Polyphenolic antioxidants are a diverse class of plant-derived secondary metabolites ubiquitously found in plant-based foods, highly promising for therapeutic intervention of various diseases. This review systematically co-vers dietary polyphenols from common food sources, purified compounds, polyphenol-rich plant extracts, and emerging delivery systems for bioavaila-bility enhancement, with a core focus on their molecular mechanisms of ac-tion and therapeutic potential in neurodegenerative diseases, cardiovascular diseases, and malignancies. The review details diverse molecular mecha-nisms underpinning polyphenol efficacy, extending beyond direct antioxidant activity to include modulation of signaling pathways, enzyme inhibition, and gene expression regulation. Evidence demonstrates their potential in miti-gating oxidative stress, inflammation, and specific pathological processes characteristic of Alzheimer’s disease, Parkinson’s disease, atherosclerosis, hypertension, and various cancers. However, significant challenges in phar-macokinetics, particularly poor bioavailability and extensive metabolism, hinder clinical translation. While preclinical evidence is compelling, over-coming bioavailability limitations via novel delivery systems or structural optimization is crucial for clinical advancement.
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