The Association Between Dietary Antioxidants Intakes and The Risk of Cardiovascular Disease: Tehran Lipid and Glucose Study

Background: Cardiovascular disease (CVD), the leading cause of death worldwide, is the collective term/compound name for disorders afflicting the blood vessels and heart that accounts for 17.9 million deaths in 2016 1 . Inflammation and enhanced oxidative stress have been shown as fundamental risk factors in the onset and progression of CVD 2 . Chronic inflammatory conditions attenuate blood levels of antioxidants because of the continuous generation of elevated levels of reactive oxygen species (ROS). A sufficient intake of antioxidants is also suggested to beneficially interfere with CVD by quenching ROS 3 . Antioxidant vitamins and minerals, such as vitamins A, E, and C, and zinc may slow the development and progression of CVD Aim: This study aimed at investigating the association between daily consumption of dietary vitamins A, E, and C, and zinc and the incidence of cardiovascular disease (CVD). Methods: : Eligible adults (n=5102) were selected from the participants of the Tehran Lipid and Glucose Study with an average follow-up of 5.3 years. Dietary intakes were assessed using a valid and reliable semi-quantitative food frequency questionnaire. Anthropometrics and biochemical variables were evaluated at baseline and follow-up examinations. Multivariate Cox proportional hazard regression models were used to estimate the development of CVD associated with total intakes of vitamins A, E, and C, and zinc. Results: : This study was conducted on 2,253 men and 2,849 women aged 47.0±11.6 and 45.6±10.5 years, respectively. The main sources of dietary vitamins A, E, and C and zinc were fruits, vegetables, and legumes. Risk of CVD decreased from quartile 1 to quartile 4 for vitamin E intake (HR (95% CI): 1.00, 0.91, 0.77, and 0.57; P trend =0.03). The association between risk of CVD and the quartiles of vitamins A and C and zinc intake was not significant. Conclusion: Our study suggested an inverse association between vitamin E intake and the risk of CVD. The results emphasized a potential protective role of its dietary sources in the prevention of CVD.