Aune, D, Keum, N, Giovannucci, E et al. (7 more authors) (2018) Dietary intake and blood concentrations of antioxidants and the risk of cardiovascular disease, total cancer, and all-cause mortality: a systematic review and dose-response meta-analysis of prospective studies. American Journal of Clinical Nutrition, 108 (5). pp. 1069-1091. ISSN 0002-9165
Abstract
Background: High dietary intake or blood concentrations (as biomarkers of dietary intake) of vitamin C, carotenoids and vitamin E have been associated with reduced risk of cardiovascular disease, cancer and mortality, but these associations have not been systematically assessed.
Objective: We conducted a systematic review and meta-analysis of prospective studies of dietary intake and blood concentrations of vitamin C, carotenoids, and vitamin E in relation to these outcomes.
Design: We searched PubMed and Embase up to 16th of February 2017. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects models.
Results: Sixty six prospective studies (95 publications) were included. The summary RR per 100 mg/d increment of dietary vitamin C intake was 0.87 (95% CI, 0.79-0.95, I2=23%, n=10) for coronary heart disease, 0.93 (95% CI, 0.87-0.99, I2=60%, n=11) for stroke, 0.92 (95% CI, 0.88-0.97, I2=0%, n=6) for cardiovascular disease, 0.93 (95% CI, 0.86-1.01, I2=51%, n=6) for total cancer, and 0.90 (95% CI, 0.85-0.95, I2=77%, n=12) for all-cause mortality. Corresponding RRs per 50 μmol/L increase in blood concentrations of vitamin C were 0.74 (95% CI, 0.65-0.83, I2=0%, n=4), 0.72 (95% CI, 0.62-0.82, I2=0%, n=4), 0.76 (95% CI, 0.65-0.87, I2=56%, n=6), 0.74 (95% CI, 0.66-0.82, I2=0%, n=5), and 0.72 (95% CI, 0.66-0.79, I2=0%, n=8). Dietary intake and/or blood concentrations of carotenoids (total, beta-carotene, alpha-carotene, beta-cryptoxanthin, lycopene) and alpha-tocopherol, but not dietary vitamin E, were similarly inversely associated with coronary heart disease, stroke, cardiovascular disease, cancer and/or all-cause mortality.
Conclusions: Higher dietary intake and/or blood concentrations of vitamin C, carotenoids, and alpha-tocopherol (as markers of fruit, vegetable and nut intake) were associated with reduced risk of cardiovascular disease, total cancer and all-cause mortality. These results support dietary recommendations to increase fruit and vegetable intake for chronic disease prevention, although antioxidant supplement use may not have these same benefits.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2018 American Society for Nutrition. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com. |
Keywords: | Vitamin C; carotenoids; alpha-carotene; beta-carotene; lycopene; lutein; beta-cryptoxanthin; alpha-tocopherol; vitamin E; coronary heart disease; stroke; cardiovascular disease; cancer; mortality; meta-analysis |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 28 Jun 2018 13:49 |
Last Modified: | 25 Jun 2023 21:25 |
Status: | Published |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/ajcn/nqy097 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:132459 |