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Objective: Dietary intake of flavonoids has been reported to protect against coronary heart disease (CHD) risk, but associations of specific classes of flavonoids with CHD have not been adequately studied. Design: Hospital-based case–control study relying on interviewer administered questionnaires. Setting: Cardiology Department of the University of Athens Medical School in the Hippokrateion General Hospital (1990–1991). Subjects: Cases were 329 patients with electrocardiographically confirmed first coronary infarct or a first positive coronary arteriogram, or both (participation fraction 93%). Controls were 570 patients admitted to the same hospital for minor conditions unrelated to nutrition (participation fraction 95%). All cases and controls were interviewed in the hospital wards by experienced interviewers, and a 110-item food frequency questionnaire was administered. Results: There was statistically significant evidence (P∼0.03) for an inverse association between intake of flavan-3-ols and CHD risk, an increase of about 21 mg per day corresponding to a 24% decrease in CHD risk. The inverse association between flavan-3-ols and CHD risk was largely accounted for by the intake of wine and to a lesser extent tea. For none of the other flavonoid classes was there statistically significant evidence of an association. Conclusion: Flavan-3-ols, which are largely found in wine and tea, are inversely associated with, and may be protective against, coronary heart disease.

Nutritional data concerning the comparison (control) series of six case-control studies undertaken in the 1980s in Athens were used to estimate the percent energy intake from major macronutrient groups in the contemporary Greek diet. The data were generated by interviewer-administered semi-quantitative food frequency questionnaires in the context of studies probing the nutritional aetiology of several chronic diseases. The analyses were eventually based on 228 men and 610 women 40-79 years old. The main results were as follows: (i) age has very little effect on the proportion of energy intake from the macronutrients studied, although a declining trend is evident with respect to total energy intake; (ii) the proportion of energy intake from saturated fat and monounsaturated fat and, accordingly, total fat is higher among women than among men; (iii) in the Athenian (urban) Greek population in the 1980s, the proportion of energy derived from proteins is about 19%, from carbohydrates is about 37% and from fats is about 44%; and (iv) the P/S ratio is approximately 1:4 whereas the M/S ratio is approximately 1:1, although the latter ratio may be underestimated. It is concluded that low total fat intake is not a characteristic of the Greek diet and cannot explain the apparently health-promoting consequences of this diet.