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Nutritional Epidemiology

Both - and β-Carotene, but Not Tocopherols and Vitamin C, Are Inversely Related to 15-Year Cardiovascular Mortality in Dutch Elderly Men^1,2

³ Division of Human Nutrition, Wageningen University, Wageningen, 6700 EV The Netherlands; ⁴ National Institute for Public Health and the Environment, (RIVM), Bilthoven, 3720 BA The Netherlands; ⁵ German Institute for Human Nutrition (DIfE), Department of Epidemiology, Nuthetal, 14558 Germany; and ⁶ Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454

^* To whom correspondence should be addressed. E-mail: daan.kromhout{at}wur.nl.

The role of β-carotene, -tocopherol, and vitamin C in the prevention of cardiovascular diseases (CVD) is controversial. Prospective studies on -tocopherol and carotenoids other than β-carotene are sparse. We assessed relations between the intake of different carotenoids, - and -tocopherol, and vitamin C with 15-y CVD mortality in elderly men who participated in the Zutphen Elderly Study. Information on diet and potential confounding factors was collected in 1985, 1990, and 1995. In 1985, 559 men (mean age 72 y) free of chronic diseases were included in the current analysis. After 15 y of follow-up, comprising 5744 person-years, 197 men had died from CVD. After adjustment for age, smoking, and other potential lifestyle and dietary confounders, relative risks (RR) (95% CI) of CVD death for a 1-SD increase in intake were 0.81 (0.66–0.99) for -carotene and 0.80 (0.66–0.97) for β-carotene. Carrots were the primary source of - and β-carotene and their consumption was related to a lower risk of death from CVD (adjusted RR, 0.83; 95% CI = 0.68–1.00). Intakes of carotenoids other than - and β-carotene were not associated with CVD mortality, nor were vitamin C and - and tocopherol. In conclusion, dietary intakes of -carotene and β-carotene are inversely associated with CVD mortality in elderly men. This study does not indicate an important role for other carotenoids, tocopherols, or vitamin C in lowering the risk of CVD death.