Vitamin E and heart disease: A case study

Lawrence H. Kushi

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

The role of nutritional epidemiology studies in the development of nutritional recommendations has been controversial, in part because individual studies supporting either side of a given issue can often be identified. Several sets of criteria for inference of a causal relation between a dietary factor and a disease from epidemiologic studies have been suggested. One such set is that of Sir Austin Bradford Hill, which includes criteria such as strength of association, dose-response relation, consistency of association, temporally correct association, specificity of association, and biological plausibility. Another set of criteria, used by the US Preventive Services Task Force, ranks evidence according to study design, designating evidence from randomized controlled trials as superior to evidence from cohort or case-control studies, which are in turn superior to evidence from ecologic studies or opinions of respected authorities. The application of these criteria to the question of whether vitamin E intake is associated with coronary heart disease is examined here. It is suggested that the epidemiologic evidence from prospective cohort studies generally supports an inverse association of vitamin E intake and risk of coronary heart disease. The information available from randomized trials is limited but suggestive of an inverse association with nonfatal, but not with fatal, coronary events. It is suggested that the application of criteria for causal inference to specific questions in nutritional epidemiology may provide clarity to seemingly contradictory information.

Original languageEnglish (US)
JournalAmerican Journal of Clinical Nutrition
Volume69
Issue number6
StatePublished - Jun 1999
Externally publishedYes

Fingerprint

heart diseases
Vitamin E
Coronary Disease
vitamin E
epidemiology
Heart Diseases
Epidemiology
case studies
dietary recommendations
Advisory Committees
case-control studies
cohort studies
epidemiological studies
dose response
Case-Control Studies
Epidemiologic Studies
Cohort Studies
Randomized Controlled Trials
experimental design
Prospective Studies

Keywords

  • α-Tocopherol
  • Causal inference
  • Coronary heart disease
  • Epidemiologic studies
  • Prospective studies
  • Vitamin E

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Vitamin E and heart disease : A case study. / Kushi, Lawrence H.

In: American Journal of Clinical Nutrition, Vol. 69, No. 6, 06.1999.

Research output: Contribution to journalArticle

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