Analysis of urine samples from 1,180 PREDIMED trial participants identified eight specific polyphenol metabolites that collectively predicted cardiovascular disease risk with remarkable precision. Individuals in the highest quartile of this metabolite signature showed a 52% lower risk of stroke, heart attack, heart failure, or cardiovascular death compared to those in the lowest quartile, with a clear dose-response relationship across all levels.
This biomarker approach represents a significant advancement over traditional dietary questionnaires, which rely on self-reported food intake and miss individual variations in polyphenol absorption and metabolism. The eight-compound signature likely captures the synergistic effects of Mediterranean diet polyphenols from olive oil, nuts, wine, and plant foods working together rather than in isolation. For health-conscious adults, this suggests that polyphenol diversity—not just total intake—may be crucial for cardiovascular protection. The findings also validate that urinary metabolites can serve as objective measures of dietary adherence and biological response. However, the study's focus on older adults at high cardiovascular risk means the protective thresholds may differ in younger, healthier populations. This metabolomic fingerprint could eventually guide personalized nutrition recommendations based on individual polyphenol metabolism patterns.
