Dietary Vitamin E Intake and Risk of Coronary Heart Disease in a Representative Sample of US Adults: NHANES I Epidemiologic Follow-up Study
Epidemiologic studies suggest that dietary vitamin E intake is inversely related to the risk of coronary heart disease (CHD). We examined the relationship between dietary intake of vitamin E and incidence of and mortality from CHD and cardiovascular disease (CVD) in 9,766 men and women who participated in the NHANES I Epidemiologic Follow-up Study and were free of CVD at their baseline examination. A 24-hour dietary recall was conducted at the baseline examination and nutrient intakes were recalculated using ESHA Food Processor software. Other important risk factors for CVD including age, sex, race, serum cholesterol, blood pressure, body mass index, history of diabetes, education, physical activity, cigarette smoking, and alcohol consumption were also measured at baseline. Those risk factors and dietary intake of saturated fat and total energy were used for adjustment in multivariate analyses. Incidence and mortality data for CHD and CVD were obtained from medical records and death certificates. Cox proportional hazard models were used to examine the relationship between dietary vitamin E intake and the incidence of and mortality from CHD and CVD. Over an average of 19 years of follow-up, 1,845 incident cases of CHD (669 fatal) and 3,760 incident cases of CVD (1,197 fatal) were documented. The adjusted relative risk (RR) was 0.89 (95% confidence interval [CI], 0.77-1.02, p=0.03 for trend) for incident CHD events, 0.69 (95% CI: 0.55−.86, p=0.001 for trend) for fatal CHD events, and 0.85 (95% CI: 0.70-1.02, p=0.03 for trend) for fatal CVD events among those in the highest quartile of dietary vitamin E intake (median, 17.5 mg/d) compared with those in the lowest quartile (median, 3.0 mg/d). These findings support the hypothesis that increasing vitamin E intake may be an important element of dietary approaches to reducing the incidence of and mortality from CHD in the US population.