Dietary antioxidant vitamins intake and mortality: A report from two cohort studies of Chinese adults in Shanghai

J Epidemiol. 2017 Mar;27(3):89-97. doi: 10.1016/ Epub 2016 Dec 26.


Background: Few studies have evaluated dietary antioxidant vitamins intake in relation to risk of mortality in Asia.

Methods: We examined the associations between total carotene, vitamin C, and vitamin E from diet and risk of mortality from all causes, cancer, and cardiovascular disease in 134,358 participants (59,739 men and 74,619 women) from the Shanghai Men's Health Study and Shanghai Women's Health Study, two prospective cohort studies of middle-aged and elderly Chinese adults in urban Shanghai. Participants were followed up for a median period of 8.3 and 14.2 years for men and women, respectively. Hazard ratios (HRs) and 95% confidence interval (CIs) were estimated using Cox proportional hazards regression models.

Results: During the 495,332 and 1,029,198 person-years of follow-up for men and women, respectively, there were 10,079 deaths (4170 men and 5909 women). For men, compared with the lowest quintiles, the multivariable-adjusted risk reductions in the highest categories were 17% (HR 0.83; 95% CI, 0.76-0.92) for dietary total carotene and 17% (HR 0.83; 95% CI, 0.75-0.91) for dietary vitamin C. Associations were weaker in women than in men, though they were still statistically significant (highest versus lowest quintiles of dietary total carotene, HR 0.87; 95% CI, 0.80-0.95; dietary vitamin C: HR 0.83; 95% CI, 0.77-0.91). Significant inverse associations were observed between dietary total carotene, vitamin C, and risk of cardiovascular disease mortality but not cancer mortality.

Conclusion: This study suggests that total carotene and vitamin C intake from diet were inversely associated with deaths from all causes and cardiovascular disease in middle-aged or elderly people in China.

Keywords: Antioxidants; Cohort studies; Mortality; Vitamins.

MeSH terms

  • Adult
  • Aged
  • Antioxidants / administration & dosage*
  • Ascorbic Acid / administration & dosage*
  • Asian Continental Ancestry Group / statistics & numerical data*
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / mortality*
  • Carotenoids / administration & dosage*
  • Cause of Death
  • China / epidemiology
  • Cohort Studies
  • Diet*
  • Dietary Supplements*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Male
  • Neoplasms / ethnology
  • Neoplasms / mortality*
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Vitamin E / administration & dosage*
  • Vitamins / administration & dosage*


  • Antioxidants
  • Vitamins
  • Vitamin E
  • Carotenoids
  • Ascorbic Acid