Review: Dietary Flavonoids and Cancer Risk: Evidence From Human Population Studies

Abstract: High dietary intake of fruits and vegetables is consistently associated with a reduced risk of common human cancers, including cancers of the lung, breast, prostate, and colon. It is unknown which bioactive compound or compounds in plant foods provide the chemoprotective effects. One class of compounds currently under investigation is flavonoids, a large group of compounds with similar structure, consisting of two phenolic benzene rings linked to a heterocyclic pyran or pyrone. Although there are numerous in vitro and animal model data suggesting that flavonoids influence important cellular and molecular mechanisms related to carcinogenesis, such as cell cycle control and apoptosis, there are limited data from human population studies. This article reviews data from four cohort studies and six case-control studies, which have examined associations of flavonoid intake with cancer risk. There is consistent evidence from these studies that flavonoids, especially quercetin, may reduce the risk of lung cancer. Further research using new dietary databases for food flavonoid content is needed to confirm these findings before specific public health recommendations about flavonoids can be formulated.

[1]  A. Reunanen,et al.  Flavonoid intake and risk of chronic diseases. , 2002, The American journal of clinical nutrition.

[2]  E. Riboli,et al.  Intake of specific carotenoids and flavonoids and the risk of lung cancer in women in Barcelona, Spain. , 1998, Nutrition and cancer.

[3]  A. Folsom,et al.  Dietary catechins and cancer incidence among postmenopausal women: the Iowa Women's Health Study (United States) , 2002, Cancer Causes & Control.

[4]  Peter C. H. Hollman,et al.  Content of potentially anticarcinogenic flavonoids of 28 vegetables and 9 fruits commonly consumed in the Netherlands , 1992 .

[5]  M. Melamed,et al.  Dietary beta carotene and lung cancer risk in U.S. nonsmokers. , 1994, Journal of the National Cancer Institute.

[6]  V. Steele,et al.  Chemoprevention studies of the flavonoids quercetin and rutin in normal and azoxymethane-treated mouse colon. , 2000, Carcinogenesis.

[7]  J. Blumberg,et al.  The Role of Tea in Human Health: An Update , 2002, Journal of the American College of Nutrition.

[8]  Abelardo Avila Curiel Food, nutrition and the prevention of cancer: a global perspective , 2004 .

[9]  D. Albanes,et al.  Flavonol and flavone intake and the risk of cancer in male smokers (Finland) , 2001, Cancer Causes & Control.

[10]  J. Kepa,et al.  Induction of human NAD(P)H:quinone oxidoreductase (NQO1) gene expression by the flavonol quercetin. , 2001, Toxicology letters.

[11]  J. Lampe Isoflavonoid and lignan phytoestrogens as dietary biomarkers. , 2003, The Journal of nutrition.

[12]  P. Boffetta,et al.  Dietary antioxidants and lung cancer risk: a case-control study in Uruguay. , 1999, Nutrition and cancer.

[13]  G. Hageman,et al.  Assessment of the anticarcinogenic potential of raw garlic in humans. , 1997, Cancer letters.

[14]  E. Riboli,et al.  High intake of specific carotenoids and flavonoids does not reduce the risk of bladder cancer. , 1999, Nutrition and cancer.

[15]  G. Yang,et al.  Tea and tea polyphenols in cancer prevention. , 2000, The Journal of nutrition.

[16]  J. Potter,et al.  Vegetables, fruit, and cancer prevention: a review. , 1996, Journal of the American Dietetic Association.

[17]  J. McLachlan,et al.  Flavonoid phytochemicals regulate activator protein-1 signal transduction pathways in endometrial and kidney stable cell lines. , 2002, The Journal of nutrition.

[18]  W. Craig Phytochemicals: guardians of our health. , 1997, Journal of the American Dietetic Association.

[19]  L. Le Marchand,et al.  Intake of flavonoids and lung cancer. , 2000, Journal of the National Cancer Institute.

[20]  J. Potter Vegetables, fruit, and cancer , 2005, The Lancet.

[21]  C. la Vecchia,et al.  Flavonoid intake and breast cancer risk: a case–control study in Greece , 2003, British Journal of Cancer.

[22]  E. Feskens,et al.  Dietary catechins and epithelial cancer incidence: The Zutphen elderly study , 2001, International journal of cancer.

[23]  M. Chopra,et al.  Dietary supplementation with the anti-tumour promoter quercetin: its effects on matrix metalloproteinase gene regulation. , 2001, Mutation research.

[24]  L. Packer,et al.  Inhibition Mechanisms of Bioflavonoids Extracted from the Bark of Pinus maritima on the Expression of Proinflammatory Cytokines , 2001, Annals of the New York Academy of Sciences.

[25]  G. Beecher Proceedings of the Third International Scientific Symposium on Tea and Human Health: Role of Flavonoids in the Diet , 2003 .

[26]  T. Shapiro,et al.  Human metabolism and excretion of cancer chemoprotective glucosinolates and isothiocyanates of cruciferous vegetables. , 1998, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[27]  G. Hallmans,et al.  Phytoestrogens and prostate disease. , 2000, The Journal of nutrition.

[28]  J. Brooks,et al.  Potent induction of phase 2 enzymes in human prostate cells by sulforaphane. , 2001, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[29]  E. Feskens,et al.  Dietary flavonoids and cancer risk in the Zutphen Elderly Study. , 1994, Nutrition and cancer.

[30]  E. Riboli,et al.  Intake of specific carotenoids and flavonoids and the risk of gastric cancer in Spain , 1999, Cancer Causes & Control.

[31]  R. Ziegler,et al.  Vegetables, fruits, and carotenoids and the risk of cancer. , 1991, The American journal of clinical nutrition.

[32]  J. Manthey,et al.  Antiproliferative activities of citrus flavonoids against six human cancer cell lines. , 2002, Journal of agricultural and food chemistry.

[33]  J. Dwyer,et al.  Measuring flavonoid intake: need for advanced tools , 2002, Public Health Nutrition.

[34]  R. Ziegler,et al.  Nutrition and lung cancer , 2004, Cancer Causes & Control.

[35]  J. Potter,et al.  Vegetables, fruit, and cancer. I. Epidemiology , 1991, Cancer Causes & Control.

[36]  J. Potter,et al.  Vegetables, fruit, and cancer. II. Mechanisms , 1991, Cancer Causes & Control.

[37]  S. J. Lee,et al.  Induction of cell cycle arrest and apoptosis in human breast cancer cells by quercetin. , 2001, International journal of oncology.

[38]  N. O'Brien,et al.  Dietary flavonols: chemistry, food content, and metabolism. , 2002, Nutrition.