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In 1126 female twins (<jats:italic>n<\/jats:italic>=224 with a 10-year follow-up of diet and cognition data) aged 18\u201389 years, habitual intakes of total flavonoids and seven subclasses (flavanones, anthocyanins, flavan-3-ols, flavonols, flavones, polymeric flavonoids (and proanthocyanidins separately)) were calculated using validated food frequency questionnaires. Cognition was assessed using the Cambridge Neuropsychological Test Automated Battery test. Hippocampal volumes were measured in a subset using magnetic resonance imaging (16 monozygotic-twin pairs). Statistical models were adjusted for a range of diet and lifestyle factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher intakes of flavanones (tertile (T)3-T1=0.45, 95%CI 0.13,0.77;<jats:italic>p<\/jats:italic>=0.01) and anthocyanins (T3-T1=0.45, 95%CI 0.08,0.81;<jats:italic>p<\/jats:italic>=0.02) were associated with improvements in age-related cognition score over 10 years. In cross-sectional analysis higher intake of flavanones (T3-T1= 0.12, 95% CI 0.02, 0.21;<jats:italic>p<\/jats:italic>=0.02) and proanthocyanidins (T3-T1= 0.13, 95% CI 0.02, 0.24;<jats:italic>p<\/jats:italic>=0.02) were associated with improved paired-associates learning. Higher intake of anthocyanins was significantly associated with improved executive function (T3-T1= \u22120.52, 95% CI 0.19, 0.84;<jats:italic>p<\/jats:italic>=0.001) and with faster simple reaction times (T3-T1= \u221218.1, 95% CI \u221235.4, \u22120.7; p=0.04). In co-twin analysis, those with higher anthocyanin (2.0%,<jats:italic>p<\/jats:italic>=0.01) and proanthocyanidin (2.0%,<jats:italic>p<\/jats:italic>=0.02) intakes at baseline had the largest left hippocampal volumes after 12 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Small increases in habitual intake of flavonoid-rich foods (containing anthocyanins, flavanones and proanthocyanidins; equivalent to approximately two servings of oranges and blueberries per day) over long time periods have the potential to attenuate cognitive ageing.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12916-021-02057-7","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T01:02:12Z","timestamp":1629680532000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Increased habitual flavonoid intake predicts attenuation of cognitive ageing in twins"],"prefix":"10.1186","volume":"19","author":[{"given":"Amy","family":"Jennings","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire J.","family":"Steves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Macgregor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Spector","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aed\u00edn","family":"Cassidy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,23]]},"reference":[{"issue":"1","key":"2057_CR1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1002\/ana.23594","volume":"72","author":"EE Devore","year":"2012","unstructured":"Devore EE, Kang JH, Breteler MM, Grodstein F. 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