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Original Article

Intakes of vitamin C and carotenoids and risk of amyotrophic lateral sclerosis: Pooled results from 5 cohort studies

  1. Kathryn C. Fitzgerald ScM1,*,
  2. Éilis J. O'Reilly ScD1,2,
  3. Elinor Fondell PhD1,
  4. Guido J. Falcone MD, MPH3,4,
  5. Marjorie L. McCullough ScD5,
  6. Yikyung Park ScD6,
  7. Laurence N. Kolonel MD, PhD7,
  8. Alberto Ascherio MD, DrPH1,2,4

Article first published online: 29 JAN 2013

DOI: 10.1002/ana.23820

Issue

Annals of Neurology

Annals of Neurology

Volume 73, Issue 2, pages 236–245, February 2013

Additional Information

How to Cite

Fitzgerald, K. C., O'Reilly, É. J., Fondell, E., Falcone, G. J., McCullough, M. L., Park, Y., Kolonel, L. N. and Ascherio, A. (2013), Intakes of vitamin C and carotenoids and risk of amyotrophic lateral sclerosis: Pooled results from 5 cohort studies. Ann Neurol., 73: 236–245. doi: 10.1002/ana.23820

Author Information

  1. 1

    Department of Nutrition, Harvard School of Public Health, Boston, MA

  2. 2

    Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA

  3. 3

    Department of Neurology, Massachusetts General Hospital, Boston, MA

  4. 4

    Department of Epidemiology, Harvard School of Public Health, Boston, MA

  5. 5

    Epidemiology Research Program, American Cancer Society, Atlanta, GA

  6. 6

    Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD

  7. 7

    Epidemiology Program, Cancer Center, University of Hawaii, Honolulu, HI

*Address correspondence to Kathryn C. Fitzgerald, 665 Huntington Ave, Boston, MA 02115. E-mail: hpkcf@channing.harvard.edu

Publication History

  1. Issue published online: 22 MAR 2013
  2. Article first published online: 29 JAN 2013
  3. Accepted manuscript online: 26 NOV 2012 10:31AM EST
  4. Manuscript Accepted: 28 SEP 2012
  5. Manuscript Revised: 15 SEP 2012
  6. Manuscript Received: 11 JUN 2012

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Objective

Prior research has suggested the possible role of oxidative stress in the pathogenesis of amyotrophic lateral sclerosis (ALS). Prospective data examining dietary antioxidants such carotenoids and vitamin C are limited.

Methods

Risk of ALS associated with carotenoid and vitamin C intake was investigated in 5 prospective cohorts: the National Institutes of Health–Association of American Retired Persons Diet and Health Study, the Cancer Prevention Study II Nutrition Cohort, the Multiethnic Cohort, the Health Professionals Follow-up Study (HPFS), and the Nurses Health Study (NHS). ALS deaths were documented using the National Death Index, and confirmed nonfatal ALS cases were included from HPFS and NHS. A total of 1,153 ALS deaths occurred among 1,100,910 participants (562,942 men; 537,968 women). Participants were categorized into cohort-specific quintiles of intake for dietary variables. We applied Cox proportional hazards regression to calculate cohort-specific risk ratios (RRs), and pooled results using random-effects methods.

Results

A greater total major carotenoids intake was associated with a reduced risk of ALS (pooled, multivariate-adjusted RR for the highest to the lowest quintile = 0.75, 95% confidence interval [CI] = 0.61–0.91, p for trend = 0.004). Individually, higher dietary intakes of β-carotene and lutein were inversely associated with ALS risk. The pooled multivariate RRs comparing the highest to the lowest quintile for β-carotene and lutein were 0.85 (95% CI = 0.64–1.13, p for trend = 0.03) and 0.79 (95% CI = 0.64–0.96, p for trend = 0.01), respectively. Lycopene, β-cryptoxanthin, and vitamin C were not associated with reduced risk of ALS.

Interpretation

Consumption of foods high in carotenoids may help prevent or delay onset of ALS. ANN NEUROL 2013;73:236–245

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