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Vitamin C consumption is associated with less progression in carotid intima media thickness in elderly men: A 3-year intervention study

      Abstract

      Background and aim

      Plant foods may lower the risk of cardiovascular disease.

      Methods and results

      We assessed changes in the intima media thickness (IMT) of the carotid artery and diet in elderly men. Men (n=563) aged 70±5 years were randomly assigned to 1 of 4 groups (dietary intervention, omega-3 supplementation, both or neither) using a 2×2 factorial design. B-mode ultrasound of the carotid arteries and calculation of dietary intake were performed at baseline and after 3 years. We previously showed that omega-3 supplementation did not influence the IMT, thus the dietary intervention (n=233) and no dietary intervention (n=231) groups were pooled.
      The dietary intervention group had less progression in the carotid IMT compared with the controls (0.044±0.091 mm versus 0.062±0.105 mm; P=0.047). This group increased their daily vitamin C intake (P=0.005) and intake of fruit, berries and vegetables (P0.001). Increased intake of vitamin C and of fruit and berries was inversely associated with IMT progression (r=−0.181; P=0.006 and r=−0.125; P=0.056, respectively). Multivariate linear regression analysis showed that increased intakes of vitamin C and of fruit and berries were associated with less IMT progression in the intervention group and in the total study population, after adjustment for consumption of dietary cholesterol, cheese, saturated fat and group assignment.

      Conclusion

      Vitamin C containing foods may protect against the progression of carotid atherosclerosis in elderly men.

      Keywords

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      References

        • Astrup A.
        How to maintain a healthy body weight.
        Int J Vitam Nutr Res. 2006; 76: 208-215
        • Dauchet L.
        • Amouyel P.
        • Hercberg S.
        • Dallongeville J.
        Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies.
        J Nutr. 2006; 136: 2588-2593
        • Diaz M.N.
        • Frei B.
        • Vita J.A.
        • Keaney J.F.
        Antioxidants and atherosclerotic heart disease.
        N Engl J Med. 1997; 337: 408-416
        • de Lorgeril M.
        • Renaud S.
        • Mamelle N.
        • Salen P.
        • Martin J.L.
        • Monjaud I.
        • et al.
        Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease.
        Lancet. 1994; 343: 1454-1459
        • Enstrom J.E.
        • Kanim L.E.
        • Klein M.A.
        Vitamin C intake and mortality among a sample of the United States population.
        Epidemiology. 1992; 3: 194-202
        • Frei B.
        On the role of vitamin C and other antioxidants in atherogenesis and vascular dysfunction.
        Proc Soc Exp Biol Med. 1999; 222: 196-204
        • Friedewald W.T.
        • Levy R.I.
        • Fredrickson D.S.
        Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.
        Clin Chem. 1972; 18: 499-502
        • Halliwell B.
        The antioxidant paradox.
        Lancet. 2000; 355: 1179-1180
        • He F.J.
        • Nowson C.A.
        • MacGrecor G.A.
        Fruit and vegetable consumption and stroke: metaanalysis of cohort studies.
        Lancet. 2006; 367: 320-326
        • Hjerkinn E.M.
        Effects of diet and/or very long chain n-3 fatty acids in men with long-standing hyperlipidemia. Results from the DOIT study.
        Hjerteforum. 2005; 18 ([thesis])
        • Hjerkinn E.M.
        • Abdelnoor M.
        • Breivik L.
        • Bergengen L.
        • Ellingsen I.
        • Seljeflot I.
        • et al.
        Effect of diet or very long chain ω-3 fatty acids on progression of atherosclerosis, evaluated by carotid plaques, intima-media thickness and by pulse wave propagation in elderly men with hypercholesterolaemia.
        Eur J Cardiovasc Prev Rehab. 2006; 13: 325-333
        • Hjermann I.
        • Velve B.K.
        • Holme I.
        • Leren P.
        Effect of diet and smoking intervention on the incidence of coronary heart disease.
        Lancet. 1981; 2: 1303-1310
        • Hung H.C.
        • Joshipura K.J.
        • Jiang R.
        • Hu F.B.
        • Hunter D.
        • Smith-Warner S.A.
        • et al.
        Fruit and vegetable intake and risk of major chronic disease.
        J Natl Cancer Inst. 2004; 96: 1577-1584
        • Ignarro L.J.
        • Balestrieri M.L.
        • Napoli C.
        Nutrition, physical activity, and cardiovascular disease: an update.
        Cardiovasc Res. 2007; 73: 326-340
        • Iribarren C.
        • Folsom A.
        • Jacobs Jr., D.R.
        • Gross M.D.
        • Belcher J.D.
        • Eckfeldt J.H.
        • et al.
        Association of serum vitamin levels, LDL susceptibility to oxidation, and autoantibodies against MDA–LDL with carotid atherosclerosis.
        Arterioscler Thromb Vasc Biol. 1997; 17: 1171-1177
        • Joshipura K.J.
        • Hu F.B.
        • Manson J.E.
        • Stampfer M.J.
        • Rimm E.B.
        • Speizer F.E.
        • et al.
        The effect of fruit and vegetable intake on risk for coronary heart disease.
        Ann Intern Med. 2001; 134: 1106-1114
        • Lekakis J.P.
        • Papamichael C.
        • Papaioannou T.G.
        • Stamatelopoulos K.S.
        • Cimponeriu A.
        • Protogerou A.D.
        • et al.
        Intima-media thickness score from carotid and femoral arteries predicts the extent of coronary artery disease.
        Int J Cardiovasc Imaging. 2005; 21: 495-501
        • Lawlor D.A.
        • Smith G.D.
        • Bruckdorfer K.R.
        • Kundu D.
        • Ebrahim S.
        Those confounded vitamins: what can we learn from the differences between observational versus randomised trial evidence?.
        Lancet. 2004; 363: 1724-1727
        • Ness A.R.
        • Powles J.W.
        The role of diet, fruit and vegetables and antioxidants in the etiology of stroke.
        J Cardiovasc Risk. 1999; 6: 229-234
        • Nowson D.A.
        • Worsley A.
        • Margerison C.
        • Jorna M.K.
        • Godfrey S.J.
        • Booth A.
        Blood pressure change with weight loss is affected by diet type in men.
        Am J Clin Nutr. 2005; 81: 983-989
        • Ornish D.
        • Scherwitz L.W.
        • Billings J.H.
        • Brown S.E.
        • Gould K.L.
        • Meritt T.A.
        • et al.
        Intensive lifestyle changes for reversal of coronary heart disease.
        JAMA. 1998; 280: 2001-2007
        • Persson J.
        • Stavenow L.
        • Wikstrand J.
        • Israelsson B.
        • Formgren J.
        • Berglund G.
        Noninvasive quantification of atherosclerotic lesions. Reproducibility of ultrasonographic measurement of arterial wall thickness and plaque size.
        Arterioscler Thromb. 1992; 12: 261-266
        • Rumley A.G.
        • Woodward M.
        • Rumley A.
        • Rumley J.
        • Lowe G.D.O.
        Plasma lipid peroxides: relationship to cardiovascular risk factors and prevalent cardiovascular disease.
        Q J Med. 2004; 97: 809-816
        • Solvoll K.
        • Lund-Larsen K.
        • Søyland E.
        • Sandstad B.
        • Drevon C.A.
        A quantitative food frequency questionnaire evaluated in a group of dermatologic outpatients.
        Scand J Nutr. 1993; 37: 150-155
        • Stadler N.
        • Eggermann J.
        • Voo S.
        • Kranz A.
        • Waltenberger J.
        Smoking-induced monocyte dysfunction is reversed by vitamin C supplementation in vivo.
        Arterioscler Thromb Vasc Biol. 2007; 27: 120-126
        • Steffen L.M.
        • Folsom A.R.
        • Cushman M.
        • Jacobs D.
        • Rosamond W.D.
        Greater fish, fruit, and vegetable intakes are related to lower incidence of venous thromboembolism: the longitudinal investigation of thromboembolism etiology.
        Circulation. 2007; 115: 188-195
        • Stensland-Bugge E.
        • Bønaa K.H.
        • Joakimsen O.
        • Njølstad I.
        Sex differences in the relationship of risk factors to subclinical carotid atherosclerosis measured 15 years later: the Tromsø study.
        Stroke. 2000; 31: 574-581
        • Suurkula M.
        • Agewall S.
        • Fagerberg B.
        • Wendelhag I.
        • Wikstrand J.
        Multiple risk intervention in high-risk hypertensive patients. A 3-year ultrasound study of intima-media thickness and plaques in the carotid artery.
        Arterioscler Thromb Vasc Biol. 1996; 16 (Risk Intervention Study (RIS) Group): 971-977
        • Svendsen M.
        • Blomhoff R.
        • Holme I.
        • Tonstad S.
        The effect of an increased intake vegetables and fruit on weight loss, blood pressure and antioxidant defence in subjects with sleep related breathing disorders.
        Eur J Clin Nutr. Jan 31, 2007; ([epub ahead of print])
        • Tobias M.
        • Turley M.
        • Stefanogiannis N.
        • Vander Hoorn S.
        • Lawes C.
        • Mhurchu C.N.
        • et al.
        Vegetable and fruit intake and mortality from chronic disease in New Zealand.
        Aust N Z J Public Health. 2006; 30: 26-31
        • Tofler G.H.
        • Stec J.J.
        • Stubbe I.
        • Beadle J.
        • Feng D.
        • Lipinska I.
        • et al.
        The effect of vitamin C supplementation on coagulability and lipid levels in healthy male subjects.
        Thromb Res. 2000; 100: 35-41
        • Tribble D.L.
        Antioxidant consumption and risk of coronary heart disease: emphasis on vitamin C, vitamin E, and β-carotene: a statement for healthcare professional from the American Heart Association.
        Circulation. 1999; 99: 591-595
        • van't Veer P.
        • Jansen M.C.J.K.
        • Klerk M.
        • Kok F.J.
        Fruits and vegetables in the prevention of cancer and cardiovascular disease.
        Public Health Nutr. 2000; 3: 103-107
        • Wood D.
        • deBacker G.
        • Fagermann O.
        • Graham I.
        • Mancia G.
        • Pyörälä
        Task force report: prevention of coronary heart in clinical practice.
        Eur Heart J. 1998; 19: 1434-1503
        • Wannamethee S.G.
        • Lowe G.D.O.
        • Rumley A.
        • Bruckdorfer K.R.
        • Whincup P.H.
        Associations of vitamin C status, fruit and vegetable intakes, and markers of inflammation and hemostasis.
        Am J Clin Nutr. 2006; 83: 567-574