PURPOSE: To investigate relationships between use of vitamin supplements an
d the three principal cataract types in a population-based sample.
METHODS: We studied 2873 of the 3654 participants (79%) aged 49 to 97 years
attending the cross sectional Blue Mountains Eye Study who completed a det
ailed food frequency questionnaire, which included type, dose, and duration
of vitamin supplement use. Masked grading of nuclear, cortical, and poster
ior subcapsular opacities from lens photographs was performed, using the Wi
sconsin method.
RESULTS: Use of multivitamin supplements was associated with reduced preval
ence of nuclear cataract, odds ratio 0.6, 95% confidence interval 0.4 to 1.
0, P = .05. For both nuclear and cortical cataract, longer duration of mult
ivitamin use was associated with reduced cataract prevalence (nuclear catar
act, trend P = .02; cortical cataract, trend P = .03). Use of thiamin suppl
ements was associated with reduced prevalence of nuclear (odds ratio 0.6, c
onfidence interval 0.4 to 1.0, P = .03, dose trend P = .03) and cortical ca
taract (odds ratio 0.7, confidence interval 0.5 to 0.9, P = .01, dose trend
P = .02). Riboflavin (odds ratio 0.8, confidence interval 0.6 to 1.0, P =
.05) and niacin (odds ratio 0.7, confidence interval 0.6 to 1.0, P = .04) s
upplements exerted a weaker protective influence on cortical cataract. Vita
min A supplements were protective against nuclear cataract (odds ratio 0.4,
confidence interval 0.2 to 0.8, P = .01, dose trend P = .01). Folate (odds
ratio 0.4, confidence interval 0.2 to 0.9, P = .03) appeared protective fo
r nuclear cataract, whereas both folate (odds ratio 0.6, confidence interva
l 0.3 to 0.9, P = .01, dose trend P = .04) and vitamin B12 supplements (odd
s ratio 0.7, confidence interval 0.5 to 1.0, P = .03, dose trend P = .02) w
ere strongly protective against cortical cataract.
CONCLUSIONS: Long-term use of multivitamins, B group and vitamin A suppleme
nts was associated with reduced prevalence of either nuclear or cortical ca
taract. A strong protective influence on cortical cataract, from use of fol
ate or vitamin B12 supplements, is a new finding. (Am J Ophthalmol 2001;132
:19-26. (C) 2001 by Elsevier Science Inc. All rights reserved).