title: Vitamin E administration may decrease the incidence of pneumonia in elderly males.
abstract: BACKGROUND
  Vitamin E has influenced the immune system in laboratory studies. Dozens of animal experiments have found that vitamin E offered protection against infections caused by viruses and bacteria. Previously, significant heterogeneity was found in the effect of vitamin E supplementation on pneumonia in humans. The aim of this study was to examine how the effect of vitamin E on pneumonia risk depends on age.
  
  
  METHODS
  Secondary analysis of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention study in Finland, 1985-1993, was performed. Participants were male smokers aged 50-69 years at the baseline who started to smoke at ≥21 years (N=7,469). Intervention was 50 mg/d of vitamin E for 5-8 years. The outcome was the incidence of hospital-treated, community-acquired pneumonia by the age at the follow-up.
  
  
  RESULTS
  Among 2,216 participants who smoked 5-19 cigarettes per day at baseline and exercised at leisure time, vitamin E supplementation reduced the incidence of pneumonia by 69% (95% confidence interval [CI]: 43%-83%; 57 pneumonia cases). In this subgroup, vitamin E prevented pneumonia in 12.9% of participants by the age of 74 years. Among 5,253 participants who smoked ≥20 cigarettes per day at baseline or did not exercise, the incidence of pneumonia was 14% lower in the vitamin E participants (95% CI: -38% to +21%; 139 cases). One-third of the participants quit smoking for a period, of whom 27 got pneumonia. The incidence of pneumonia was 72% (95% CI: 31%-89%) lower in the vitamin E group, and this benefit was also seen among those males who smoked ≥20 cigarettes per day at baseline or did not exercise.
  
  
  CONCLUSIONS
  Although the evidence of benefit from vitamin E against pneumonia in elderly males is strong in this analysis, the overall findings about vitamin E have been complex. Further research on vitamin E in nonsmoking elderly males is warranted.
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Hemilä
mesh_terms: D000368:Aged; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000517:prevention & control; D019587:Dietary Supplements; D015444:Exercise; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology* / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking; D014810:Vitamin E / Q000008:administration & dosage*; D024502:alpha-Tocopherol / Q000008:administration & dosage*; D019207:beta Carotene / Q000008:administration & dosage*
chemical_list: D019207:beta Carotene; D014810:Vitamin E; D024502:alpha-Tocopherol
keywords: antioxidants; exercise; randomized controlled trial; respiratory tract infections; smoking