Dietary Antioxidant Vitamins and Death from Coronary Heart Disease in Postmenopausal Women

Kushi, Lawrence H.; Folsom, Aaron R.; Prineas, Ronald J.; Mink, Pamela J.; Wu, Ying; Bostick, Roberd M.

doi:10.1056/nejm199605023341803

Cited by 855 publications

(285 citation statements)

References 26 publications

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“…Antioxidants and heart disease in the Czech Republic M Boba Âk et al most observational studies which reported that persons with lower intakes or plasma levels of tocopherol or carotenoids are at increased risk of CVD (Rimm et al, 1993;Stampfer et al, 1993;Kardinaal et al, 1993;Riemersma, 1996;Riemersma et al, 1991;Street et al, 1994;Kushi et al, 1996). Several mechanisms have been proposed for the protective role of these vitamins, including their in-vitro and in-vivo antioxidant activity (Di Mascio et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

Bobák

Brunner

et al. 1998

Eur J Clin Nutr

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Objectives: To compare plasma levels of antioxidant vitamins in the Czech population with those in a western European population, and to investigate whether plasma levels of antioxidant vitamins in Czech population are related to risk of MI. Design: The study has two parts: a cross-sectional survey and a population based case-control study. Setting: Adult population in two districts of the Czech Republic, and London based civil servants group as the comparison. Subjects: A random sample of men and women aged 25±64 y resident in two districts were selected for the cross-sectional survey. Subjects in the age group 40±49 y were compared to a sample of British civil servants of the same age enrolled in the Whitehall II Study. Men in the Czech sample served as controls to 52 male cases of ®rst non-fatal myocardial infarction (MI) which occurred in the same population. Plasma samples were obtained from venepuncture during an interview in hospital in the population sample and immediately after hospitalization in the MI cases. Main outcome measures: Plasma levels of b-carotene and a-tocopherol, and the event of MI. Identical protocol and one laboratory was used for all analyses. Results: The mean plasma levels of b-carotene and a-tocopherol in healthy Czech men and women were substantially lower than in a subsample of British civil servants examined in the same laboratory. Smoking was strongly related to b-carotene in both populations but differences between Czechs and Brits were present in both smokers and non-smokers. In the case-control study among Czech men, low levels of the vitamins were strongly related to an increases risk of MI. Age-adjusted odds ratios for concentrations below the median were 3.33 (95% con®dence interval 1.43±8.33) for b-carotene and 1.89 (0.94±3.45) for a-tocopherol; further adjustment for a range of variables reduced these estimates only slightly. Conclusions: Plasma concentrations of antioxidants in the Czech population appeared to be very low, and men with low levels of these substances are at increased risk of MI. This indicates that sub-optimal intake of antioxidants or related dietary factors may have played a role in the high rates of coronary heart disease in this population. Sponsorship: This study was supported by grants from the Wellcome Trust, Czech Ministry of Health and the British Heart Foundation. MB was a Wellcome Trust fellow in clinical epidemiology.

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Section: Discussionmentioning

confidence: 99%

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

Bobák

Brunner

et al. 1998

Eur J Clin Nutr

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“…Four prospective studies conducted in the US have reported a beneficial effect of nut consumption on CHD incidence after follow-up ranging from six to 18 years of large cohorts of previously healthy subjects [1,41,42,43]. A pooled analysis of these studies shows that subjects in the highest intake group for nut consumption had a 37% reduction in multivariable-adjusted risk of fatal CHD [15].…”

Section: Epidemiological Studies Of Nut Consumption and Health Outmentioning

confidence: 99%

“…It must be underlined that in all these studies [1,41,42,43,44] the protective effect of nut consumption on total CHD or sudden cardiac death was independent of gender, age, body mass index, alcohol use, other nutritional characteristics or presence of cardiovascular risk factors. The dose-relationship between nut intake and incident CHD translates into an average 8.3 reduction for each weekly serving of nuts [15].…”

Section: Epidemiological Studies Of Nut Consumption and Health Outmentioning

confidence: 99%

Health Benefits of Nut Consumption

2010

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Nuts (tree nuts and peanuts) are nutrient dense foods with complex matrices rich in unsaturated fatty and other bioactive compounds: high-quality vegetable protein, fiber, minerals, tocopherols, phytosterols, and phenolic compounds. By virtue of their unique composition, nuts are likely to beneficially impact health outcomes. Epidemiologic studies have associated nut consumption with a reduced incidence of coronary heart disease and gallstones in both genders and diabetes in women. Limited evidence also suggests beneficial effects on hypertension, cancer, and inflammation. Interventional studies consistently show that nut intake has a cholesterol-lowering effect, even in the context of healthy diets, and there is emerging evidence of beneficial effects on oxidative stress, inflammation, and vascular reactivity. Blood pressure, visceral adiposity and the metabolic syndrome also appear to be positively influenced by nut consumption. Thus it is clear that nuts have a beneficial impact on many cardiovascular risk factors. Contrary to expectations, epidemiologic studies and clinical trials suggest that regular nut consumption is unlikely to contribute to obesity and may even help in weight loss. Safety concerns are limited to the infrequent occurrence of nut allergy in children. In conclusion, nuts are nutrient rich foods with wide-ranging cardiovascular and metabolic benefits, which can be readily incorporated into healthy diets.

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“…The most notable positive findings on vitamin E come from two large epidemiological studies in the United States, where subjects with the highest vitamin E intake had a 30-40% reduction in CVD risk (Rimm et al, 1993;Stampfer et al, 1993). This association was mainly attributed to high vitamin E consumption from nutrient supplements; however, other observational studies have demonstrated protective effects from food-derived vitamin E alone (Knekt et al, 1994;Kushi et al, 1996). In contrast, most primary and secondary randomised clinical trials of vitamin E that have supplemented with doses well above upper dietary intake levels have not shown clear beneficial effects on CVD outcomes (Collaborative Group of the Primary Prevention Project, 2001;Czernichow & Hercberg, 2001;Hooper et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Childhood and adult dietary vitamin E intake and cardiovascular risk factors in mid-life in the 1946 British Birth Cohort

et al. 2003

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Objectives: To determine whether dietary vitamin E intake in childhood or mid-life was predictive of adult hypertension and high waist circumference, as two important risk factors for cardiovascular disease. Design: Longitudinal study of a social class stratified random sample of all the legitimate, singleton births in the week of 3-9 March 1946. Settings: England, Scotland and Wales. Subjects: The 2980 survey members who provided information on diet, health and sociodemographic information at two time points; age 4 y in 1950 (24-h dietary recall) and 43 y in 1989 (48-h dietary recall). Main outcome measures: Outcomes were adjusted odds ratios (ORs) for hypertension and high waist circumference at age 43 y by thirds of vitamin E intake, relative to the highest intake thirds at both ages. Results: The lowest consumers of vitamin E in both childhood and adulthood were more likely to be hypertensive (OR 1.8, 95% confidence interval (CI): 1.03-3.08) and have high waist circumference (OR 1.6, 95% CI: 1.02-2.43) than those consuming high levels at both ages. A low intake of vitamin E at just one time point was not associated with a statistically significant increased risk of hypertension or high waist circumference. Social class was also an independent and equally strong predictor of these coronary risk factors, indicating that the relation between social class and cardiovascular risks was not mediated solely by the current measures of diet and lifestyle. Conclusions: Unique data on vitamin E intake from foods in both childhood and adulthood have indicated that relatively low intake of vitamin E at both ages predicted hypertension and high waist circumference at age 43 y.

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Dietary Antioxidant Vitamins and Death from Coronary Heart Disease in Postmenopausal Women

Cited by 855 publications

References 26 publications

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

Health Benefits of Nut Consumption

Childhood and adult dietary vitamin E intake and cardiovascular risk factors in mid-life in the 1946 British Birth Cohort

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