Following dietary guidelines may not provide flavanol intake levels linked to cardiovascular benefits. Digest
Previous studies have linked flavanols, a group of naturally occurring compounds produced by plants, to cardiovascular benefits. However, it is less clear whether following standard dietary advice is enough to reach levels associated with these benefits (about 500 mg per day). To answer that question, researchers turned to data from two studies in the United States and the United Kingdom.
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The analysis included more than 30,000 adults. Participants reported what they ate, and urine samples were used to estimate flavanol intake. The researchers then compared people with different levels of fruit and vegetable intake and overall diet quality to see how many reached a flavanol intake consistent with about 500 mg per day.
- Only 17.9% to 19.2% of participants had urinary marker levels consistent with the target flavanol intake of about 500 mg per day.
- Participants with the highest adherence to fruit and vegetable recommendations and overall diet-quality recommendations were still unlikely to reach the intake level linked to cardiovascular benefits.
- A separate analysis using food composition data pointed to a limitation of serving-based recommendations. Five daily servings of fruits and vegetables were often unlikely to provide the desired flavanol intake when foods reflected typical eating habits. The likelihood increased only when flavanol-rich options were selected.
The findings suggest that meeting fruit and vegetable recommendations does not reliably translate into the flavanol intake level linked to cardiovascular benefits. Flavanol content differs substantially across fruits and vegetables and even among different varieties of the same food. For example, flavanol levels can range from around 80 mg in 150 g of blueberries and 90 mg in 200 g of strawberries to roughly 250 mg in 200 g of blackberries, 300 mg in 250 g of cranberries, and 450 mg in 500 g of plums. As a result, two people eating similar amounts of fruits and vegetables may consume very different amounts of flavanols.
The data were observational, so they cannot determine how much changing food choices would affect urinary flavanol markers. In addition, the markers reflect only recent exposure and do not capture some flavanol compounds, including tea-specific flavanols. Still, the findings suggest that, for many people, simply eating more fruits and vegetables may not be enough, and that adding flavanol-rich foods to the diet may be necessary to reach levels linked to health benefits. In this clip, I highlight the health benefits of cocoa flavanols for circulation, cognition, and skin, plus my dosing insights.