Published Online
on June 3, 2004

A more recent version of this article appeared on July 1, 2004

This Article Full Text (PDF) All Versions of this Article: 35/7/1584    most recent 01.STR.0000132197.67350.bdv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hak, A. E. Articles by Stampfer, M. J. Search for Related Content PubMed PubMed Citation Articles by Hak, A. E. Articles by Stampfer, M. J. Related Collections Risk Factors Embolic stroke Epidemiology

Submitted on March 29, 2004
Accepted on April 28, 2004

Prospective Study of Plasma Carotenoids and Tocopherols in Relation to Risk of Ischemic Stroke

A. Elisabeth Hak MD, PhD; Jing Ma MD, PhD^*; Calpurnyia B. Powell BS; Hannia Campos PhD; J. Michael Gaziano MD; Walter C. Willett MD, DrPH; and Meir J. Stampfer MD, DrPH

From the Departments of Epidemiology (A.E.H., C.B.P., W.C.W., M.J.S.) and Nutrition (J.M., W.C.W., M.J.S., H.C.), Harvard School of Public Health, Boston, Mass; Channing Laboratory (J.M., W.C.W., M.J.S.) and the Division of Preventive Medicine (J.M.G., M.J.S.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass; VA Boston Healthcare System (J.M.G.), Boston, Mass; and the Departments of Epidemiology & Biostatistics and Internal Medicine (A.E.H.), Erasmus MC, Rotterdam, the Netherlands.

^* To whom correspondence should be addressed. E-mail: jing.ma{at}channing.harvard.edu.

Background and Purpose--Intake of fruits and vegetables has been related to lower risk of ischemic stroke, but nutrients responsible for this apparent benefit remain ill-defined. Tocopherols (vitamin E) have also been proposed to be protective.

Methods--We conducted a prospective, nested case-control analysis among male physicians without diagnosed cardiovascular disease followed-up for up to 13 years in the Physicians’ Health Study. Samples from 297 physicians with ischemic stroke were analyzed with paired controls, matched for age and smoking, for 5 major carotenoids (- and -carotene, -cryptoxanthin, lutein, and lycopene), retinol, and - and -tocopherol.

Results--Baseline plasma levels of -carotene and -carotene and lycopene tended to be inversely related to risk of ischemic stroke with an apparent threshold effect. As compared with men whose plasma levels were in the lowest quintile, the multivariate adjusted odds ratios (ORs) of ischemic stroke among men with levels in the second through fifth quintiles were 0.59 (95% CI, 0.36 to 0.98) for -carotene, 0.62 (95% CI, 0.38 to 1.01) for -carotene, and 0.61 (95% CI, 0.37 to 1.00) for lycopene. A tendency toward an inverse association was found for -cryptoxanthin, but the result was not statistically significant. No association was found for lutein, retinol, and tocopherols.

Conclusion--Our data suggest that higher plasma levels of carotenoids, as markers of fruit and vegetable intake, are inversely related to risk of ischemic stroke and provide support for recommendations to consume fruits and vegetables regularly.

Key words: antioxidants • carotenoids • tocopherols • ischemic stroke

This article has been cited by other articles:

				S. J Padayatty and M. Levine Fruit and vegetables: think variety, go ahead, eat! Am. J. Clinical Nutrition, January 1, 2008; 87(1): 5 - 7. [Full Text] [PDF]

				T. Ohira, A. Hozawa, C. Iribarren, M. L. Daviglus, K. A. Matthews, M. D. Gross, and D. R. Jacobs Jr. Longitudinal Association of Serum Carotenoids and Tocopherols with Hostility: The CARDIA Study Am. J. Epidemiol., January 1, 2008; 167(1): 42 - 50. [Abstract] [Full Text] [PDF]

				N. R. Cook, C. M. Albert, J. M. Gaziano, E. Zaharris, J. MacFadyen, E. Danielson, J. E. Buring, and J. E. Manson A Randomized Factorial Trial of Vitamins C and E and Beta Carotene in the Secondary Prevention of Cardiovascular Events in Women: Results From the Women's Antioxidant Cardiovascular Study Arch Intern Med, August 13, 2007; 167(15): 1610 - 1618. [Abstract] [Full Text] [PDF]

				O. I. Okereke, J. H. Kang, J. Ma, J. M. Gaziano, and F. Grodstein Midlife Plasma Insulin-Like Growth Factor I and Cognitive Function in Older Men J. Clin. Endocrinol. Metab., November 1, 2006; 91(11): 4306 - 4312. [Abstract] [Full Text] [PDF]

				S. Voutilainen, T. Nurmi, J. Mursu, and T. H Rissanen Carotenoids and cardiovascular health Am. J. Clinical Nutrition, June 1, 2006; 83(6): 1265 - 1271. [Abstract] [Full Text] [PDF]

				O. I. Bermudez, J. D. Ribaya-Mercado, S. A. Talegawkar, and K. L. Tucker Hispanic and Non-Hispanic White Elders from Massachusetts Have Different Patterns of Carotenoid Intake and Plasma Concentrations J. Nutr., June 1, 2005; 135(6): 1496 - 1502. [Abstract] [Full Text] [PDF]

				H. D Sesso, J. E Buring, E. P Norkus, and J M. Gaziano Plasma lycopene, other carotenoids, and retinol and the risk of cardiovascular disease in men Am. J. Clinical Nutrition, May 1, 2005; 81(5): 990 - 997. [Abstract] [Full Text] [PDF]