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Antioxidant vitamin intake and mortality in three Central and Eastern European urban populations: the HAPIEE study.

Abstract

PURPOSE

The aim of the study was to assess the relationships between individual-level dietary intakes of antioxidant vitamins C, E and beta-carotene with all-cause and cause-specific mortality in three Central and Eastern European (CEE) populations.

METHODS

Data from the Health, Alcohol and Psychosocial factors in Eastern Europe cohort study were used. At the baseline survey, between 2002 and 2005, 28,945 men and women aged 45-69 years were examined in Novosibirsk (Russia), Krakow (Poland) and seven Czech towns. Deaths in the cohorts were identified through mortality registers. Cox regression was used to estimate the association between vitamin consumption and all-cause, cardiovascular (CVD) disease and cancer mortality.

RESULTS

In multivariable-adjusted analyses, there were no clear inverse associations between antioxidant vitamin intakes and mortality, although in some groups, several hazard ratios (HRs) were significant. For example, in men, compared with the lowest quintile of vitamin C intake, all-cause mortality in the third and fourth quintiles was lower by 28 % (HR 0.72; 95 % CI 0.61-0.85) and by 20 % (HR 0.80; 95 % CI 0.68-0.95), respectively. CVD mortality was lower by 35 % (HR 0.65; 95 % CI 0.50-0.84) and by 23 % (HR 0.77; 95 % CI 0.59-0.99) in third and fourth quintile of vitamin C intake, respectively. In women, the third and fourth quintiles of dietary intake of vitamin E were associated with reduced risk of all-cause death by 33 % (HR 0.67; 95 % CI 0.53-0.84) and by 23 % (HR 0.77; 95 % CI 0.61-0.97), respectively. Consumption of vitamin C, vitamin E and beta-carotene was not related to CVD mortality in women and to cancer mortality in either gender.

CONCLUSION

This large prospective cohort study in CEE populations with low prevalence of vitamin supplementation did not find a strong, dose-response evidence for protective effects of antioxidant vitamin intake.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland. mxbiela@cyf-kr.edu.pl.

    ,

    Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland.

    ,

    Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy.

    ,

    Department of Epidemiology and Public Health, University College London, London, UK.

    ,

    Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland.

    ,

    National Institute of Public Health, Prague, Czech Republic.

    ,

    Institute of Internal and Preventive Medicine Siberian Branch Under the Russian Academy of Medical Sciences, Novosibirsk, Russia. Novosibirsk State Medical University, Novosibirsk, Russia.

    ,

    Department of Epidemiology and Public Health, University College London, London, UK.

    ,

    Department of Epidemiology and Public Health, University College London, London, UK.

    ,

    Institute of Internal and Preventive Medicine Siberian Branch Under the Russian Academy of Medical Sciences, Novosibirsk, Russia.

    ,

    Department of Epidemiology and Public Health, University College London, London, UK.

    Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland.

    Source

    European journal of nutrition 55:2 2016 Mar pg 547-560

    MeSH

    Aged
    Antioxidants
    Ascorbic Acid
    Cardiovascular Diseases
    Cause of Death
    Czech Republic
    Dietary Supplements
    Female
    Follow-Up Studies
    Humans
    Male
    Middle Aged
    Neoplasms
    Poland
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Russia
    Socioeconomic Factors
    Surveys and Questionnaires
    Urban Population
    Vitamin E
    Vitamins
    beta Carotene

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25762013

    Citation

    Stepaniak, Urszula, et al. "Antioxidant Vitamin Intake and Mortality in Three Central and Eastern European Urban Populations: the HAPIEE Study." European Journal of Nutrition, vol. 55, no. 2, 2016, pp. 547-560.
    Stepaniak U, Micek A, Grosso G, et al. Antioxidant vitamin intake and mortality in three Central and Eastern European urban populations: the HAPIEE study. Eur J Nutr. 2016;55(2):547-560.
    Stepaniak, U., Micek, A., Grosso, G., Stefler, D., Topor-Madry, R., Kubinova, R., ... Pająk, A. (2016). Antioxidant vitamin intake and mortality in three Central and Eastern European urban populations: the HAPIEE study. European Journal of Nutrition, 55(2), pp. 547-560. doi:10.1007/s00394-015-0871-8.
    Stepaniak U, et al. Antioxidant Vitamin Intake and Mortality in Three Central and Eastern European Urban Populations: the HAPIEE Study. Eur J Nutr. 2016;55(2):547-560. PubMed PMID: 25762013.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Antioxidant vitamin intake and mortality in three Central and Eastern European urban populations: the HAPIEE study. AU - Stepaniak,Urszula, AU - Micek,Agnieszka, AU - Grosso,Giuseppe, AU - Stefler,Denes, AU - Topor-Madry,Roman, AU - Kubinova,Ruzena, AU - Malyutina,Sofia, AU - Peasey,Anne, AU - Pikhart,Hynek, AU - Nikitin,Yuri, AU - Bobak,Martin, AU - Pająk,Andrzej, Y1 - 2015/03/12/ PY - 2014/11/10/received PY - 2015/03/02/accepted PY - 2015/3/13/entrez PY - 2015/3/13/pubmed PY - 2016/12/16/medline KW - Antioxidant vitamin KW - Cardiovascular KW - Central and Eastern Europe KW - Mortality SP - 547 EP - 560 JF - European journal of nutrition JO - Eur J Nutr VL - 55 IS - 2 N2 - PURPOSE: The aim of the study was to assess the relationships between individual-level dietary intakes of antioxidant vitamins C, E and beta-carotene with all-cause and cause-specific mortality in three Central and Eastern European (CEE) populations. METHODS: Data from the Health, Alcohol and Psychosocial factors in Eastern Europe cohort study were used. At the baseline survey, between 2002 and 2005, 28,945 men and women aged 45-69 years were examined in Novosibirsk (Russia), Krakow (Poland) and seven Czech towns. Deaths in the cohorts were identified through mortality registers. Cox regression was used to estimate the association between vitamin consumption and all-cause, cardiovascular (CVD) disease and cancer mortality. RESULTS: In multivariable-adjusted analyses, there were no clear inverse associations between antioxidant vitamin intakes and mortality, although in some groups, several hazard ratios (HRs) were significant. For example, in men, compared with the lowest quintile of vitamin C intake, all-cause mortality in the third and fourth quintiles was lower by 28 % (HR 0.72; 95 % CI 0.61-0.85) and by 20 % (HR 0.80; 95 % CI 0.68-0.95), respectively. CVD mortality was lower by 35 % (HR 0.65; 95 % CI 0.50-0.84) and by 23 % (HR 0.77; 95 % CI 0.59-0.99) in third and fourth quintile of vitamin C intake, respectively. In women, the third and fourth quintiles of dietary intake of vitamin E were associated with reduced risk of all-cause death by 33 % (HR 0.67; 95 % CI 0.53-0.84) and by 23 % (HR 0.77; 95 % CI 0.61-0.97), respectively. Consumption of vitamin C, vitamin E and beta-carotene was not related to CVD mortality in women and to cancer mortality in either gender. CONCLUSION: This large prospective cohort study in CEE populations with low prevalence of vitamin supplementation did not find a strong, dose-response evidence for protective effects of antioxidant vitamin intake. SN - 1436-6215 UR - https://www.unboundmedicine.com/medline/citation/25762013/Antioxidant_vitamin_intake_and_mortality_in_three_Central_and_Eastern_European_urban_populations:_the_HAPIEE_study_ L2 - https://dx.doi.org/10.1007/s00394-015-0871-8 DB - PRIME DP - Unbound Medicine ER -