Background: A meta-analysis of 19 trials suggested a small increase in the risk of all-cause
mortality with
high-dose
vitamin E supplementation. Little is known, however, about the relation between mortality and circulating
concentrations of vitamin E resulting from dietary intake, low-dose supplementation, or both.
Objective: We examined whether baseline serum -
tocopherol concentrations are associated with total and cause-specific mortality.
Design: A prospective cohort study of 29 092 Finnish male smokers aged 50–69 y who participated in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study was carried out. Fasting serum -tocopherol was measured at baseline by using HPLC. Only 10% of participants reported
vitamin E supplement use at baseline, and thus serum concentrations of
vitamin E mainly reflected dietary intake and other host factors. Risks of total and cause-specific mortality were estimated by using proportional hazards models.
Results: During up to 19 y of follow-up, 13 380 deaths (including 4518 and 5776 due to cancer and cardiovascular disease, respectively) were identified. Men in the higher quintiles of serum -tocopherol had significantly lower risks of total and cause-specific mortality than did those in the lowest quintile
P for trend for all < 0.0001>. Cubic regression spline analysis of continuous serum -tocopherol values indicated greater risk reductions with increasing concentrations up to 13–14 mg/L, after which no further benefit was noted. Conclusion: Higher circulating concentrations of -tocopherol within the normal range are associated with significantly lower total and cause-specific mortality in older male smokers.