Plasma vitamin C concentrations and risk of incident respiratory diseases and mortality in the European Prospective Investigation into Cancer-Norfolk population-based cohort study

Phyo Kyaw Myint (Corresponding Author), Andrew M. Wilson, Allan B. Clark, Robert N. Luben, Nicholas J. Wareham, Kay-Tee Khaw

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background/ObjectivesCancerous and non-cancerous respiratory diseases are common and contribute significantly to global disease burden. We aim to quantify the association between plasma vitamin C concentrations as an indicator of high fruit and vegetable consumption and the risk of incident respiratory diseases and associated mortality in a general population.Subjects/MethodsNineteen thousand three hundred and fifty-seven men and women aged 40–79 years without prevalent respiratory diseases at the baseline (1993–1997) and participating in the European Prospective Investigation into Cancer (EPIC)-Norfolk study in the United Kingdom were followed through March 2015 for both incidence and mortality from respiratory diseases.ResultsThere were a total of 3914 incident events and 407 deaths due to any respiratory diseases (excluding lung cancers), 367 incident lung cancers and 280 lung cancer deaths during the follow-up (total person-years >300,000 years). Cox's proportional hazards models showed that persons in the top quartiles of baseline plasma vitamin C concentrations had a 43% lower risk of lung cancer (hazard ratio (HR) 0.57; 95% confidence interval (CI): 0.41–0.81) than did those in the bottom quartile, independently of potential confounders. The results are similar for any non-cancerous respiratory diseases (HR 0.85; 0.77–0.95), including chronic respiratory diseases (HR 0.81; 0.69–0.96) and pneumonia (HR 0.70; 0.59–0.83). The corresponding values for mortality were 0.54 (0.35–0.81), 0.81 (0.59–1.12), 0.85 (0.44–1.66) and 0.61 (0.37–1.01), respectively. Confining analyses to non-smokers showed 42% and 53% risk reduction of non-smoking-related lung cancer incidence and death.ConclusionsHigher levels of vitamin C concentrations as a marker of high fruit and vegetable consumption reduces the risk of cancerous and non-cancerous respiratory illnesses including non-smoking-related cancer incidence and deaths.
Original languageEnglish
Pages (from-to)1492-1500
Number of pages9
JournalEuropean Journal of Clinical Nutrition
Volume73
Early online date31 Jan 2019
DOIs
Publication statusPublished - Nov 2019

Keywords

  • fruit and vegetable consumption
  • Vitamin C
  • Lung cancer
  • chronic respiratory disease
  • Pneumonia
  • incidence
  • mortality
  • OXIDATIVE STRESS
  • ANTIOXIDANTS
  • STROKE
  • SUPPLEMENTATION
  • INDIVIDUALS
  • EPIC-NORFOLK
  • QUESTIONNAIRE

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