Dietary Intakes of Antioxidant Vitamins and Mortality From Cardiovascular Disease The Japan Collaborative Cohort Study (JACC) Study

Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka-fu 565-0871, Japan.
Stroke (Impact Factor: 6.02). 06/2011; 42(6):1665-72. DOI: 10.1161/STROKEAHA.110.601526
Source: PubMed

ABSTRACT Only a few reports have dealt with the association of antioxidant vitamin intakes with mortality or morbidity from cardiovascular disease in Asia. We investigated the relation of dietary vitamins A, E, and C intake with mortality from cardiovascular disease for Japanese men and women.
The subjects were 23,119 men and 35 611 women aged 40 to 79 years without a history of cardiovascular disease or cancer who responded to the food frequency questionnaire as part of the Japan Collaborative Cohort Study for Cancer Risk (JACC) Study. They were followed up for a median period of 16.5 years. Hazard ratios were calculated per quintile of dietary vitamins A, E, and C intake by using Cox proportional hazard model.
During the 859,962 person-year follow-up, there were 2690 deaths (1343 men and 1347 women) from cardiovascular disease, comprising 1227 (607 men and 620 women) from stroke and 557 (311 men and 246 women) from coronary heart disease. The multivariable hazard ratios (95% CI) associated with the highest versus lowest quintiles of vitamin C intake were 0.70 (0.54 to 0.92) for total stroke, 0.63 (0.41 to 0.97) for coronary heart disease, and 0.79 (0.66 to 0.94) for total cardiovascular disease for women, but the inverse associations observed were weak and did not reach statistical significance for men. No significant association was observed between vitamins A or E intake and risk of mortality for either men or women.
Vitamin C intake is inversely associated with mortality from cardiovascular disease for Japanese women.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the study was to assess the relationships between individual-level dietary intakes of antioxidant vitamins C, E and beta-carotene with all-cause and cause-specific mortality in three Central and Eastern European (CEE) populations. Data from the Health, Alcohol and Psychosocial factors in Eastern Europe cohort study were used. At the baseline survey, between 2002 and 2005, 28,945 men and women aged 45-69 years were examined in Novosibirsk (Russia), Krakow (Poland) and seven Czech towns. Deaths in the cohorts were identified through mortality registers. Cox regression was used to estimate the association between vitamin consumption and all-cause, cardiovascular (CVD) disease and cancer mortality. In multivariable-adjusted analyses, there were no clear inverse associations between antioxidant vitamin intakes and mortality, although in some groups, several hazard ratios (HRs) were significant. For example, in men, compared with the lowest quintile of vitamin C intake, all-cause mortality in the third and fourth quintiles was lower by 28 % (HR 0.72; 95 % CI 0.61-0.85) and by 20 % (HR 0.80; 95 % CI 0.68-0.95), respectively. CVD mortality was lower by 35 % (HR 0.65; 95 % CI 0.50-0.84) and by 23 % (HR 0.77; 95 % CI 0.59-0.99) in third and fourth quintile of vitamin C intake, respectively. In women, the third and fourth quintiles of dietary intake of vitamin E were associated with reduced risk of all-cause death by 33 % (HR 0.67; 95 % CI 0.53-0.84) and by 23 % (HR 0.77; 95 % CI 0.61-0.97), respectively. Consumption of vitamin C, vitamin E and beta-carotene was not related to CVD mortality in women and to cancer mortality in either gender. This large prospective cohort study in CEE populations with low prevalence of vitamin supplementation did not find a strong, dose-response evidence for protective effects of antioxidant vitamin intake.
    European Journal of Nutrition 03/2015; DOI:10.1007/s00394-015-0871-8 · 3.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: An effect of multivitamin supplement on stroke risk is uncertain. We aimed to examine the association between multivitamin use and risk of death from stroke and its subtypes. A total of 72 180 Japanese men and women free from cardiovascular diseases and cancers at baseline in 1988 to 1990 were followed up until December 31, 2009. Lifestyles including multivitamin use were collected using self-administered questionnaires. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of total stroke and its subtypes in relation to multivitamin use. During a median follow-up of 19.1 years, we identified 2087 deaths from stroke, including 1148 ischemic strokes and 877 hemorrhagic strokes. After adjustment for potential confounders, multivitamin use was associated with lower but borderline significant risk of death from total stroke (HR, 0.87; 95% confidence interval, 0.76-1.01), primarily ischemic stroke (HR, 0.80; 95% confidence interval, 0.63-1.01), but not hemorrhagic stroke (HR, 0.96; 95% confidence interval, 0.78-1.18). In a subgroup analysis, there was a significant association between multivitamin use and lower risk of mortality from total stroke among people with fruit and vegetable intake <3 times/d (HR, 0.80; 95% confidence interval, 0.65-0.98). That association seemed to be more evident among regular users than casual users. Similar results were found for ischemic stroke. Multivitamin use, particularly frequent use, was associated with reduced risk of total and ischemic stroke mortality among Japanese people with lower intake of fruits and vegetables. © 2015 American Heart Association, Inc.
    Stroke 03/2015; DOI:10.1161/STROKEAHA.114.008270 · 6.02 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Significance: Phagocytes play a key role in promoting the oxidative stress after ischemic stroke occurrence. The phagocytic NADPH oxidase (NOX) 2 is a membrane-bound enzyme complex involved in the antimicrobial respiratory burst and free radical production in these cells. Critical issue: NOX2 might promote carotid plaque rupture and stroke occurrence. In addition, NOX2-derived reactive oxygen species (ROS) released by resident and recruited phagocytes enhance cerebral ischemic injury, activating the inflammatory apoptotic pathways. The aim of this review is to update evidence on phagocyte-related oxidative stress, focusing on the role of NOX2 as a potential therapeutic target to reduce ROS-related cerebral injury after stroke. Recent advances: Different oxidants have been shown to induce opposite effects on neuronal homeostasis after a stroke. However, several experimental models support the detrimental effects of NOX activity (especially the phagocytic isoform) on brain recovery after stroke. Therapeutic strategies selectively targeting the neurotoxic ROS and increasing neuroprotective oxidants have recently produced promising results. Future Directions: Radical scavenger compounds (such as Ebselen and Edaravone) are under clinical investigation as therapeutic approach against stroke. On the other hand, NOX inhibition might represent a promising strategy to prevent the stroke-related injury. Although selective NOX inhibitors are not yet available, non-selective compounds (such as apocynin and fasudil) provided encouraging results in pre-clinical studies. Whereas additional studies are needed to better evaluate this therapeutic potential in human beings, the development of specific NOX inhibitors (such as monoclonal antibodies, small-molecule inhibitors or aptamers) might further improve brain recovery after stroke.
    Antioxidants & Redox Signaling 03/2014; DOI:10.1089/ars.2013.5778 · 7.67 Impact Factor