AJCN Tufts Nutrition Symposium, Boston Sept 24-26
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American Journal of Clinical Nutrition, Vol. 70, No. 4, 509-516, October 1999
© 1999 American Society for Clinical Nutrition

Original Research Communications

A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women1,2,3,4

Lisa Chasan-Taber, Walter C Willett, Johanna M Seddon, Meir J Stampfer, Bernard Rosner, Graham A Colditz, Frank E Speizer and Susan E Hankinson

1 From the Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst; the Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston; the Departments of Epidemiology, Nutrition, and Biostatistics, Harvard School of Public Health, Boston; and Department of Ophthalmology, Harvard Medical School, Boston, and Massachusetts Eye and Ear Infirmary.

Background: Oxidation of lens proteins plays a central role in the formation of age-related cataracts, suggesting that dietary antioxidants may play a role in prevention. However, the relation between specific antioxidants and risk of cataract remains uncertain.

Objective: Our objective was to examine prospectively the association between carotenoid and vitamin A intakes and cataract extraction in women.

Methods: A prospective cohort of registered female nurses aged 45–71 y and free of diagnosed cancer was followed; in 1980, 50461 were included and others were added as they became 45 y of age for a total of 77466. Information on nutrient intake was assessed by repeated administration of a food-frequency questionnaire during 12 y of follow-up.

Results: During 761762 person-years of follow-up, 1471 cataracts were extracted. After age, smoking, and other potential cataract risk factors were controlled for, those with the highest intake of lutein and zeaxanthin had a 22% decreased risk of cataract extraction compared with those in the lowest quintile (relative risk: 0.78; 95% CI: 0.63, 0.95; P for trend = 0.04). Other carotenoids ({alpha}-carotene, ß-carotene, lycopene, and ß-cryptoxanthin), vitamin A, and retinol were not associated with cataract in multivariate analysis. Increasing frequency of intakes of spinach and kale, foods rich in lutein, was associated with a moderate decrease in risk of cataract.

Conclusions: Lutein and zeaxanthin and foods rich in these carotenoids may decrease the risk of cataracts severe enough to require extraction.

Key Words: Cataract • cataract extraction • diet • women • prospective studies • vitamin A • carotene • lutein • zeaxanthin • carotenoids • Nurses' Health Study • food-frequency questionnaire




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