Prospective study of diet, lifestyle, and intermittent claudication in male smokers

The association between dietary and lifestyle factors and intermittent clau dication was investigated in the Finnish Alpha-Tocopherol, Beta-Carotene Ca ncer Prevention Study. The cohort comprised 26,872 male smokers aged 50-69 years who were free of claudication at study entry. At baseline (1985-1988) , subjects completed a diet history questionnaire. During a median follow-u p period of 4 years (ending in spring 1993), 2,578 men reported symptoms of claudication on the Rose questionnaire, which was administered annually. S moking status was assessed every 4 months. Smoking, systolic blood pressure , serum total cholesterol, and diabetes mellitus were positively associated with risk for claudication, whereas serum high density lipoprotein cholest erol, education, and leisure time exercise were inversely associated with r isk. Dietary carbohydrates, fiber, and n-6 polyunsaturated fatty acids were inversely associated with risk for claudication, as were some dietary and serum antioxidants: dietary vitamin C (highest quartile vs. lowest: relativ e risk (RR) - 0.86; 95% confidence interval (CI): 0.77, 0.97), dietary gamm a-tocopherol (RR = 0.89; 95% CI: 0.79, 1.00), dietary carotenoids (RR = 0.8 2; 95% CI: 0.73, 0.92), serum alpha-tocopherol (RR = 0.88; 95% CI: 0.77, 1. 00), and serum beta-carotene (RR = 0.77; 95% CI: 0.68, 0.86). Smoking cessa tion reduced subsequent risk for claudication (RR = 0.86; 95% CI: 0.75, 0.9 9). The authors conclude that classical risk factors for atherosclerosis ar e associated with claudication. High intakes of antioxidant vitamins may be protective. Further research is needed before antioxidants can be recommen ded for the prevention of intermittent claudication.