Association of Antioxidants Use with All-Cause and Cause-Specific Mortality: A Prospective Study of the UK Biobank

Abstract

Prospective studies and randomized controlled trials elucidating the impact of antioxidants supplementation on mortality risk are inconclusive. The present analysis determined association between regular antioxidants use and all-cause (primary objective), as well as cause-specific, mortality in 345,626 participants of the UK Biobank cohort using Cox proportional hazard models. All models were adjusted for confounders and multiple testing. Antioxidants users were defined as participants who indicated to regularly use at least one of the following: multivitamins, vitamin C, vitamin E, selenium, and zinc. Median age of antioxidants users (n = 101,159) and non-users (n = 244,467) at baseline was 57 years. During 3.9 million person-years and a median follow-up of 11.5 years, 19,491 deaths occurred. Antioxidants use was not significantly associated with all-cause, cancer, and non-cancer mortality including several cancer and non-cancer subtypes. Interestingly, mortality risk from respiratory disease was significantly 21% lower among antioxidants users as compared to non-users (hazard ratio: 0.79; 95% confidence interval: 0.67, 0.92). In conclusion, the present study findings do not support recommendations for antioxidants supplementation to prevent all-cause, cancer, or non-cancer mortality on a population level. The significant inverse association between antioxidants use and respiratory disease mortality needs further study.

Association of all-cause mortality with sugar intake from different sources in the prospective cohort of UK Biobank participants

“…2. Similar to a previous study (20) , the following exclusion criteria were applied: 1) malabsorption/celiac disease, 2) missing lifestyle risk factors (physical activity and/or smoking status), 3) missing socioeconomic factors (Townsend deprivation index, total household income, ethnic background, highest qualification, and/or overall health rating), 4) missing data of the physical exam (body mass index (BMI), systolic blood pressure (SBP)), 5) history of diabetes mellitus, 6) implausible energy or carbohydrate intake, i.e., being in the upper 0.1 % of total energy and/or carbohydrate intake or total energy intake <1.1 × basal metabolic rate -500 kcal (under-reporting) or >2.5 × basal metabolic rate + 500 kcal (over-reporting) resulting in a study population of 186,811 participants (Supplementary Fig. 2 and 3).…”

Association of sugar intake from different sources with incident depression in the prospective cohort of UK Biobank participants

“…Consumption of sugar and sugar subtypes was calculated based on the Oxford WebQ data with methodology similar to recent studies [ 27 , 28 ]. In brief, energy and total sugar contents were estimated for each Oxford WebQ questionnaire item based on McCance and Widdowson’s The Composition of Foods and its supplements [ 26 ], the UK Data Archive Standard Recipes Database [ 29 ], and product labels.…”

The Role of Diet, Alcohol, BMI, and Physical Activity in Cancer Mortality: Summary Findings of the EPIC Study

“…Other bioactive compounds, such as antioxidants, could also exert protective effects againts cancer mortality by mitigating the impact of oxidative stress on the body. A potential association between non-recent use of antioxidant vitamin supplements and vitamin C and cancer mortality prevention was observed in EPIC [55], but this association remains controversial in light of a research study conducted in the UK-Biobank cohort (n = 10,780 cancer deaths) that found different results [83]. A diet rich in vitamin K was also associated with reduced mortality for all cancers in one EPIC study [52], but not in another country-based EPIC study [53].…”