Epidemiologic evidence on the relationship between antioxidant vitamin intake and stroke is limited. We aimed to investigate the association between dietary intake of antioxidant vitamins and the incidence of total stroke and ischemic stroke.
The subjects were 82 044 Japanese men and women aged 45–74 years under the Japan Public Health Center-based Prospective Cohort Study. Between 1995 and 1997, dietary assessment was done using a food frequency questionnaire. During 983 857 person-years of follow-up until the end of 2009 we documented 3541 incident total strokes and 2138 ischemic strokes.
Dietary intakes of α-carotene, β-carotene, α-tocopherol and vitamin C were not inversely associated with the incidence of total stroke and ischemic stroke adjustment for cardiovascular risk factors and selected lifestyle variables. When stratified by current smoking status, the inverse association between dietary vitamin C intake and incidence of total stroke observed among non-smokers but not smokers, with respective multivariable hazard ratios for the highest versus lowest quintiles of vitamin C of 0.81 (95% confidence interval (CI), 0.68–0.96; P-trend=0.03) among non-smokers; and 1.03 (0.84–1.25; P-trend=0.55) among smokers. As for ischemic stroke, the corresponding multivariable hazard ratios were 0.76 (0.60–0.96; P-trend=0.02) among non-smokers; and 1.00 (0.78–1.28; P-trend=0.61) among smokers.
Dietary vitamin C intake was inversely associated with the incidence of total stroke and ischemic stroke among non-smokers.
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This study was supported by National Cancer Center Research and Development Fund (23-A-31 [toku] and 26-A-2) (since 2011) and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010). This study was supported by Grants-in-Aid for Center Research and for the 3rd Term Comprehensive 10-year Strategy for Cancer Control from the Ministry of Health, Labor and Welfare of Japan. We are indebted to the Aomori, Iwate, Ibaraki, Niigata, Osaka, Kochi, Nagasaki and Okinawa Cancer Registries for providing their incidence data. Members of the Japan Public Health Center-based Prospective Study (JPHC Study, principal investigator: S Tsugane) Group are shown in Supplementary Material. Funding for this study was obtained by one of the authors (ST). Support was also obtained in the form of a financial contribution from the AXA Research Fund to one of the authors (MI) as chair holder of the AXA Department of Health and Human Security, Graduate School of Medicine, The University of Tokyo. The AXA Research Fund had no role in the study design, data collection, analysis, interpretation or manuscript drafting or in the decision to submit the manuscript for publication.
The authors declare no conflict of interest.
Supplementary Information accompanies this paper on European Journal of Clinical Nutrition website
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Uesugi, S., Ishihara, J., Iso, H. et al. Dietary intake of antioxidant vitamins and risk of stroke: the Japan Public Health Center–based Prospective Study. Eur J Clin Nutr 71, 1179–1185 (2017). https://doi.org/10.1038/ejcn.2017.71
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