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Division of Preventive Medicine (Y.S., J.E.M., J.E.B., H.D.S., S.L.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
Channing Laboratory (J.E.M.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
Department of Epidemiology (Y.S., J.E.M., J.E.B., S.L.), Harvard School of Public Health, Boston, Massachusetts
Department of Nutrition (Y.S.), Harvard School of Public Health, Boston, Massachusetts
Department of Ambulatory Care and Prevention, Harvard Medical School (J.E.B.), Boston, Massachusetts
Address correspondence to: Dr. Yiqing Song, Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Avenue East, Boston, MA 02215. E-mail: ysong{at}hsph.harvard.edu
Objective: Flavonoids, as antioxidants, may prevent the progressive impairment of pancreatic ß-cell function due to oxidative stress and may thus reduce the occurrence of type 2 diabetes. The aim of the present study was to examine the association of dietary flavonol and flavone intake with type 2 diabetes, and biomarkers of insulin resistance and systemic inflammation.
Methods: In 38,018 women aged 
45 y and free of cardiovascular disease, cancer and diabetes with an average 8.8y of follow-up, we calculated relative risks (RRs) of incident type 2 diabetes (1,614 events) according to dietary intake of total or individual flavonols and flavones and flavonoid-rich foods. We also measured and examined plasma concentrations of insulin, HbA1C, CRP, and IL-6 in relation to total flavonol and flavone intake among 344 nondiabetic women.
Results: During 332,905 person-years of follow-up, none of total flavonols and flavones, quercetin, kaempferol, myricetin, apigenin, and luteolin was significantly associated with risk of type 2 diabetes. Among flavonoid-rich foods, apple and tea consumption was associated with diabetes risk. Women consuming 1 apple/d showed a significant 28% reduced risk of type 2 diabetes compared with those who consumed no apples (the multivariate-adjusted RR = 0.72, 95% CI: 0.56, 0.92; p = 0.006 for trend). Tea consumption was also inversely associated with diabetes risk but with a borderline significant trend (4 cups/d vs. none: RR 0.73, 95% CI: 0.52–1.01; p for trend = 0.06). In 344 nondiabetic women, total intake of flavonols and flavones was not significantly related to plasma concentrations of fasting insulin, HbA1C, CRP, or IL-6.
Conclusions: These results do not support the hypothesis that high intake of flavonols and flavones reduces the development of type 2 diabetes, although we cannot rule out a modest inverse association with intake of apples and tea.
Key words: flavonoids, flavonols and flavones, type 2 diabetes, insulin resistance, systemic inflammation
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