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ORIGINAL RESEARCH COMMUNICATION |
1 From the Division of Preventive Medicine (YS, NRC, CMA, MVD, and JEM) and Cardiology Division (CMA), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, and the Department of Epidemiology (NRC and JEM), Harvard School of Public Health, Boston, MA.
2 Supported by investigator-initiated grant HL46959 from the National Heart, Lung, and Blood Institute. YS is supported by a grant (K01-DK078846) from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. Vitamin E and its placebo were supplied by Cognis Corporation (LaGrange, IL). All of the other agents and their placebos were supplied by BASF Corporation (Mount Olive, NJ). Pill packaging was provided by Cognis and BASF. Neither Cognis nor BASF provided any input into the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. 3 Address reprint requests and correspondence to Y Song, Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215. E-mail: ysong3{at}rics.bwh.harvard.edu.
Background: Vitamin C, vitamin E, and β-carotene are major antioxidants and as such may protect against the development of type 2 diabetes via reduction of oxidative stress.
Objective: The purpose of this study was to investigate the long-term effects of supplementation with vitamin C, vitamin E, and β-carotene for primary prevention of type 2 diabetes.
Design: In the Women's Antioxidant Cardiovascular Study, a randomized trial that occurred between 1995 and 2005, 8171 female health professionals aged 
40 y with either a history of cardiovascular disease (CVD) or 3 CVD risk factors were randomly assigned to receive vitamin C (ascorbic acid, 500 mg every day), vitamin E (RRR-
-tocopherol acetate, 600 IU every other day), β-carotene (50 mg every other day), or their respective placebos.
Results: During a median follow-up of 9.2 y, a total of 895 incident cases occurred among 6574 women who were free of diabetes at baseline. There was a trend toward a modest reduction in diabetes risk in women assigned to receive vitamin C compared with those assigned to receive placebo [relative risk (RR): 0.89; 95% CI: 0.78, 1.02; P = 0.09], whereas a trend for a slight elevation in diabetes risk was observed for vitamin E treatment (RR: 1.13; 95% CI: 0.99, 1.29; P = 0.07). However, neither of these effects reached statistical significance. No significant effect was observed for β-carotene treatment (RR: 0.97; 95% CI: 0.85, 1.11; P = 0.68).
Conclusion: Our randomized trial data showed no significant overall effects of vitamin C, vitamin E, and β-carotene on risk of developing type 2 diabetes in women at high risk of CVD. This trial was registered at clinicaltrials.gov as NCT00000541.
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  M. Meydani and A. Azzi Diabetes risk: antioxidants or lifestyle? Am. J. Clinical Nutrition, August 1, 2009; 90(2): 253 - 254. [Full Text] [PDF]
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