Micronutrient intake in relation to all-cause mortality in a prospective Danish cohort

Figures & data

Table 1. Baseline characteristics of cases and study-population by selected demographic and established risk factors and intake of micronutrients

Cases (n = 6,767)			Cohort (n = 55,453)
Median		5–95% percentile	N (%)	Median	5—95%	N (%)
Age at baseline	59.0	51.0–64.0		56.0	50.0–64.0
Sex
Male			4073 (60.2)			26609 (48.0)
Female			2694 (39.8)			28844 (52.0)
Smoking status
Never			1223 (18.1)			19573 (35.3)
Former			1630 (24.1)			15733 (28.4)
Current			3914 (57.8)			20147 (36.3)
BMI (kg/m^2)	26.0	19.9–34.9		25.6	20.5–33.4
Education
< 7 years			2886 (42.7)			18365 (33.1)
7 – 10 years			2807 (41.5)			25513 (46.0)
> 10 years			1074 (15.9)			11575 (20.9)
Alcohol intake (g/day) ^4	15.7	1.0–89.2		13.4	1.1–65.1
Sport			2589 (38.3)			29653 (53.5)
Cycling			3949 (58.4)			37428 (67.5)
Vitamin C (mg/day)
Dietary intake	91.8	38.0–213.6		97.8	44.1–210.2
Supplemental intake^5	60.0	7.1–666.0		60.0	7.1–590.0
Percentage using supplements			3193 (47.2)			28563 (51.5)
Folate (µg/day)
Dietary intake	318.8	178.7–542.3		325.2	189.4–521.8
Supplemental intake^5	100.0	16.7–300.0		100.0	11.9–283.2
Percentage using supplements			2620 (38.7)			23418 (42.2)
Vitamin E (mg/day)
Dietary intake	8.3	4.4–14.8		8.6	4.7–14.3
Supplemental intake^5	10.0	1.4–72.0		10.0	1.2–75.0
Percentage using supplements			3001 (44.1)			27417 (49.4)
Beta-carotene (µg/day)
Dietary intake	2480.9	603.1–11769.8		3205.4	795.9–13016.3
Supplemental intake^5	2254.5	187.2–15300.0		2254.5	187.2–16002.5
Percentage using supplements			120 (1.8)			1435 (2.6)

¹ Among ever smokers.

² Among current smokers.

³ Among former smokers.

⁴ Among drinkers.

⁵ Among users.

Table 2. Incidence rate ratios (IRR) for all-cause mortality associated with intake of vitamin C, folate, vitamin E, and beta-carotene

	Continuous analyses				Categorical analyses^2
	Crude IRR^1 95% CI	Adjusted IRR^1.2 95% CI	Group 1 (low)	Group 2	Group 3	Group 4 (high)	Test for trend
Vitamin C^3
Dietary intake	0.85 (0.81–0.90)	1.05 (0.99–1.11)	1.0 (ref.)	0.88 (0.82–0.94)	0.87 (0.80–0.93)	0.97 (0.89–1.06)	0.08
Supplemental intake	1.00 (0.99–1.00)	1.00 (0.99–1.01)	1.0 (ref.)	0.97 (0.88–1.07)	1.06 (0.95–1.18)	1.02 (0.93–1.12)	0.51
Folate^4
Dietary intake	0.94 (0.91–0.96)	1.02 (0.98–1.05)	1.0 (ref.)	0.88 (0.82–0.95)	0.87 (0.81–0.94)	0.93 (0.85–1.03)	0.38
Supplemental intake	1.00 (0.99–1.02)	1.02 (1.01-–1.03)	1.0 (ref.)	1.06 (0.96–1.16)	1.13 (1.02–1.24)	1.04 (0.94–1.16)	0.0025
Vitamin E^5
Dietary intake	0.76 (0.70–0.82)	0.90 (0.80–1.02)	1.0 (ref.)	0.85 (0.80–0.92)	0.81 (0.75–0.88)	0.85 (0.78–0.94)	0.10
Supplemental intake	0.99 (0.99–1.00)	1.00 (1.00–1.01)	1.0 (ref.)	0.83 (0.75–0.92)	0.89 (0.80–0.99)	0.88 (0.79–0.98)	0.70
Beta-carotene^6
Dietary intake	0.86 (0.83–0.89)	0.98 (0.95–1.01)	1.0 (ref.)	0.86 (0.80–0.92)	0.81 (0.75–0.87)	0.79 (0.73–0.86)	0.29
Supplemental intake	0.91 (0.82–1.01)	1.02 (0.91–1.15)	1.0 (ref.)	0.80 (0.58–1.09)	0.92 (0.68–1.26)	0.87 (0.63–1.19)	0.78

¹ Per 100 mg increment/day for vitamin C, 100 µg increment/day for folate/folic acid, 10 mg increment/day for vitamin E, and 5,000 µg increment/day for beta-carotene.

² Adjusted for total intake of the three other micronutrients as well as dietary intake for the supplemental intake and supplemental intake for the dietary intake and further for alcohol intake, BMI, waist circumference, smoking status (never/former/present), smoking duration, smoking intensity, time since cessation, education, and physical activity (sport yes/no and cycling yes/no).

³ Cut points for dietary vitamin C: ≤65.19 mg; ≤91.77 mg; ≤127.75 mg; cut points for supplemental vitamin C: 0 mg; >0 mg – ≤ 39.96 mg; ≤60.00 mg.

⁴ Cut points for dietary folate: ≤254.96 µg; ≤318.77 µg; ≤ 395.80 µg; cut points for supplemental folate: 0 µg; >0 µg – ≤ 83.2 µg; ≤150.0 µg.

⁵ Cut points for dietary vitamin E: ≤6.51 mg; ≤8.36 mg; ≤10.60 mg; cut points for supplemental vitamin E: 0 mg; >0 mg – ≤ 6.66 mg; ≤ 10 mg.

⁶ Cut points for dietary beta-carotene: ≤1317.07 µg; ≤2480.90 µg; ≤4797.69 µg; cut points for supplemental beta-carotene: 0 µg; >0– ≤ 1250.00 µg; ≤ 5994.00 µg.

Table 3. Incidence rate ratio for mortality associated with intake of vitamin C, folate, vitamin E, and beta-carotene

	Never Smokers (1,223 cases / 18,350 non-cases)		Former smokers (1,630 cases/14,103 non-cases)		Current Smokers (3,914 cases/16,233 non-cases)
	Crude IRR^1 95% CI	Adjusted IRR^1,.2 95% CI	Crude IRR^1 95% CI	Adjusted IRR^1,.2 95% CI	Crude IRR^1 95% CI	Adjusted IRR^1,.2 95% CI	P-value from adjusted analyses
Vitamin C	1.03 (0.93–1.14)	1.11 (1.00–1.24)	0.96 (0.87–1.05)	1.06 (0.96–1.17)	0.90 (0.85–0.96)	1.03 (0.96–1.10)	0.37
Dietary intake
Supplemental intake	1.01 (0.98–1.04)	1.01 (0.98–1.03)	0.99 (0.97–1.01)	0.99 (0.97–1.02)	1.00 (0.99–1.02)	1.01 (0.99–1.02)	0.54
Folate
Dietary intake	1.05 (0.99–1.11)	1.12 (1.05–1.19)	0.97 (0.92–1.01)	1.03 (0.97–1.09)	0.95 (0.92–0.98)	0.99 (0.95–1.03)	0.0005
Supplemental intake	1.02 (1.01–1.04)	1.02 (1.01–1.03)	1.01 (0.99–1.03)	1.01 (0.99–1.03)	1.02 (0.99–1.05)	1.01 (0.98–1.04)	0.69
Vitamin E
Dietary intake	1.21 (1.01–1.45)	1.27 (1.04–1.55)	0.91 (0.77–1.07)	0.98 (0.81–1.18)	0.72 (0.65–0.80)	0.79 (0.69–0.91)	<.0001
Supplemental intake	1.00 (0.99–1.01)	1.00 (0.99–1.01)	1.01 (1.00–1.01)	1.01 (1.00–1.02)	1.00 (0.99–1.01)	1.00 (0.99–1.01)	0.26
Beta-carotene
Dietary intake	0.95 (0.90–1.01)	0.97 (0.92–1.03)	0.97 (0.92–1.02)	1.01 (0.96–1.06)	0.88 (0.84–0.92)	0.97 (0.93–1.01)	0.36
Supplemental intake	1.08 (0.89–1.31)	1.04 (0.85–1.27)	1.06 (0.89–1.26)	1.05 (0.89–1.25)	0.98 (0.82–1.18)	0.97 (0.81–1.16)	0.77

Note: Stratified by smoking status.

¹ Per each additional 100 mg vitamin C, 100 µg folate, 10 mg vitamin E, or 5,000 µg beta-carotene.

² Adjusted for total intake of the three other micronutrients as well as dietary intake for the supplemental intake and supplemental intake for the dietary intake and further for alcohol intake, BMI, waist circumference, smoking duration, smoking intensity, time since cessation, education, and physical activity (sport yes/no and cycling yes/no).

Table 4. Incidence rate ratio for mortality, associated with intake of vitamin C, folate, vitamin E, and beta-carotene

	Abstainers (314 cases/974 non-cases)		>0– ≤ 10 g/day (2,231 cases/18,040 non-cases)		> 10 g/day (4,222 cases /29,672 non-cases)
	Crude IRR^1 95% CI	Adjusted IRR^1,.2 95% CI	Crude IRR^1 95% CI	Adjusted IRR^1,.2 95% CI	Crude IRR^1 95% CI	Adjusted IRR^1,.2 95% CI	P-value from adjusted analyses
Vitamin C
Dietary intake	0.96 (0.82–1.13)	1.04 (0.89–1.22)	0.91 (0.84–0.98)	1.09 (1.01.00–1.18)	0.81 (0.76–0.86)	1.00 (0.94–1.08)	0.24
Supplemental intake	1.02 (0.98–1.06)	1.03 (0.99–1.07)	1.02 (1.01–1.03)	1.01 (1.00–1.03)	1.00 (0.99–1.02)	0.99 (0.98–1.01)	0.07
Folate
Dietary intake	0.99 (0.90–1.08)	1.05 (0.96–1.15)	0.93 (0.90–0.97)	1.07 (1.01–1.12)	0.93 (0.91–0.96)	1.04 (1.00–1.08)	0.60
Supplemental intake	1.08 (0.97–1.19)	1.08 (0.97–1.20)	1.04 (1.02–1.05)	1.03 (1.02–1.05)	1.00 (0.98–1.02)	1.00 (0.98–1.03)	0.07
Vitamin E
Dietary intake	1.05 (0.79–1.41)	0.97 (0.71–1.31)	0.89 (0.78–1.03)	0.93 (0.79–1.10)	0.67 (0.60–0.74)	0.76 (0.66–0.87)	0.0325
Supplemental intake	0.99 (0.96–1.02)	1.00 (0.97–1.02)	1.01 (1.00–1.01)	1.01 (1.00–1.02)	1.00 (0.99–1.00)	1.00 (0.99–1.00)	0.05
Beta-carotene
Dietary intake	0.79 (0.69–0.90)	0.90 (0.79–1.02)	0.89 (0.85–0.93)	0.98 (0.94–1.03)	0.85 (0.81–0.89)	0.98 (0.94–1.02)	0.39
Supplemental intake	0.85 (0.47–1.55)	0.96 (0.55–1.68)	1.02 (0.86–1.21)	1.01 (0.85–1.22)	1.05 (0.91–1.21)	1.03 (0.89–1.19)	0.97

Note: Stratified by alcohol intake.

¹ Per each additional 100 mg vitamin C, 100 µg folate, 10 mg vitamin E, or 5,000 µg beta-carotene.

² Adjusted for total intake of the three other micronutrients as well as dietary intake for the supplemental intake and supplemental intake for the dietary intake and further for BMI, waist circumference, smoking status (never/former/present), smoking duration, smoking intensity, time since cessation, education, and physical activity (leisure time sport yes/no and cycling yes/no).