teas & Infusions.