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Long-term Nutrient Intake and Early Age-Related Nuclear Lens Opacities
Paul F. Jacques, ScD;
Leo T. Chylack, Jr, MD;
Susan E. Hankinson, ScD;
Patricia M. Khu, MD;
Gail Rogers, MA;
Judith Friend, MA;
William Tung;
John K. Wolfe, PhD;
Nita Padhye, MD;
Walter C. Willett, MD, DrPH;
Allen Taylor, PhD
Arch Ophthalmol. 2001;119:1009-1019.
Objective To assess the relation between usual nutrient intake and subsequently
diagnosed age-related nuclear lens opacities.
Subjects Four hundred seventy-eight nondiabetic women aged 53 to 73 years from
the Boston, Mass, area without previously diagnosed cataracts sampled from
the Nurses' Health Study cohort.
Methods Usual nutrient intake was calculated as the average intake from 5 food
frequency questionnaires that were collected during a 13- to 15-year period
before the evaluation of lens opacities. The duration of vitamin supplement
use was determined from 7 questionnaires collected during this same period.
We defined nuclear opacities as a nuclear opalescence
grade of 2.5 or higher using the Lens Opacification Classification System
III.
Results The prevalence of nuclear opacification was significantly lower in the
highest nutrient intake quintile category relative to the lowest quintile
category for vitamin C (P<.001), vitamin E (P = .02), riboflavin (P = .005),
folate (P = .009), -carotene (P = .04), and lutein/zeaxanthin (P = .03).
After adjustment for other nutrients, only vitamin C intake remained significantly
associated (P = .003 for trend) with the prevalence
of nuclear opacities. The prevalence of nuclear opacities was significantly
lower (P<.001) in the highest vitamin C intake
quintile category relative to the lowest quintile category (odds ratio, 0.31;
95% confidence interval, 0.16-0.58). There were also statistically significant
trends of decreasing prevalence of nuclear opacities with increasing duration
of use of vitamin C (P = .004 for trend), vitamin
E (P = .03 for trend), and multivitamin (P = .04 for trend) supplements, but only duration of vitamin C supplement
use remained significantly associated with nuclear opacities after mutual
adjustment for use of vitamin E (P = .05 for trend)
or multivitamin (P = .02 for trend) supplements.
The prevalence of nuclear opacities was significantly lower (P = .004) for women who used a vitamin C supplement for 10 or more
years relative to women who never used vitamin C supplements (odds ratio,
0.36; 95% confidence interval, 0.18-0.72). Plasma measures of vitamins C and
E taken at the eye examination were also inversely associated with the prevalence
of nuclear opacities.
Conclusion These results provide additional evidence that antioxidant nutrients
play a role in the prevention of age-related nuclear lens opacities.
From the Jean Mayer US Department of Agriculture Human Nutrition Research
Center on Aging (Drs Jacques and Taylor and Ms Rogers) and the School of Nutrition
Science and Policy (Drs Jacques and Taylor), Tufts University; the Departments
of Ophthalmology (Dr Chylack) and Medicine (Drs Hankinson and Willett), Harvard
Medical School, Brigham and Women's Hospital, and the Channing Laboratory
(Drs Hankinson and Willett); the Center for Ophthalmic Research (Drs Chylack,
Khu, Wolfe, and Padhye, Ms Friend, and Mr Tung); and the Departments of Epidemiology
(Drs Hankinson and Willett) and Nutrition (Dr Willett), Harvard School of
Public Health, Boston, Mass.
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