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The Effect of Vitamin E on Common Cold Incidence Is Modified by Age, Smoking and Residential Neighborhood

Department of Public Health, University of Helsinki, (H.H., J.K.)
Department of Epidemiology and Health Promotion, National Public Health Institute (J.V.), Helsinki, FINLAND
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland (D.A.)

Address reprint requests to: Harri Hemilä, PhD, MD, Department of Public Health, POB 41, University of Helsinki, Helsinki, FIN-00014, FINLAND. E-mail: harri.hemila{at}helsinki.fi

Background: We have previously found a 28% reduction in common cold incidence with 50 mg/day vitamin E supplementation in a subgroup of the Alpha-Tocopherol Beta-Carotene Cancer Prevention (ATBC) Study cohort: older city-dwelling men (65 years) who smoked only 5–14 cigarettes/day.

Objective: To carry out more detailed analyses to explore the modification of vitamin E effect by age, smoking, and residential neighborhood.

Methods: We examined the effect of vitamin E on common cold risk in subjects consisting of the placebo and vitamin E arms (n = 14,573) of the ATBC Study, which recruited males aged 50–69 years who smoked 5 cigarettes/day at the baseline. The ATBC Study was conducted in southwestern Finland in 1985–1993; the active follow-up lasted for 4.7 years (mean). We modeled common cold risk as a function of age-at-follow-up in the vitamin E arm compared with the placebo arm using linear splines in Poisson regression.

Results: In participants of 72 years or older at follow-up, the effect of vitamin E diverged. Among those smoking 5–14 cigarettes per day at baseline and living in cities, vitamin E reduced common cold risk (RR = 0.54; 95% CI 0.37–0.80), whereas among those smoking more and living away from cities, vitamin E increased common cold risk (RR = 1.58; 1.23–2.01).

Conclusions: Vitamin E may cause beneficial or harmful effects on health depending on various modifying factors. Accordingly, caution should be maintained in public health recommendations on vitamin E supplementation until its effects are better understood.

Key words: aging, alpha-tocopherol, cities, randomized controlled trial, respiratory infections

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