Association between dietary vitamin E intake and incident cardiovascular disease, cardiovascular, and all-cause mortality: A prospective cohort study using NHANES 2003–2018 data

Qingping Zeng , Mengqian Liao , Yu Li , Fei She , Ping Zhang
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Abstract

Background

The relationship between dietary vitamin E intake and the risk of cardiovascular diseases, as well as cardiovascular and all-cause mortality, remains inconclusive. This study aimed to investigate these associations in a large, representative sample of the U.S. population.

Methods

We analyzed data from 39,293 participants in the National Health and Nutrition Examination Survey (NHANES) 2003–2018. Dietary vitamin E intake was assessed using 24-h recall data. Outcomes included incident cardiovascular disease (CVD), CVD mortality, and all-cause mortality. We employed weighted logistic and Cox regression models, adjusting for potential confounders. Restricted cubic spline (RCS) analyses and were conducted to assess non-linear relationships.

Results

Compared to participants with a vitamin E intake of 4.08 mg or lower (lowest quartile), the multivariable-adjusted odds ratio for those with an intake of 9.86 mg or higher (highest quartile) was 0.57 (95 % CI, 0.50–0.64) for cardiovascular disease (P for trend <0.01). The multivariable-adjusted hazard ratios for participants with a vitamin E intake of 9.86 mg or higher were 0.85 (95 % CI, 0.75–0.98) for all-cause mortality (P for trend = 0.04) and 0.96 (95 % CI, 0.76–1.21) for CVD mortality (P for trend <0.001). RCS analyses revealed non-linear associations for most outcomes, including overall CVD, coronary heart disease, heart attack, stroke, and all-cause mortality (all P-nonlinear <0.05).

Conclusions

In this large NHANES cohort, higher dietary intake of vitamin E was associated with reduced risks of cardiovascular disease and all-cause mortality. These findings suggest potential benefits of vitamin E-rich diets in cardiovascular health promotion and mortality reduction.
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膳食维生素E摄入量与心血管疾病、心血管和全因死亡率之间的关系:一项使用NHANES 2003-2018数据的前瞻性队列研究
背景:膳食维生素E摄入量与心血管疾病风险以及心血管疾病和全因死亡率之间的关系尚不明确。这项研究的目的是在美国人口的一个大的、有代表性的样本中调查这些联系。方法:我们分析了2003-2018年国家健康与营养检查调查(NHANES)的39293名参与者的数据。采用24小时回忆数据评估膳食维生素E摄入量。结果包括心血管疾病(CVD)事件、CVD死亡率和全因死亡率。我们采用加权logistic和Cox回归模型,调整潜在混杂因素。限制三次样条(RCS)分析和评估非线性关系。结果:与维生素E摄入量为4.08毫克或更低(最低四分位数)的参与者相比,摄入量为9.86毫克或更高(最高四分位数)的参与者心血管疾病的多变量调整优势比为0.57 (95% CI, 0.50-0.64) (P为趋势)。结论:在这个大型NHANES队列中,较高的维生素E饮食摄入量与心血管疾病风险降低和全因死亡率降低相关。这些发现表明富含维生素e的饮食在促进心血管健康和降低死亡率方面的潜在益处。
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