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Document Type

Dissertation - University Access Only

Award Date


Degree Name

Doctor of Philosophy (PhD)


Health and Nutritional Sciences

First Advisor

C.Y. Wang


The overall objective of this study is to investigate the consumption of flavonoids, the prevalence of APOA1/C3/A4/A5 gene cluster, the interaction between these genes and flavonoids intake on how they impact cardiovascular disease (CVD) risks among U.S. adults. We focused on four aims: (1) to estimate the dietary flavonoids intake among U.S. adults; (2) to determine the effects of flavonoids consumption on blood lipids among U.S. adults; (3) to investigate the effect of APOA1/C3/A4/A5 gene cluster on blood lipids among U.S. adults; (4) to study the effect of APOA1/C3/A4/A5 gene cluster on the risks of CVDs and the interaction between these genes and flavonoids consumption. We used data from NHANES III to fulfill our aims. We calculated individual, subclasses and total flavonoid intakes. We received special permission from CDC and remotely accessed their genetic database for our data analysis. We studied the prevalence of APOA1/C3/A4/A5 gene cluster among U.S. adults. We did descriptive and regression analyses to determine the associations between flavonoids and lipids, genes and lipids, genes and CVDs and interactions between flavonoids consumption and genes on the risks of CVD. The study showed that estimated mean total flavonoid intake by U.S. adults was 305.3±17.5 mg/day. The flavan-3-ols (247±16.9mg/day) were the most abundant flavonoid class followed by flavanones (25.9±1.1mg/day), flavonols (19.6±0.9mg/day), anthocyanidins (9.5±0.6mg/day), isoflavones (2.4±0.1mg/day), and flavones (1.0±0.0mg/day). The three most dominant individual flavonoids were catechin (167.5±6.1mg/day), epicatechin (68.5±2.3mg/day) and hesperetin (19.1±1.0mg/day). People with high alcohol consumption, low educational level, low-income level, and smokers tended to consume less flavonoids. Tea (32.7%), beers (22.7%), wines (9.8%), banana (9.7%) and citrus fruits (6.8%) were the most important sources of total flavonoid intake. Our study also clearly demonstrated the impacts of socio-demographic factors on blood lipids levels among U.S. adults and revealed that higher consumption of total flavonoids, flavan_3_ols, flavone, and flavonol led to higher high-density lipoprotein cholesterol. Our data showed that allele frequencies of these lipid associated SNPs varied significantly by race/ethnicity. Several associations between specific alleles and lipid levels among the racial/ethnic groups were discovered and they have the potential to be used in predicting CVD risks. We have discovered several associations between these alleles and CVD risks. In addition, we also explored the interactions between dietary flavonoids and select genes on CVDs. We are the first to report that flavonoids intakes might protect people with certain alleles against CVD by lowering the risk of heart attack, heart failure and stroke. Our research provides the foundation on clarifying the effects and interactions of dietary flavonoids and APOA1/C3/A4/A5 gene cluster on CVDs.

Library of Congress Subject Headings

Cardiovascular system -- Diseases -- Risk factors -- United States.


Includes bibliographical references



Number of Pages



South Dakota State University


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