Vitamin E Intake and Risk of Amyotrophic Lateral Sclerosis: A Pooled Analysis of Data From 5 Prospective Cohort Studies

Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
American journal of epidemiology (Impact Factor: 5.23). 02/2011; 173(6):595-602. DOI: 10.1093/aje/kwq416
Source: PubMed


The authors investigated whether vitamin E intake was associated with amyotrophic lateral sclerosis (ALS) in the Nurses' Health Study (1976-2004), the Health Professionals Follow-up Study (1986-2004), the Cancer Prevention Study II Nutrition Cohort (1992-2004), the Multiethnic Cohort Study (1993-2005), and the National Institutes of Health-AARP Diet and Health Study (1995-2005). ALS deaths were identified through the National Death Index. In the Nurses' Health Study and the Health Professionals Follow-up Study, confirmed nonfatal ALS cases were also included. Cohort-specific results were estimated using Cox proportional hazards models and pooled using random-effects models. Among 1,055,546 participants, 805 developed ALS. Overall, using vitamin E supplements was not associated with ALS. However, within cohorts with information on duration of vitamin E supplement use (231 cases), ALS rates declined with increasing years of use (P-trend=0.01). Compared with nonusers, the multivariable-adjusted relative risk was 1.05 (95% confidence interval (CI): 0.60, 1.84) among users for ≤1 year (12 cases), 0.77 (95% CI: 0.33, 1.77) among users for 2-4 years (7 cases), and 0.64 (95% CI: 0.39, 1.04) among users for ≥5 years (18 cases). For dietary vitamin E intake, the multivariable-adjusted relative risk comparing the highest quartile with the lowest was 0.79 (95% CI: 0.61, 1.03); an inverse dose-response was evident in women (P-trend=0.002) but not in men (P-trend=0.71). In this large, pooled prospective study, long-term vitamin E supplement use was associated with lower ALS rates. A possible protective effect of vitamin E deserves further consideration.

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    • "Age is also another important risk factor but, contrary to other disorders in which aging is the major risk factor, the incidence of ALS declines at the age of 75 years (Al-Chalabi and Hardiman, 2013), so it does not have the same influence as in Alzheimer's disease and Parkinson's disease. On the other hand, the influence of some protective factors, e.g., cardiovascular risk factors (Körner et al., 2013), dietary supplements of vitamin D (Camu et al., 2014), vitamin E (Wang et al., 2011), or magnesium (Fondell et al., 2013), longer reproductive lifespan or prolonged estrogen exposure (de Jong et al., 2013), and treatment with non-steroidal anti-inflammatory drugs (Popat et al., 2007), has been also investigated. "
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