Higher flavonoid intakes are beneficially associated with pulmonary function parameters; however, their association with chronic obstructive pulmonary disease (COPD) is unknown. This study aimed to examine associations between intakes of 1) total flavonoids, 2) flavonoid subclasses and 3) major flavonoid compounds with incident COPD in participants from the Danish Diet, Cancer and Health study.

This prospective cohort included 55 413 men and women without COPD, aged 50–65 years at recruitment. Habitual flavonoid intakes at baseline were estimated from a food frequency questionnaire using Phenol-Explorer. Danish nationwide registers were used to identify incident cases of COPD. Associations were modelled using restricted cubic splines within Cox proportional hazards models.

During 23 years of follow-up, 5557 participants were diagnosed with COPD. Of these, 4013 were current smokers, 1062 were former smokers and 482 were never-smokers. After multivariable adjustments, participants with the highest total flavonoid intakes had a 20% lower risk of COPD than those with the lowest intakes (quintile 5 versus quintile 1: HR 0.80, 95% CI 0.74–0.87); a 6–22% lower risk was observed for each flavonoid subclass. The inverse association between total flavonoid intake and COPD was present in both men and women but only in current smokers (HR 0.77, 95% CI 0.70–0.84) and former smokers (HR 0.82, 95% CI 0.69–0.97), not never-smokers. Furthermore, higher flavonoid intakes appeared to lessen, but not negate, the higher risk of COPD associated with smoking intensity.

Dietary flavonoids may be important for partially mitigating the risk of smoking-related COPD. However, smoking cessation should remain the highest priority.

较高的类黄酮摄入量与肺功能参数有益；然而，它们与慢性阻塞性肺病 (COPD) 的关系尚不清楚。本研究旨在检查丹麦饮食、癌症和健康研究参与者中 1) 总黄酮类化合物、2) 黄酮类化合物亚类和 3) 主要黄酮类化合物的摄入量与 COPD 事件之间的关联。

该前瞻性队列包括 55 413 名无 COPD 的男性和女性，招募时年龄为 50-65 岁。使用 Phenol-Explorer 从食物频率问卷估计基线时的习惯性类黄酮摄入量。丹麦全国登记册用于识别 COPD 事件病例。使用 Cox 比例风险模型中的受限三次样条对关联进行建模。

在 23 年的随访中，5557 名参与者被诊断出患有 COPD。其中，4013 人是当前吸烟者，1062 人曾吸烟，482 人从不吸烟。经过多变量调整后，总黄酮摄入量最高的参与者患 COPD 的风险比摄入量最低的参与者低 20%（五分之一与五分之一：HR 0.80，95% CI 0.74-0.87）；观察到每个类黄酮亚类的风险降低了 6-22%。总黄酮摄入量与慢性阻塞性肺病之间存在负相关，但仅在当前吸烟者（HR 0.77, 95% CI 0.70–0.84）和前吸烟者（HR 0.82, 95% CI 0.69–0.97）中存在，而不是从不-吸烟者。此外，较高的类黄酮摄入量似乎降低但不能否定与吸烟强度相关的 COPD 风险较高。

膳食类黄酮对于部分降低与吸烟相关的慢性阻塞性肺病的风险可能很重要。然而，戒烟仍应是重中之重。