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American Journal of Epidemiology Advance Access originally published online on July 13, 2009
American Journal of Epidemiology 2009 170(4):472-483; doi:10.1093/aje/kwp167
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Use of Supplements of Multivitamins, Vitamin C, and Vitamin E in Relation to Mortality

Gaia Pocobelli, Ulrike Peters, Alan R. Kristal and Emily White

Correspondence to Gaia Pocobelli, Fred Hutchinson Cancer Research Center, M3-B232, 1100 Fairview Avenue North, Seattle, WA 98109-1024 (e-mail: gpocobel{at}u.washington.edu).

Received for publication March 6, 2009. Accepted for publication May 22, 2009.

In this cohort study, the authors evaluated how supplemental use of multivitamins, vitamin C, and vitamin E over a 10-year period was related to 5-year total mortality, cancer mortality, and cardiovascular disease (CVD) mortality. Participants (n = 77,719) were Washington State residents aged 50–76 years who completed a mailed self-administered questionnaire in 2000–2002. Adjusted hazard ratios and 95% confidence intervals were computed using Cox regression. Multivitamin use was not related to total mortality. However, vitamin C and vitamin E use were associated with small decreases in risk. In cause-specific analyses, use of multivitamins and use of vitamin E were associated with decreased risks of CVD mortality. The hazard ratio comparing persons who had a 10-year average frequency of multivitamin use of 6–7 days per week with nonusers was 0.84 (95% confidence interval: 0.70, 0.99); and the hazard ratio comparing persons who had a 10-year average daily dose of vitamin E greater than 215 mg with nonusers was 0.72 (95% confidence interval: 0.59, 0.88). In contrast, vitamin C use was not associated with CVD mortality. Multivitamin and vitamin E use were not associated with cancer mortality. Some of the associations we observed were small and may have been due to unmeasured healthy behaviors that were more common in supplement users.

ascrobic acid; cohort studies; coronary disease; dietary supplements; mortality; neoplasms; vitamin E; vitamins

Abbreviations: CI, confidence interval; CVD, cardiovascular disease; ICD-10, International Classification of Diseases, Tenth Revision; PHS, Physicians’ Health Study; RR, relative risk; WACS, Women's Antioxidant Cardiovascular Study


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