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Dietary carotenoids and risk of coronary artery disease in women^1,2,3

¹ From the Children’s Hospital, Department of Medicine, Boston (SKO); the Department of Nutrition, Harvard School of Public Health, Boston (MJS, ER, and WCW); the Department of Epidemiology, Harvard School of Public Health, Boston (MJS, ER, DS, JEM, and WCW); the Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston (MJS, ER, DS, JEM, and WCW); the Department of Biostatistics, Harvard School of Public Health, Boston (DS); and the Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston (JEM).

Background: Numerous studies have shown that higher intakes or higher blood concentrations of carotenes are associated with a lower risk of coronary artery disease (CAD). Given the null results in trials of ß-carotene supplementation, considerable attention has focused on the potential role of other dietary carotenoids in the prevention of CAD.

Objective: Our objective was to prospectively examine the relation between dietary intakes of specific carotenoids and risk of CAD in women.

Design: In 1984, 73 286 female nurses completed a semiquantitative food-frequency questionnaire that assessed their consumption of carotenoids and various other nutrients. The women were followed for 12 y for the development of incident CAD (nonfatal myocardial infarction and fatal CAD), and dietary information was updated in 1986, 1990, and 1994.

Results: During 12 y of follow-up (803 590 person-years), we identified 998 incident cases of CAD. After adjustment for age, smoking, and other CAD risk factors, we observed modest but significant inverse associations between the highest quintiles of intake of ß-carotene and -carotene and risk of CAD but no significant relation with intakes of lutein/zeaxanthin, lycopene, or ß-cryptoxanthin. For women in the highest compared with the respective lowest quintile of intake, the relative risks for ß-carotene and -carotene were 0.74 (95% CI: 0.59, 0.93) and 0.80 (95% CI: 0.65, 0.99), respectively. The association between the specific carotenoids and CAD risk did not vary significantly by current smoking status.

Conclusion: Higher intakes of foods rich in -carotene or ß-carotene are associated with a reduction in risk of CAD.

Key Words: Carotenoids • antioxidants • coronary artery disease • diet • Nurses’ Health Study • women

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