Quercetin glucosides are completely hydrolyzed in ileostomy patients before absorption

Flavonoids, dietary components in vegetables, fruits and beverages, may protect against coronary heart disease, stroke and cancer. However, the bioavailability of these compounds is questionable. A previous study in ileostomy patients of the most abundant flavonoid, quercetin, suggested a 52% absorption of its major dietary forms, monoglucoside (QMG) and diglucoside (QDG), from an onion meal. However, this was based on indirect measurements after acid hydrolysis. Because human intestinal Caco-2 cell monolayers showed minimal absorption of the glucosides, we repeated the study in ileostomy patients, using molecularly specific analytical methodology for the intact glucosides and quercetin. The onion meal had high concentrations of both QMG and QDG with only trace amounts of quercetin. The intake of QMG and QDG in four patients ranged from 10.9 to 51.6 mg. No QMG or QDG was detected in the ileostomy fluid. In contrast, the amounts of the aglycone quercetin were substantial, 2.9-11.3 mg. This corresponded to 19.5-35.2% of total quercetin glucosides ingested, implying absorption of 64.5-80.7%. These findings suggest a different interpretation than that from the previous study, i.e., that both QMG and QDG are efficiently hydrolyzed in the small intestine by beta-glucosidases to quercetin, most of which is then absorbed.