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Diet and 20-year chronic obstructive pulmonary disease mortality in middle-aged men from three European countries

European Journal of Clinical Nutrition volume 56, pages 638–643 (2002)Cite this article

Abstract

Objective: To investigate the relation of baseline antioxidant, fruit, vegetable and fish intake with 20 y chronic obstructive pulmonary disease (COPD) mortality in middle-aged men from three European countries.

Design: Prospective study (1970–1990).

Setting: Five population-based cohorts of middle-aged men from Finland, Italy and The Netherlands.

Subjects: A total of 2917 men aged 50–69 y at baseline.

Methods: Baseline information on diet was collected using the cross-check dietary history method. After 20 y of follow-up the underlying cause of death of those who died was established centrally. Survival analyses were performed using the Cox Proportional Hazards Model.

Results: After adjustment for age, smoking and country, we observed an inverse trend (P-trend <0.05) of 20 y COPD mortality across tertiles of fruit and vitamin E intake. No trend was observed for vegetables, fish, vitamin C and β-carotene. When modelled continuously, a 100 g increase in fruit intake was associated with a 24% lower COPD mortality risk (RR=0.76, 95% CI=0.60–0.92). For vitamin E intake (per 5 mg) the RR was 0.77 (95% CI=0.55–1.06), after adjustment for age, smoking and country. Additional adjustment for body mass index, total energy intake and alcohol consumption reduced the RR to 0.86 (95% CI=0.69–1.07, P=0.12) for fruit and 0.93 (95% CI=0.65–1.33) for vitamin E.

Conclusions: Our results suggest a protective effect of fruit and possibly vitamin E intake against COPD. No effect was observed for intake of vitamin C, β-carotene, vegetables and fish.

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Acknowledgements

The authors thank the many people that were involved in this longitudinal study. This includes the men who took part in the surveys and the organisers of the fieldwork in the three countries, Professor A Menotti and Dr S Giampaoli in Italy, Professor A Nissinen in Finland and Professor D Kromhout in The Netherlands.

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Author notes

  1. C Tabak: Guarantor: C Tabak.

  2. IC Walda, C Tabak, HA Smit, L Räsänen, F Fidanza, A Menotti, A Nissinen, EJM Feskens and D Kromhout: Contributors: IW conducted the statistical analyses and wrote the initial version of the paper. CT wrote the final versions of the paper. HAS and EJMF were responsible for the supervision on a day-to-day basis, while DK was at all stages involved at vital moments. AM, AN and DK were part of the team that organised the data collection. All authors were involved in the interpretation of the data and reviewed the final version of the manuscript.

Authors and Affiliations

  1. Department of Chronic Disease Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands

    IC Walda, C Tabak, HA Smit, A Menotti & EJM Feskens

  2. Division Environmental and Occupational Health, Institute for Risk Assessment Sciences, Universiteit Utrecht, Utrecht, The Netherlands

    IC Walda & C Tabak

  3. Division of Nutrition, University of Helsinki, Helsinki, Finland

    L Räsänen

  4. Department of Internal Medicine and Endocrinological and Metabolical Sciences, Nutrition Section, University of Perugia, Perugia, Italy

    F Fidanza

  5. Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA

    A Menotti

  6. Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland

    A Nissinen

  7. Department of Neurology, Kuopio University Hospital, Kuopio, Finland

    A Nissinen

  8. Division of Public Health Research, National Institute of Public Health and the Environment, Bilthoven, The Netherlands

    D Kromhout

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Walda, I., Tabak, C., Smit, H. et al. Diet and 20-year chronic obstructive pulmonary disease mortality in middle-aged men from three European countries. Eur J Clin Nutr 56, 638–643 (2002). https://doi.org/10.1038/sj.ejcn.1601370

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  • DOI: https://doi.org/10.1038/sj.ejcn.1601370

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