title: Antioxidant vitamin intake and mortality in three Central and Eastern European urban populations: the HAPIEE study.
abstract: OBJECTIVE
  The aim of the study was to assess the relationships between individual-level dietary intakes of antioxidant vitamins C, E and beta-carotene with all-cause and cause-specific mortality in three Central and Eastern European (CEE) populations.
  
  
  METHODS
  Data from the Health, Alcohol and Psychosocial factors in Eastern Europe cohort study were used. At the baseline survey, between 2002 and 2005, 28,945 men and women aged 45-69 years were examined in Novosibirsk (Russia), Krakow (Poland) and seven Czech towns. Deaths in the cohorts were identified through mortality registers. Cox regression was used to estimate the association between vitamin consumption and all-cause, cardiovascular (CVD) disease and cancer mortality.
  
  
  RESULTS
  In multivariable-adjusted analyses, there were no clear inverse associations between antioxidant vitamin intakes and mortality, although in some groups, several hazard ratios (HRs) were significant. For example, in men, compared with the lowest quintile of vitamin C intake, all-cause mortality in the third and fourth quintiles was lower by 28 % (HR 0.72; 95 % CI 0.61-0.85) and by 20 % (HR 0.80; 95 % CI 0.68-0.95), respectively. CVD mortality was lower by 35 % (HR 0.65; 95 % CI 0.50-0.84) and by 23 % (HR 0.77; 95 % CI 0.59-0.99) in third and fourth quintile of vitamin C intake, respectively. In women, the third and fourth quintiles of dietary intake of vitamin E were associated with reduced risk of all-cause death by 33 % (HR 0.67; 95 % CI 0.53-0.84) and by 23 % (HR 0.77; 95 % CI 0.61-0.97), respectively. Consumption of vitamin C, vitamin E and beta-carotene was not related to CVD mortality in women and to cancer mortality in either gender.
  
  
  CONCLUSIONS
  This large prospective cohort study in CEE populations with low prevalence of vitamin supplementation did not find a strong, dose-response evidence for protective effects of antioxidant vitamin intake.
authors.affiliation: Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland. mxbiela@cyf-kr.edu.pl.
authors.forename: Urszula
authors.initials: U
authors.lastname: Stepaniak
authors.affiliation: Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Micek
authors.affiliation: Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Grosso
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Denes
authors.initials: D
authors.lastname: Stefler
authors.affiliation: Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland.
authors.forename: Roman
authors.initials: R
authors.lastname: Topor-Madry
authors.affiliation: National Institute of Public Health, Prague, Czech Republic.
authors.forename: Ruzena
authors.initials: R
authors.lastname: Kubinova
authors.affiliation: Institute of Internal and Preventive Medicine Siberian Branch Under the Russian Academy of Medical Sciences, Novosibirsk, Russia.|Novosibirsk State Medical University, Novosibirsk, Russia.
authors.forename: Sofia
authors.initials: S
authors.lastname: Malyutina
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Peasey
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Hynek
authors.initials: H
authors.lastname: Pikhart
authors.affiliation: Institute of Internal and Preventive Medicine Siberian Branch Under the Russian Academy of Medical Sciences, Novosibirsk, Russia.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Nikitin
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Bobak
authors.affiliation: Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegorzecka Street 20, Krakow, 31-531, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pająk
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D018153:Czech Republic / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D011044:Poland / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D014810:Vitamin E / Q000008:administration & dosage; D014815:Vitamins / Q000008:administration & dosage*; D019207:beta Carotene / Q000008:administration & dosage
chemical_list: D000975:Antioxidants; D014815:Vitamins; D019207:beta Carotene; D014810:Vitamin E; D001205:Ascorbic Acid
keywords: Antioxidant vitamin; Cardiovascular; Central and Eastern Europe; Mortality