title: Dietary antioxidants and risk of myocardial infarction in the elderly: the Rotterdam Study.
abstract: BACKGROUND
  Epidemiologic studies have shown dietary antioxidants to be inversely correlated with ischemic heart disease.
  
  
  OBJECTIVE
  We investigated whether dietary beta-carotene, vitamin C, and vitamin E were related to the risk of myocardial infarction (MI) in an elderly population.
  
  
  METHODS
  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 beta-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 beta-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 beta-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.
  
  
  CONCLUSIONS
  The results of this observational study in the elderly population of the Rotterdam Study support the hypothesis that high dietary beta-carotene intakes may protect against cardiovascular disease. We did not observe an association between vitamin C or vitamin E and MI.
authors.affiliation: Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Klipstein-Grobusch
authors.forename: J M
authors.initials: JM
authors.lastname: Geleijnse
authors.forename: J H
authors.initials: JH
authors.lastname: den Breeijen
authors.forename: H
authors.initials: H
authors.lastname: Boeing
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: J C
authors.initials: JC
authors.lastname: Witteman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage*; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking; D011795:Surveys and Questionnaires; D014810:Vitamin E / Q000008:administration & dosage*; D019207:beta Carotene / Q000008:administration & dosage*