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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="FSRG Dietary Data Briefs [Internet]" /><meta name="citation_title" content="Dietary Intake and Sources of Flavonoids by Adults in the U.S." /><meta name="citation_publisher" content="United States Department of Agriculture (USDA)" /><meta name="citation_date" content="2023/10" /><meta name="citation_author" content="Rhonda S. Sebastian" /><meta name="citation_author" content="Joseph D. Goldman" /><meta name="citation_author" content="Alanna J. Moshfegh" /><meta name="citation_pmid" content="38768289" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK603802/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Dietary Intake and Sources of Flavonoids by Adults in the U.S." /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="United States Department of Agriculture (USDA)" /><meta name="DC.Contributor" content="Rhonda S. Sebastian" /><meta name="DC.Contributor" content="Joseph D. Goldman" /><meta name="DC.Contributor" content="Alanna J. Moshfegh" /><meta name="DC.Date" content="2023/10" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK603802/" /><meta name="description" content="National dietary guidance encourages intake of fruits and vegetables in part due to their potential health-promoting effects (1). Flavonoids, a large family of compounds made by plants, may play a role in conferring these benefits. Studies have found that intake of flavonoids is related to lower incidence of many chronic diseases, including cardiovascular disease, diabetes, and cancer (2–5). Flavonoids fall into six distinct classes based on their chemical structure: anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones (6). This report provides intake estimates and top food group contributors to flavonoids among adults 20 years of age and older using dietary data collected in What We Eat in America (WWEIA), NHANES 2017-2018." /><meta name="og:title" content="Dietary Intake and Sources of Flavonoids by Adults in the U.S." /><meta name="og:type" content="book" /><meta name="og:description" content="National dietary guidance encourages intake of fruits and vegetables in part due to their potential health-promoting effects (1). Flavonoids, a large family of compounds made by plants, may play a role in conferring these benefits. Studies have found that intake of flavonoids is related to lower incidence of many chronic diseases, including cardiovascular disease, diabetes, and cancer (2–5). Flavonoids fall into six distinct classes based on their chemical structure: anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones (6). This report provides intake estimates and top food group contributors to flavonoids among adults 20 years of age and older using dietary data collected in What We Eat in America (WWEIA), NHANES 2017-2018." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK603802/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-usdaddb-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/usdaddb/usdaddb49/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK603802/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>FSRG Dietary Data Briefs [Internet]. Beltsville (MD): United States Department of Agriculture (USDA); 2010-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/usdaddb/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-usdaddb-lrg.png" alt="Cover of FSRG Dietary Data Briefs" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>FSRG Dietary Data Briefs [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK603802_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK603802_dtls__"><div>Beltsville (MD): <a href="https://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research-center/food-surveys-research-group/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">United States Department of Agriculture (USDA)</a>; 2010-.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/usdaddb/">Contents</a></li></ul></div><div class="bk_noprnt"><form method="get" action="/books/n/usdaddb/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/usdaddb/usdaddb50/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/usdaddb/usdaddb48/" title="Next page in this title">Next ></a></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK603802_"><span class="label">Dietary Data Brief No. 49</span><span class="title" itemprop="name">Dietary Intake and Sources of Flavonoids by Adults in the U.S.</span></h1><div class="subtitle whole_rhythm">What We Eat in America, NHANES 2017-2018</div><p class="contrib-group"><span itemprop="author">Rhonda S. Sebastian</span>, MA, <span itemprop="author">Joseph D. Goldman</span>, MA, and <span itemprop="author">Alanna J. Moshfegh</span>, MS, RD.</p><p class="small">Published online: October 2023.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>National dietary guidance encourages intake of fruits and vegetables in part due to their potential health-promoting effects (<a class="bk_pop" href="#usdaddb49.ref1">1</a>). Flavonoids, a large family of compounds made by plants, may play a role in conferring these benefits. Studies have found that intake of flavonoids is related to lower incidence of many chronic diseases, including cardiovascular disease, diabetes, and cancer (<a class="bk_pop" href="#usdaddb49.ref2"><sup>2</sup></a><sup>–</sup><a class="bk_pop" href="#usdaddb49.ref5"><sup>5</sup></a>). Flavonoids fall into six distinct classes based on their chemical structure: anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones (<a class="bk_pop" href="#usdaddb49.ref6">6</a>). This report provides intake estimates and top food group contributors to flavonoids among adults 20 years of age and older using dietary data collected in What We Eat in America (WWEIA), NHANES 2017-2018.</p><div id="usdaddb49.box1" class="box"><h3><span class="title">Highlights</span></h3><dl class="temp-labeled-list"><dt>⏩</dt><dd><p class="no_top_margin">On any given day, 99% of adults consume foods and/or beverages containing flavonoids, albeit in small amounts for most. Intake does not vary by gender.</p></dd><dt>⏩</dt><dd><p class="no_top_margin">The median flavonoid intake of non-Hispanic Asian adults is higher than that of all other race/ethnic groups.</p></dd><dt>⏩</dt><dd><p class="no_top_margin">Adults in the highest category of family income have higher median flavonoid intake relative to those with lower incomes.</p></dd><dt>⏩</dt><dd><p class="no_top_margin">Tea accounts for 91% of flavan-3-ol intake and 75% of total flavonoid intake. It is also among the top sources of flavonols and flavones.</p></dd><dt>⏩</dt><dd><p class="no_top_margin">Berries and grapes - eaten alone, as juices, and in mixtures - are the top food contributors to anthocyanidin intake.</p></dd><dt>⏩</dt><dd><p class="no_top_margin">Oranges and orange juice account for over two-thirds of flavanone intake.</p></dd><dt>⏩</dt><dd><p class="no_top_margin">Soy-containing nutritional products are the primary source of isoflavone intake.</p></dd></dl></div><div id="usdaddb49.s1"><h2 id="_usdaddb49_s1_">Who consumes flavonoids, and does intake vary by gender?</h2><p>Overall, nearly all (99%) of adults consume foods and/or beverages containing flavonoids on any given day. For most, intakes are very low (<i>see</i>
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<a href="#usdaddb49.s8">Statistical notes</a>
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<i>on page 7).</i></p><p>Mean and median flavonoid intakes among males and females 20 years of age and older are shown in <a class="figpopup" href="/books/NBK603802/figure/usdaddb49.fig1/?report=objectonly" target="object" rid-figpopup="figusdaddb49fig1" rid-ob="figobusdaddb49fig1">Figure 1</a>
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<i>(see</i>
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<a href="#usdaddb49.s6">definition</a>
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<i>of “median” on page 6).</i> Within each age group, the median intake estimates do not vary by gender (p>0.001).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figusdaddb49fig1" co-legend-rid="figlgndusdaddb49fig1"><a href="/books/NBK603802/figure/usdaddb49.fig1/?report=objectonly" target="object" title="Figure 1" class="img_link icnblk_img figpopup" rid-figpopup="figusdaddb49fig1" rid-ob="figobusdaddb49fig1"><img class="small-thumb" src="/books/NBK603802/bin/usdaddb49f1.gif" src-large="/books/NBK603802/bin/usdaddb49f1.jpg" alt="Figure 1. Total flavonoid intake (mg) among U.S. adults 20+ years, by sex and age, 2017-2018." /></a><div class="icnblk_cntnt" id="figlgndusdaddb49fig1"><h4 id="usdaddb49.fig1"><a href="/books/NBK603802/figure/usdaddb49.fig1/?report=objectonly" target="object" rid-ob="figobusdaddb49fig1">Figure 1</a></h4><p class="float-caption no_bottom_margin">Total flavonoid intake (mg) among U.S. adults 20+ years, by sex and age, 2017-2018. </p></div></div></div><div id="usdaddb49.s2"><h2 id="_usdaddb49_s2_">Does flavonoid intake vary by race/ethnicity or family income?</h2><p>Total flavonoid intakes among adults by race/ethnic group are presented in <a class="figpopup" href="/books/NBK603802/figure/usdaddb49.fig2/?report=objectonly" target="object" rid-figpopup="figusdaddb49fig2" rid-ob="figobusdaddb49fig2">Figure 2</a>. The median intake of non-Hispanic Black adults is lower than that of non-Hispanic White adults, and the median intake of non-Hispanic Asian adults is higher than that of all other groups (p<0.001).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figusdaddb49fig2" co-legend-rid="figlgndusdaddb49fig2"><a href="/books/NBK603802/figure/usdaddb49.fig2/?report=objectonly" target="object" title="Figure 2" class="img_link icnblk_img figpopup" rid-figpopup="figusdaddb49fig2" rid-ob="figobusdaddb49fig2"><img class="small-thumb" src="/books/NBK603802/bin/usdaddb49f2.gif" src-large="/books/NBK603802/bin/usdaddb49f2.jpg" alt="Figure 2. Flavonoid intake (mg) among U.S. adults 20+ years by race/ethnicity, 2017–2018." /></a><div class="icnblk_cntnt" id="figlgndusdaddb49fig2"><h4 id="usdaddb49.fig2"><a href="/books/NBK603802/figure/usdaddb49.fig2/?report=objectonly" target="object" rid-ob="figobusdaddb49fig2">Figure 2</a></h4><p class="float-caption no_bottom_margin">Flavonoid intake (mg) among U.S. adults 20+ years by race/ethnicity, 2017–2018. <sup>a,b,c</sup> Medians with different letters were significantly different from one another (p<0.001; See Statistical notes on page 7). </p></div></div><p>As shown in <a class="figpopup" href="/books/NBK603802/figure/usdaddb49.fig3/?report=objectonly" target="object" rid-figpopup="figusdaddb49fig3" rid-ob="figobusdaddb49fig3">Figure 3</a>, median intake of flavonoids is greater among adults in the highest income category relative to those in either the lowest or the middle income category <i>(see</i>
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<a href="#usdaddb49.s6">definition</a>
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<i>of family income as a percentage of poverty level on page 6)</i></p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figusdaddb49fig3" co-legend-rid="figlgndusdaddb49fig3"><a href="/books/NBK603802/figure/usdaddb49.fig3/?report=objectonly" target="object" title="Figure 3" class="img_link icnblk_img figpopup" rid-figpopup="figusdaddb49fig3" rid-ob="figobusdaddb49fig3"><img class="small-thumb" src="/books/NBK603802/bin/usdaddb49f3.gif" src-large="/books/NBK603802/bin/usdaddb49f3.jpg" alt="Figure 3. Flavonoid intake (mg) among U.S. adults 20+ years by family income, 2017-2018." /></a><div class="icnblk_cntnt" id="figlgndusdaddb49fig3"><h4 id="usdaddb49.fig3"><a href="/books/NBK603802/figure/usdaddb49.fig3/?report=objectonly" target="object" rid-ob="figobusdaddb49fig3">Figure 3</a></h4><p class="float-caption no_bottom_margin">Flavonoid intake (mg) among U.S. adults 20+ years by family income, 2017-2018. <sup>a,b</sup> Medians with different letters were significantly different from one another (p<0.001; See Statistical notes on page 7). </p></div></div></div><div id="usdaddb49.s3"><h2 id="_usdaddb49_s3_">What is the intake of flavonoid classes among U.S. adults?</h2><p>The mean and median intake of flavan-3-ols, flavonols, anthocyanidins, flavanones, flavones, and isoflavones are shown in <a class="figpopup" href="/books/NBK603802/figure/usdaddb49.fig4/?report=objectonly" target="object" rid-figpopup="figusdaddb49fig4" rid-ob="figobusdaddb49fig4">Figure 4</a>. Flavan-3-ols account for nearly 80% of total flavonoid intake.</p><p>Though some flavonoid classes are consumed by nearly all adults on any given day, for others, a large percentage of adults consume none at all. For example, whereas 99 percent of adults have non-zero intake of flavonols, only 45 percent consume any isoflavone-containing foods.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figusdaddb49fig4" co-legend-rid="figlgndusdaddb49fig4"><a href="/books/NBK603802/figure/usdaddb49.fig4/?report=objectonly" target="object" title="Figure 4" class="img_link icnblk_img figpopup" rid-figpopup="figusdaddb49fig4" rid-ob="figobusdaddb49fig4"><img class="small-thumb" src="/books/NBK603802/bin/usdaddb49f4.gif" src-large="/books/NBK603802/bin/usdaddb49f4.jpg" alt="Figure 4. Flavonoid class intake1 (mg) among U.S. adults 20+ years, 2017-2018." /></a><div class="icnblk_cntnt" id="figlgndusdaddb49fig4"><h4 id="usdaddb49.fig4"><a href="/books/NBK603802/figure/usdaddb49.fig4/?report=objectonly" target="object" rid-ob="figobusdaddb49fig4">Figure 4</a></h4><p class="float-caption no_bottom_margin">Flavonoid class intake<sup>1</sup> (mg) among U.S. adults 20+ years, 2017-2018. <sup>1</sup> The percentage of adults reporting each flavonoid class on the intake day are as follows: flavan-3-ols, 93%; flavonols, 99%; anthocyanidins, 63%; flavanones, 58%; flavones, 86%, isoflavones, <a href="/books/NBK603802/figure/usdaddb49.fig4/?report=objectonly" target="object" rid-ob="figobusdaddb49fig4">(more...)</a></p></div></div></div><div id="usdaddb49.s4"><h2 id="_usdaddb49_s4_">What are the top contributors to total flavonoids, flavan-3-ols, flavonols, and anthocyanidins?</h2><p>As shown in <a href="/books/NBK603802/table/usdaddb49.tab1/?report=objectonly" target="object" rid-ob="figobusdaddb49tab1">Table 1</a>, black and green tea provide 91% of flavan-3-ol intake. Because this class comprises the majority of flavonoid intake (<i>see</i>
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<a class="figpopup" href="/books/NBK603802/figure/usdaddb49.fig4/?report=objectonly" target="object" rid-figpopup="figusdaddb49fig4" rid-ob="figobusdaddb49fig4">Figure 4</a>
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<i>on page 3</i>), tea is the top contributor to flavonoids among U.S. adults, accounting for 75% of total intake overall (54% from black, 20% from green). <a href="/books/NBK603802/table/usdaddb49.tab1/?report=objectonly" target="object" rid-ob="figobusdaddb49tab1">Table 1</a> shows that tea also contributes approximately one-third of daily intake of flavonols. Vegetables, particularly onions and dark greens, are high in flavonol content as well. These foods are common ingredients in mixed dishes. Berries – eaten alone or as a component of foods such as nuts and seed-based trail mixes and flavored milk and other dairy drinks- account for over half of anthocyanidin intake. Grapes and grape- based products, including juice and red wine, are the other top dietary sources of this class.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figusdaddb49tab1"><a href="/books/NBK603802/table/usdaddb49.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img" rid-ob="figobusdaddb49tab1"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="usdaddb49.tab1"><a href="/books/NBK603802/table/usdaddb49.tab1/?report=objectonly" target="object" rid-ob="figobusdaddb49tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Food and beverage groups<sup></sup> that are top contributors (account for 5% or more of total intake) of flavan-3-ols, flavonols, and anthocyanidins, adults 20+ years, 2017–2018. </p></div></div></div><div id="usdaddb49.s5"><h2 id="_usdaddb49_s5_">What are the top contributors to flavanones, flavones, and isoflavones?</h2><p>The main contributors to flavanones reflect the fact that this class is found exclusively in citrus fruits (<a href="/books/NBK603802/table/usdaddb49.tab2/?report=objectonly" target="object" rid-ob="figobusdaddb49tab2">Table 2</a>). Dietary sources of flavones include vegetables, which are consumed alone or in mixed dishes. Hot peppers have high flavone content, and explain why condiments and sauces are top contributions to intake of this class. Green tea is also a notable source of flavones. Isoflavones are found exclusively in products containing soy in some form, e.g., soy protein isolate and tofu.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figusdaddb49tab2"><a href="/books/NBK603802/table/usdaddb49.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img" rid-ob="figobusdaddb49tab2"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="usdaddb49.tab2"><a href="/books/NBK603802/table/usdaddb49.tab2/?report=objectonly" target="object" rid-ob="figobusdaddb49tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Food and beverage groups<sup></sup> that are top contributors (account for 5% or more of total intake) of flavanones, flavones, and isoflavones, adults 20+ years, 2017–2018. </p></div></div></div><div id="usdaddb49.s6"><h2 id="_usdaddb49_s6_">Definitions</h2><dl><dt id="usdaddb49.abb_DL1_DI1">Family income (as percentage of poverty level)</dt><dd><p>the ratio of family income to poverty expressed as a percentage. The Department of Health and Human Services’ poverty guidelines were used as the poverty measure to calculate the ratio (<a class="bk_pop" href="#usdaddb49.ref7">7</a>).</p></dd><dt id="usdaddb49.abb_DL1_DI2">Food groups</dt><dd><p>In general, food/beverage groups listed as food sources of total flavonoids/flavonoid classes correspond to the 2017–2018 WWEIA Food Categories (<i>see</i>
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<a href="#usdaddb49.s6">definition</a>
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<i>and link below</i>). Some WWEIA categories were divided into smaller groups to underscore foods exceptionally high in a particular flavonoid class. For example, foods in the WWEIA category “Blueberries and other berries” were split into three groups- “blueberries”; “cranberries”; and “blackberries, raspberries” because berries are a top contributor to anthocyanidin intake. (Note: “Strawberries” is a separate WWEIA category.) In other cases, multiple WWEIA categories were merged to create a new group.</p></dd><dt id="usdaddb49.abb_DL1_DI3">Median</dt><dd><p>The middle value within a set of data values for a given variable. Half of all values are less than the median, and half of all values are greater than the median. In a symmetric distribution, the mean and median are similar. In a right-skewed distribution, the mean can be much larger than the median.</p></dd><dt id="usdaddb49.abb_DL1_DI4">Percentile</dt><dd><p>Value below which a certain percentage of the values in a data set are found, e.g., if a value of 200 is at the 75th percentile, 75 percent of the values are below 200, and 25 percent are above 200. The median is analogous to the 50th percentile for a given set of data values.</p></dd><dt id="usdaddb49.abb_DL1_DI5">Skewed distribution</dt><dd><p>a set of values for a variable that when plotted form an asymmetric, or non-normal (i.e., not bell-shaped) curve. Flavonoid intake distributions exhibit a right skew, characterized by a large proportion of zero/low intake observations and a long right tail reflecting a relatively small proportion of very high intake observations.</p></dd><dt id="usdaddb49.abb_DL1_DI6">Total flavonoids</dt><dd><p>Summative total of the following flavonoid classes: anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones. Excludes the contribution of dietary supplements.</p></dd><dt id="usdaddb49.abb_DL1_DI7">WWEIA Food Categories</dt><dd><p>A scheme applied to classify each food and beverage reported in WWEIA, NHANES into one of approximately 165 mutually exclusive categories (<a href="http://www.ars.usda.gov/Services/docs.htm?docid=23429" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www.ars.usda.gov/Services/docs.htm?docid=23429</a>).</p></dd></dl></div><div id="usdaddb49.s7"><h2 id="_usdaddb49_s7_">Data source</h2><p>Estimates in this data brief are based on one day of data from WWEIA, NHANES 2017–2018 (<a class="bk_pop" href="#usdaddb49.ref8">8</a>). Day 1 dietary data were collected in person using the 5-step USDA Automated Multiple-Pass Method for the 24-hour recall (<a class="bk_pop" href="#usdaddb49.ref9">9</a>). A total of 4,742 individuals age ≥20 years (2307 males and 2435 females) provided complete and reliable dietary intake data. In the race-specific analysis <i>(page 2)</i>, non-Hispanic individuals who were multi-racial or of a racial group other than those listed (n = 236) were excluded. Similarly, individuals who did not report family income (n = 558) were excluded from the income-based analysis <i>(page 2).</i> Intakes of flavonoids were calculated using the 2017–2018 versions of the Database of Flavonoid Values for USDA Food Codes (<a class="bk_pop" href="#usdaddb49.ref10">10</a>) and USDA’s Food and Nutrient Database for Dietary Studies (<a class="bk_pop" href="#usdaddb49.ref11">11</a>).</p></div><div id="usdaddb49.s8"><h2 id="_usdaddb49_s8_">Statistical notes</h2><p>The figure below shows the intake distribution of total flavonoids among adults, and the mean, median, and selected percentiles of that distribution. <i>(See</i>
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<a href="#usdaddb49.s6">definitions</a>
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<i>of “total flavonoids”, “median” and “percentile” on page 6)</i>. Flavonoids are highly concentrated in some plant foods, but low or absent in others. Individuals who consume foods in the former group have high intakes, while those who do not have relatively low intakes, resulting in highly skewed intake distributions. <i>(See</i>
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<a href="#usdaddb49.s6">definition</a>
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<i>of “skewed distribution” on page 6.)</i> Strong right-skewness as displayed here can cause means to be much larger than medians.</p><div id="usdaddb49.fig5" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Distribution1%20of%20total%20flavonoid%20intake%20by%20U.S.%20adults%2020%2B%20years%2C%202017-2018.&p=BOOKS&id=603802_usdaddb49f5.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK603802/bin/usdaddb49f5.jpg" alt="Distribution1 of total flavonoid intake by U.S. adults 20+ years, 2017-2018." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="title">Distribution<a href="#usdaddb49.fig5.fn1"><sup>1</sup></a> of total flavonoid intake by U.S. adults 20+ years, 2017-2018</span></h3><div class="caption"><p id="usdaddb49.fig5.fn1"><sup>1</sup> Mean (red line), and selected percentiles shown. Intakes above 1000 mg/d not displayed.</p></div><p>SOURCE: WWEIA, NHANES 2017-2018, day 1, adults 20 years of age and older.</p></div><p>Because flavonoid intake distributions did not meet all assumptions for parametric testing (i.e., data did not show a normal distribution), nonparametric testing were employed to detect differences in intake between population groups. Specifically, median intakes were compared using the quantile test described in (<a class="bk_pop" href="#usdaddb49.ref12">12</a>).</p><p>Sample weights were applied in all analyses to produce nationally representative estimates.</p></div><div id="usdaddb49.rl.r1"><h2 id="_usdaddb49_rl_r1_">References</h2><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="usdaddb49.ref1">Dietary Guidelines Advisory Committee. 2020. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC. Available: 10.52570/DGAC2020. [<a href="http://dx.crossref.org/10.52570/DGAC2020" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="usdaddb49.ref2">Li
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T, Zhao
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Y, Yuan
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L, et al
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Total dietary flavonoid intake and risk of cardiometabolic diseases: A does-response meta-analysis of prospective cohort studies [published online ahead of print, 2022 Sep 23]. Crit Rev Food Sci Nutr. 2022;1–13. doi:10.1080/10408398.2022.2126427. [<a href="https://pubmed.ncbi.nlm.nih.gov/36148848" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36148848</span></a>] [<a href="http://dx.crossref.org/10.1080/10408398.2022.2126427" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="usdaddb49.ref3">Zamora-Ros
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R, Forouhi
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NG, Sharp
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SJ, et al
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The association between dietary flavonoid and lignan intakes and incident type 2 diabetes in European populations: the EPIC-InterAct study. Diabetes Care. 2013;36(12):3961–3970. doi:10.2337/dc13-0877
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[<a href="/pmc/articles/PMC3836159/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3836159</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24130345" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24130345</span></a>] [<a href="http://dx.crossref.org/10.2337/dc13-0877" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="usdaddb49.ref4">Kopustinskiene
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DM, Jakstas
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V, Savickas
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A, Bernatoniene
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J. Flavonoids as Anticancer Agents. Nutrients. 2020;12(2):457. Published 2020 Feb 12. doi:10.3390/nu12020457
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[<a href="/pmc/articles/PMC7071196/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7071196</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32059369" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32059369</span></a>] [<a href="http://dx.crossref.org/10.3390/nu12020457" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="usdaddb49.ref5">Rossi
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M, Bosetti
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C, Negri
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E, Lagiou
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P, La Vecchia
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C. Flavonoids, proanthocyanidins, and cancer risk: a network of case-control studies from Italy. Nutr Cancer. 2010;62(7):871–877. doi:10.1080/01635581.2010.509534
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[<a href="https://pubmed.ncbi.nlm.nih.gov/20924962" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20924962</span></a>] [<a href="http://dx.crossref.org/10.1080/01635581.2010.509534" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="usdaddb49.ref6">Beecher
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GR. Overview of dietary flavonoids: nomenclature, occurrence and intake. J Nutr. 2003;133(10:3248S–3254S. Doi:10.1093/jn/133.10.3248S. [<a href="https://pubmed.ncbi.nlm.nih.gov/14519822" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14519822</span></a>] [<a href="http://dx.crossref.org/10.1093/jn/133.10.3248S" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="usdaddb49.ref7">U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Poverty guidelines. <a href="https://aspe.hhs.gov/poverty-guidelines" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://aspe<wbr style="display:inline-block"></wbr>.hhs.gov/poverty-guidelines</a>. Accessed March 6, 2023.</div></dd><dt>8.</dt><dd><div class="bk_ref" id="usdaddb49.ref8">Centers for Disease Control and Prevention, National Center for Health Statistics. NHANES Questionnaires, Datasets, and Related Documentation. <a href="https://wwwn.cdc.gov/nchs/nhanes/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://wwwn<wbr style="display:inline-block"></wbr>.cdc.gov/nchs/nhanes/</a>. Accessed March 15, 2023.</div></dd><dt>9.</dt><dd><div class="bk_ref" id="usdaddb49.ref9">USDA Food Surveys Research Group. AMPM - USDA Automated Multiple Pass Method. <a href="http://www.ars.usda.gov/nea/bhnrc/fsrg/ampm" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">www<wbr style="display:inline-block"></wbr>.ars.usda.gov/nea/bhnrc/fsrg/ampm</a>. Accessed February 2, 2023.</div></dd><dt>10.</dt><dd><div class="bk_ref" id="usdaddb49.ref10">USDA Food Surveys Research Group. Flavonoid Database. <a href="http://www.ars.usda.gov/northeast-area/beltsville-md-bhnrc/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/fndds-flavonoid-database/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">www<wbr style="display:inline-block"></wbr>.ars.usda.gov/northeast-area<wbr style="display:inline-block"></wbr>/beltsville-md-bhnrc<wbr style="display:inline-block"></wbr>/beltsville-human-nutrition-research-center<wbr style="display:inline-block"></wbr>/food-surveys-research-group<wbr style="display:inline-block"></wbr>/docs/fndds-flavonoid-database/</a>. Accessed February 2, 2023.</div></dd><dt>11.</dt><dd><div class="bk_ref" id="usdaddb49.ref11">USDA Food Surveys Research Group. FNDDS Documentation and Databases. <a href="http://www.ars.usda.gov/fsrg/fndds/download" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">www<wbr style="display:inline-block"></wbr>.ars.usda.gov/fsrg/fndds/download</a>. Accessed February 2, 2023.</div></dd><dt>12.</dt><dd><div class="bk_ref" id="usdaddb49.ref12">Pan
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R, Caldwell
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KL. Median and quantile tests under complex survey design using SAS and R. Comput Methods Programs Biomed. 2014;117(2):292–297. doi:10.1016/j.cmpb.2014.07.007.
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[<a href="/pmc/articles/PMC5708173/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5708173</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25123100" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25123100</span></a>] [<a href="http://dx.crossref.org/10.1016/j.cmpb.2014.07.007" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin"><div>
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<span class="mixed-citation" id="usdaddb49.suggestedcitation">Sebastian RS, Goldman JD, and Moshfegh AJ. <em>Dietary Intake and Sources of Flavonoids by Adults in the U.S.: What We Eat in America, NHANES 2017-2018.</em> Food Surveys Research Group Dietary Data Brief No. 49. October 2023.</span>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK603802/?report=reader">PubReader</a></li><li><a href="/books/NBK603802/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK603802" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK603802" style="display:none" title="Cite this Page"><div class="bk_tt">Sebastian RS, Goldman JD, Moshfegh AJ. Dietary Intake and Sources of Flavonoids by Adults in the U.S.What We Eat in America, NHANES 2017-2018. 2023 Oct. In: FSRG Dietary Data Briefs [Internet]. Beltsville (MD): United States Department of Agriculture (USDA); 2010-. Dietary Data Brief No. 49.<span class="bk_cite_avail"></span></div></div></li><li><a href="/books/NBK603802/pdf/Bookshelf_NBK603802.pdf">PDF version of this page</a> (850K)</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#usdaddb49.s1" ref="log$=inpage&link_id=inpage">Who consumes flavonoids, and does intake vary by gender?</a></li><li><a href="#usdaddb49.s2" ref="log$=inpage&link_id=inpage">Does flavonoid intake vary by race/ethnicity or family income?</a></li><li><a href="#usdaddb49.s3" ref="log$=inpage&link_id=inpage">What is the intake of flavonoid classes among U.S. adults?</a></li><li><a href="#usdaddb49.s4" ref="log$=inpage&link_id=inpage">What are the top contributors to total flavonoids, flavan-3-ols, flavonols, and anthocyanidins?</a></li><li><a href="#usdaddb49.s5" ref="log$=inpage&link_id=inpage">What are the top contributors to flavanones, flavones, and isoflavones?</a></li><li><a href="#usdaddb49.s6" ref="log$=inpage&link_id=inpage">Definitions</a></li><li><a href="#usdaddb49.s7" ref="log$=inpage&link_id=inpage">Data source</a></li><li><a href="#usdaddb49.s8" ref="log$=inpage&link_id=inpage">Statistical notes</a></li><li><a href="#usdaddb49.rl.r1" ref="log$=inpage&link_id=inpage">References</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related information</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="discovery_db_links" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pmc&DbFrom=books&Cmd=Link&LinkName=books_pmc_refs&IdsFromResult=5625802" ref="log$=recordlinks">PMC</a><div class="brieflinkpop offscreen_noflow">PubMed Central citations</div></li><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pubmed&DbFrom=books&Cmd=Link&LinkName=books_pubmed_refs&IdsFromResult=5625802" ref="log$=recordlinks">PubMed</a><div class="brieflinkpop offscreen_noflow">Links to PubMed</div></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/38134552" ref="ordinalpos=1&linkpos=1&log$=relatedarticles&logdbfrom=pubmed">Association between dietary flavonoid intake and depressive symptoms: A cross-sectional research.</a><span class="source">[Gen Hosp Psychiatry. 2024]</span><div class="brieflinkpop offscreen_noflow">Association between dietary flavonoid intake and depressive symptoms: A cross-sectional research.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Deng MG, Liu F, Wang K, Zhang MJ, Feng Q, Liu J. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Gen Hosp Psychiatry. 2024 Jan-Feb; 86:75-84. 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Epub 2024 Feb 26.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/25272572" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Flavonoids--food sources and health benefits.</a><span class="source">[Rocz Panstw Zakl Hig. 2014]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Flavonoids--food sources and health benefits.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Kozłowska A, Szostak-Wegierek D. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Rocz Panstw Zakl Hig. 2014; 65(2):79-85. </em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/30041489" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Dietary Flavonoids and the Risk of Colorectal Cancer: An Updated Meta-Analysis of Epidemiological Studies.</a><span class="source">[Nutrients. 2018]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Dietary Flavonoids and the Risk of Colorectal Cancer: An Updated Meta-Analysis of Epidemiological Studies.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Chang H, Lei L, Zhou Y, Ye F, Zhao G. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Nutrients. 2018 Jul 23; 10(7). 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