Comparison of Polyphenol Intakes in Relation to Dietary Patterns and Food Sources in the Adventist Health Study‐2 Cohort
Authors: Burkholder‐Cooley Nasira , Rajaram Sujatha , Haddad Ella , Fraser Gary , Jaceldo‐Siegl Karen 
Published: November 2023

Evidence suggests a relationship between polyphenol intake and health benefits. Polyphenol intake among a large United States cohort with diverse dietary practices ranging from meatless to omnivorous diets has not been previously evaluated. The primary aim of this study was to compare polyphenol intakes of several vegetarian and non‐vegetarian dietary patterns and to assess phenolic intake by food source. To characterize dietary intake, a food frequency questionnaire was obtained from 77,441 participants (mean age 57.1 years, 65% female) of the Adventist Health Study‐2 (AHS‐2). Dietary patterns were defined based on the absence of animal food consumption as vegan, lacto‐ovo‐, pesco‐, semi‐ and non‐vegetarian. Polyphenol intakes were calculated using the AHS‐2 Polyphenol Food Composition Database, which was developed using chromatography‐derived data from Phenol‐Explorer, US Department of Agriculture databases, and relevant literature. The mean total polyphenol intake in all subjects was 801 ± 356 mg/d and the main foods contributing to polyphenol intakes were coffee, fruits and fruit juices. Total polyphenol intake differed significantly between dietary patterns, with phenolic acids from coffee contributing the greatest variation. The dominant classes and sources of dietary polyphenols differed between vegetarian and non‐vegetarian diets. Among all subjects, mean total polyphenol intake was highest among non‐vegetarians (946 ± 924 mg/d), followed by pesco‐vegetarians (754 ± 629 mg/d) and was lowest in vegans (593 ± 415 mg/d). In the non‐coffee consuming subgroup, pesco‐vegetarians had the highest total polyphenol intake (613 ± 398 mg/d), followed by vegans (568 ± 343 mg/d), non‐vegetarians (532 ± 398 mg/d), lacto‐ovo‐vegetarians (528 ± 329 mg/d) and semi‐vegetarians (488 ± 334 mg/d). Flavonoid intake was highest in pesco‐vegetarians (336 ± 243 mg/d) and phenolic acid intake was highest in non‐vegetarians (548 ± 887 mg/d). In conclusion, coffee consumers appear to have a different dietary profile than non‐coffee consumers, including a reduced proportionate contribution of fruits, vegetables and legumes to total phenolic intake. Further evaluating these differences may be important in identifying relationships between plant‐based diets and health outcomes.Support or Funding InformationThis work was supported by National Cancer Institute grant 1U01CA152939, the McLean Endowment, and the Hulda Crooks Grant. The funding agencies had no role in the design and analysis of the study or in the writing of this abstract.
Percentiles of unadjusted total polyphenol intake stratified by dietary pattern

Percentiles of total polyphenol intake (mg/d)

n
5th percentile
50th percentile
95lh percentile

Dietary pattern

All
77441
176
556
2339

Vegan
5870
202
497
1288

Lacto‐ovo‐vegetarian
22372
189
498
1575

Pesco‐vegetarian
7604
202
580
1920

Semi‐vegetarian
4298
159
514
2066

Non‐vegetarian
37297
162
635
2847

Estimated mean total dietary polyphenol intake (mg/d) in coffee consumers and non‐coffee consumers in the Adventist Health Study‐2 cohort stratified by diet pattern* (mean values with 95% confidence intervals)

Total polyphenol intake (mg/d), mean (95% Cl)

Entire cohort
Coffee consumers
Non‐coffee consumers

Dietary pattern
n
Mean
95% Cl
n
Mean
95% Cl
n
Mean
95% Cl

All
74,668
562
559, 566
23,563
984
963, 1006
51,105
456
453, 458

Vegan
5,677
498a
488, 507
218
954a
870, 104
5,459
492a
483, 501

Lacto‐ovo‐vegetarian
21,666
504a
499, 509
3,720
929a
907, 951
17,946
463b
458, 467

Pesco‐vegetarian
7,318
589b
580, 599
1,713
949a
917, 981
5,605
484a
476, 492

Semi‐vegetarian
4,154
573b
560, 586
1,495
980a
946, 1016
2,659
432c
423, 442

Non‐vegetarian
35,853
662c
657, 668
16,417
1119b
1106, 1132
19,436
412d
409, 416

ANCOVA was used to determine differences in energy‐adjusted total dietary polyphenol intake between diet groups with covariates age, gender, race, BMI level, and physical activity level. Bonferroni adjustment for multiple comparisons.
Mean values within a column with unlike superscript letters indicate that pairwise comparisons were significantly different (p < 0.01).