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

Background: Epidemiologic studies have shown dietary antioxidants to be inv ersely correlated with ischemic heart disease. Objective: we investigated whether dietary beta-carotene, vitamin C, and vi tamin E were related to the risk of myocardial infarction (MI) in an elderl y population. Design: The study sample consisted of 4802 participants of the Rotterdam St udy 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 bet ween energy-adjusted beta-carotene, vitamin C, and vitamin E intakes and ri sk of MI was examined by multivariate logistic regression. Results: Risk of MI for the highest compared with the lowest tertile of bet a-carotene intake was 0.55 (95% CI: 0.34, 0.83; P for trend = 0.013), adjus ted for age, sex, body mass index, pack-years, income, education, alcohol i ntake, energy-adjusted intakes of vitamin C and E, and use of antioxidative vitamin supplements. When beta-carotene intakes from supplements were cons idered, the inverse relation with risk of MI was slightly more pronounced. Stratification by smoking status indicated that the association was most ev ident in current and former smokers. No association with risk of MI was obs erved for dietary vitamin C and vitamin E, Conclusion: The results of this observational study in the elderly populati on of the Rotterdam Study support the hypothesis that high dietary beta-car otene intakes may protect against cardiovascular disease. We did not observ e an association between vitamin C or vitamin E and MI.