Six‐year supplementation with alpha‐tocopherol and beta‐carotene and age‐related maculopathy

Abstract

ABSTRACT.Purpose: Animal research and observational studies in man suggest a protective effect of antioxidant vitamins in the development of age-related maculopathy (ARM). Methods: The ATBC study, a population-based, controlled clinical trial of alpha-tocopherol and beta carotene to prevent lung cancer, took place in Finland between 1984 and 1993. Over 29,000 smoking males aged 50 to 69 years were randomly assigned to alpha-tocopherol (AT; 50 mg/day), beta-carotene (BC; 20 mg/day), both of these, or placebo. We performed an end-of-trial ophthalmological examination on a random sample of 941 participants aged 65 years or more from two of the fourteen study areas, to discover if the five to eight-year intervention with alpha-tocopherol and/or beta-carotene had been associated with a difference in ARM prevalence. Age-related maculopathy was assessed using colour photographs of the macula. Results: Altogether, 269 cases of ARM were found; there were more cases in the AT group (32%; 75/237), BC group (29%; 68/234), and combined antioxidant group (28%; 73/257) than in the placebo group (25%; 53/213). However, neither substance was significantly associated with the risk of ARM in a logistic regression analysis controlling for possible risk factors. Conclusions: No beneficial effect of long-term supplementation with alpha-tocopherol or beta-carotene on the occurrence of ARM was detected among smoking males.

Antioxidant supplements to prevent or slow down the progression of AMD: a systematic review and meta-analysis

“…9 There was no association of treatment group with any sign of maculopathy. There were 216 cases of ARM in the antioxidant groups and 53 in the placebo group (risk ratio (RR) ¼ 1.19, 95% confidence interval (CI), 0.92-1.54).…”

“…In the Alpha-Tocopherol and BetaCarotene (ATBC) Study in Finland, 29 133 male smokers were randomly allocated to a-tocopherol (vitamin E) (50 mg/day), b-carotene (20 mg/day), vitamin E or b-carotene, or placebo. 9 Treatment ranged from 5 to 8 years. A random sample of 1035 men aged 65 years and above were sampled at the end of the study and fundus photographs were taken and graded for ARM and AMD.…”

National Institutes of Health State-of-the-Science Conference Statement: Multivitamin/Mineral Supplements and Chronic Disease Prevention

“…Another trial (15) yielded inconclusive results for main cardiovascular end points because of small numbers and because the trial was stopped prematurely. Two trials examined development of age-related cataract (16) and lens opacity (14), respectively, and reported no effect of vitamin E supplementation.…”

Nutritional Supplement Use and Age-Related Macular Degeneration

“…The Alpha-Tocopherol and Beta-Carotene (ATBC) Study involved over 29,000 smoking males aged 50 to 69 years who were randomly assigned to alphatocopherol (50 mg/day), beta-carotene (20 mg/day), both of these, or placebo 43 . Of these, an end-of-trial ophthalmological examination was performed in a random sample of 941 participants aged 65 years or more.…”

“…The Alpha-Tocopherol and Beta-Carotene (ATBC) Study in Finland assessed the involvement of beta-carotene in occurrence of AMD among smoking males 43 . Over 29,000 smoking males aged 50 to 69 years were given alpha-tocopherol (50 mg/day), betacarotene (20 mg/day), both of these, or placebo randomly.…”