title: Vitamin C and the risk of developing inflammatory polyarthritis: prospective nested case-control study.
abstract: OBJECTIVE
  To investigate whether, there is an association between consumption of fruit and vegetables and dietary antioxidants and the risk of developing inflammatory polyarthritis (IP).
  
  
  METHODS
  In a prospective, population based, nested case-control study of residents of Norfolk, UK, men and women aged 45-74 years were recruited, between 1993 and 1997 through general practice age-sex registers to the Norfolk arm of the European Prospective Investigation of Cancer (EPIC-Norfolk). Dietary intake was assessed at baseline using 7 day diet diaries. Seventy three participants who went on to develop IP between 1993 and 2001 and were registered by the Norfolk Arthritis Register (NOAR) were identified. Incident cases of IP, assessed by general practitioners, fulfilled the criteria of two or more swollen joints, persisting for a minimum of 4 weeks. Each case of IP was matched for age and sex with two controls free of IP.
  
  
  RESULTS
  Lower intakes of fruit and vegetables, and vitamin C were associated with an increased risk of developing IP. Those in the lowest category of vitamin C intake, compared with the highest, increased their risk of developing IP more than threefold, adjusted odds ratio (OR) with 95% confidence intervals (CI) 3.3 (95% CI 1.4 to 7.9). Weak inverse associations between vitamin E and beta-carotene intake and IP risk were found.
  
  
  CONCLUSIONS
  Patients with IP (cases) consumed less fruit and vitamin C than matched controls, which appeared to increase their risk of developing IP. The mechanism for this effect is uncertain. Thus similar studies are necessary to confirm these results.
authors.affiliation: Arthritis Research Campaign, Epidemiology Unit, University of Manchester, Oxford Road, Manchester M13 9PT, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Pattison
authors.forename: A J
authors.initials: AJ
authors.lastname: Silman
authors.forename: N J
authors.initials: NJ
authors.lastname: Goodson
authors.forename: M
authors.initials: M
authors.lastname: Lunt
authors.forename: D
authors.initials: D
authors.lastname: Bunn
authors.forename: R
authors.initials: R
authors.lastname: Luben
authors.forename: A
authors.initials: A
authors.lastname: Welch
authors.forename: S
authors.initials: S
authors.lastname: Bingham
authors.forename: K-T
authors.initials: KT
authors.lastname: Khaw
authors.forename: N
authors.initials: N
authors.lastname: Day
authors.forename: D P M
authors.initials: DP
authors.lastname: Symmons
mesh_terms: D000368:Aged; D001168:Arthritis / Q000517:prevention & control*; D001205:Ascorbic Acid / Q000008:administration & dosage*; D016022:Case-Control Studies; D004032:Diet; D004739:England; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D014675:Vegetables; D014810:Vitamin E / Q000008:administration & dosage; D019207:beta Carotene / Q000008:administration & dosage
chemical_list: D019207:beta Carotene; D014810:Vitamin E; D001205:Ascorbic Acid