Dietary Intake of (Poly)phenols and Risk of All-Cause and Cause-Specific Mortality in the Mexican Teachers' Cohort Study

Background: Observational studies have reported that total (poly)phenol intake is associated with a reduction in all-cause and cardiovascular mortality, but mainly from high-income countries, where (poly)phenol intake may differ from that of low- and middle-income countries. Objectives: Our objective was to evaluate the association between the intake of total, all classes, and subclasses of (poly)phenols and risk of all-cause and cause-specific fi c mortality in a Mexican cohort. Methods: We used data from the Mexican Teachers' ' Cohort, which included 95,313 adult females. After a median follow-up of 11.2 y, 1725 deaths were reported, including 674 from cancer and 282 from cardiovascular diseases. (Poly)phenol intake was estimated using a validated food frequency questionnaire and the Phenol-Explorer database. Multivariable Cox models were applied to estimate the association between (poly)phenol intake and all-cause mortality and competitive risk models for cause-specific fi c mortality. Results: Comparing extreme quartiles, total (poly)phenol intake was associated with lower risk of all-cause [hazard ratio (HR) Q4vs.Q1 : 0.88; 95% CI: 0.76, 0.99; P-trend = 0.01] and cancer mortality (HR Q4vs.Q1 : 0.81; 95% CI: 0.64, 0.99; P-trend = 0.02). Among (poly)phenol classes, phenolic acids, particularly hydroxycinnamic acids from coffee, showed an inverse association with all-cause (HR Q4vs.Q1 : 0.79; 95% CI: 0.69, 0.91; P-trend = 0.002) and cancer mortality (HR Q4vs.Q1 : 0.75; 95% CI: 0.61, 0.94; P-trend = 0.03). No associations were observed with fl avonoids or with cardiovascular mortality. Conclusion: Our study suggests that high (poly)phenol intake, primarily consisting of phenolic acids such as hydroxycinnamic acids, may have a protective effect on overall and cancer mortality. Null associations for fl avonoid intake might be due to the potential underestimation of their intake in this population.