Dietary antioxidants and risk of myocardial infarction in the elderly: the Rotterdam Study

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Abstract
Background: Epidemiologic studies have shown dietary antioxidants to be inversely correlated with ischemic heart disease. Objective: We investigated whether dietary β-carotene, vitamin C, and vitamin E were related to the risk of myocardial infarction (MI) in an elderly population. Design: The study sample consisted of 4802 participants of the Rotterdam Study aged 55–95 y who were free of MI at baseline and for whom dietary data assessed by a semiquantitative food frequency questionnaire were available. During a 4-y follow-up period, 124 subjects had an MI. The association between energy-adjusted β-carotene, vitamin C, and vitamin E intakes and risk of MI was examined by multivariate logistic regression. Results: Risk of MI for the highest compared with the lowest tertile of β-carotene intake was 0.55 (95% CI: 0.34, 0.83; P for trend = 0.013), adjusted for age, sex, body mass index, pack-years, income, education, alcohol intake, energy-adjusted intakes of vitamin C and E, and use of antioxidative vitamin supplements. When β-carotene intakes from supplements were considered, the inverse relation with risk of MI was slightly more pronounced. Stratification by smoking status indicated that the association was most evident in current and former smokers. No association with risk of MI was observed for dietary vitamin C and vitamin E. Conclusion: The results of this observational study in the elderly population of the Rotterdam Study support the hypothesis that high dietary β-carotene intakes may protect against cardiovascular disease. We did not observe an association between vitamin C or vitamin E and MI.