Dietary antioxidant capacity and all-cause and cause-specific mortality in the E3N/EPIC cohort study

Eur J Nutr. 2017 Apr;56(3):1233-1243. doi: 10.1007/s00394-016-1172-6. Epub 2016 Feb 18.


Purpose: The cellular oxidative stress (balance between pro-oxidant and antioxidant) may be a major risk factor for chronic diseases. Antioxidant capacity of human diet can be globally assessed through the dietary non-enzymatic antioxidant capacity (NEAC). Our aim was to investigate the relationship between the NEAC and all-cause and cause-specific mortality, and to test potential interactions with smoking status, a well-known pro-oxidant factor.

Methods: Among the French women of the E3N prospective cohort study initiated in 1990, including 4619 deaths among 1,199,011 persons-years of follow-up. A validated dietary history questionnaire assessed usual food intake; NEAC intake was estimated using a food composition table from two different methods: ferric ion reducing antioxidant power (FRAP) and total radical-trapping antioxidant parameter (TRAP). Hazard ratio (HR) estimates and 95 % confidence intervals (CI) were derived from Cox proportional hazards regression models.

Results: In multivariate analyses, FRAP dietary equivalent intake was inversely associated with mortality from all-causes (HR for the fourth vs. the first quartile: HR4 = 0.75, 95 % CI 0.67, 0.83, p trend < 0.0001), cancer, and cardiovascular diseases. Similar results were obtained with TRAP. There was an interaction between NEAC dietary equivalent intake and smoking status for all-cause and cardiovascular disease mortality, but not cancer mortality (respectively, for FRAP, p inter = 0.002; 0.013; 0.113, results were similar with TRAP), and the association was the strongest among current smokers.

Conclusion: This prospective cohort study highlights the importance of antioxidant consumption for mortality prevention, especially among current smokers.

Keywords: All-cause and cause-specific mortality; E3N study; FRAP; Non-enzymatic antioxidant capacity; TRAP.

MeSH terms

  • Antioxidants / administration & dosage*
  • Cardiovascular Diseases / mortality*
  • Cardiovascular Diseases / prevention & control
  • Cohort Studies
  • Diet*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / mortality*
  • Neoplasms / prevention & control
  • Proportional Hazards Models
  • Prospective Studies
  • Reactive Oxygen Species / metabolism
  • Reproducibility of Results
  • Risk Factors
  • Smoking
  • Surveys and Questionnaires


  • Antioxidants
  • Reactive Oxygen Species