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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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