 |
|
Vitamin E and Respiratory Tract Infections in Elderly Nursing Home Residents
A Randomized Controlled Trial
Simin Nikbin Meydani, DVM, PhD;
Lynette S. Leka, BS;
Basil C. Fine, MD;
Gerard E. Dallal, PhD;
Gerald T. Keusch, MD;
Maria Fiatarone Singh, MD;
Davidson H. Hamer, MD
JAMA. 2004;292:828-836.
Context Respiratory tract infections are prevalent in elderly individuals, resulting in increased morbidity, mortality, and use of health care services. Vitamin E supplementation has been shown to improve immune response in elderly persons. However, the clinical importance of these findings has not been determined.
Objective To determine the effect of 1 year of vitamin E supplementation on respiratory tract infections in elderly nursing home residents.
Design, Setting, and Participants A randomized, double-blind, placebo-controlled trial was conducted from April 1998 to August 2001 at 33 long-term care facilities in the Boston, Mass, area. A total of 617 persons aged at least 65 years and who met the study's eligibility criteria were enrolled; 451 (73%) completed the study.
Intervention Vitamin E (200 IU) or placebo capsule administered daily; all participants received a capsule containing half the recommended daily allowance of essential vitamins and minerals.
Main Outcome Measures Incidence of respiratory tract infections, number of persons and number of days with respiratory tract infections (upper and lower), and number of new antibiotic prescriptions for respiratory tract infections among all participants randomized and those who completed the study.
Results Vitamin E had no significant effect on incidence or number of days with infection for all, upper, or lower respiratory tract infections. However, fewer participants receiving vitamin E acquired 1 or more respiratory tract infections (60% vs 68%; risk ratio [RR], 0.88; 95% confidence interval [CI], 0.76-1.00; P = .048 for all participants; and 65% vs 74%; RR, 0.88; 95% CI, 0.75-0.99; P = .04 for completing participants), or upper respiratory tract infections (44% vs 52%; RR, 0.84; 95% CI, 0.69-1.00; P = .05 for all participants; and 50% vs 62%; RR, 0.81; 95% CI, 0.66-0.96; P = .01 for completing participants). When common colds were analyzed in a post hoc subgroup analysis, the vitamin E group had a lower incidence of common cold (0.67 vs 0.81 per person-year; RR, 0.83; 95% CI, 0.68-1.01; P = .06 for all participants; and 0.66 vs 0.83 per person-year; RR, 0.80; 95% CI, 0.64-0.98; P = .04 for completing participants) and fewer participants in the vitamin E group acquired 1 or more colds (40% vs 48%; RR, 0.83; 95% CI, 0.67-1.00; P = .05 for all participants; and 46% vs 57%; RR, 0.80; 95% CI, 0.64-0.96; P = .02 for completing participants). Vitamin E had no significant effect on antibiotic use.
Conclusions Supplementation with 200 IU per day of vitamin E did not have a statistically significant effect on lower respiratory tract infections in elderly nursing home residents. However, we observed a protective effect of vitamin E supplementation on upper respiratory tract infections, particularly the common cold, that merits further investigation.
Author Affiliations: Nutritional Immunology Laboratory (Dr Meydani and Ms Leka) and Biostatistics Unit (Dr Dallal), Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Mass; Department of Pathology, Sackler Graduate School of Biochemical Sciences, Tufts University, Boston (Dr Meydani); Department of Medicine, Mount Auburn Hospital, Cambridge, Mass (Dr Fine); Department of International Health, Boston University School of Public Health, Boston, Mass (Dr Keusch); University of Sydney, Lidcombe, Australia (Dr Singh); Department of Medicine, Tufts University School of Medicine, Boston (Dr Hamer); and the Center for International Health and Development, Boston University School of Public Health, Boston (Dr Hamer).
RELATED LETTERS
Vitamin E and Respiratory Tract Infections in Elderly Persons
Harri Hemilä and Jaakko Kaprio
JAMA. 2004;292(23):2834.
EXTRACT
| FULL TEXT
Vitamin E and Respiratory Tract Infections in Elderly Persons—Reply
Davidson H. Hamer and Simin Nikbin Meydani
JAMA. 2004;292(23):2834.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Age-associated changes in immune and inflammatory responses: impact of vitamin E intervention
Wu and Meydani
J. Leukoc. Biol. 2008;84:900-914.
ABSTRACT
| FULL TEXT
Gene polymorphisms of oxidative stress enzymes: prediction of elderly renutrition
Fabre et al.
Am. J. Clin. Nutr. 2008;87:1504-1512.
ABSTRACT
| FULL TEXT
Serum zinc and pneumonia in nursing home elderly
Meydani et al.
Am. J. Clin. Nutr. 2007;86:1167-1173.
ABSTRACT
| FULL TEXT
Dietary Intake of Selected Nutrients Affects Bacterial Vaginosis in Women
Neggers et al.
J. Nutr. 2007;137:2128-2133.
ABSTRACT
| FULL TEXT
Immunological Parameters: What Do They Mean?
Calder
J. Nutr. 2007;137:773S-780S.
ABSTRACT
| FULL TEXT
Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-analysis
Bjelakovic et al.
JAMA 2007;297:842-857.
ABSTRACT
| FULL TEXT
Age-Associated Decline in Effective Immune Synapse Formation of CD4+ T Cells Is Reversed by Vitamin E Supplementation
Marko et al.
J. Immunol. 2007;178:1443-1449.
ABSTRACT
| FULL TEXT
Age and Vitamin E-Induced Changes in Gene Expression Profiles of T Cells
Han et al.
J. Immunol. 2006;177:6052-6061.
ABSTRACT
| FULL TEXT
An aged host promotes the evolution of avirulent coxsackievirus into a virulent strain
Gay et al.
Proc. Natl. Acad. Sci. USA 2006;103:13825-13830.
ABSTRACT
| FULL TEXT
Effect of concomitant consumption of fish oil and vitamin e on T cell mediated function in the elderly: a randomized double-blind trial.
Wu et al.
J. Am. Coll. Nutr. 2006;25:300-306.
ABSTRACT
| FULL TEXT
The effect of vitamin e on common cold incidence is modified by age, smoking and residential neighborhood.
Hemila et al.
J. Am. Coll. Nutr. 2006;25:332-339.
ABSTRACT
| FULL TEXT
Reply to H Hemila
Hathcock et al.
Am. J. Clin. Nutr. 2005;82:1142-1143.
FULL TEXT
Strategies, Time, and Costs Associated With the Recruitment and Enrollment of Nursing Home Residents for a Micronutrient Supplementation Clinical Trial
Gismondi et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2005;60:1469-1474.
ABSTRACT
| FULL TEXT
Intake of n-6 and n-3 fatty acids and fish and risk of community-acquired pneumonia in US men
Merchant et al.
Am. J. Clin. Nutr. 2005;82:668-674.
ABSTRACT
| FULL TEXT
Vitamin and mineral supplements for preventing infections in older people
Gariballa
BMJ 2005;331:304-305.
FULL TEXT
Effect of multivitamin and multimineral supplements on morbidity from infections in older people (MAVIS trial): pragmatic, randomised, double blind, placebo controlled trial
Avenell et al.
BMJ 2005;331:324-329.
ABSTRACT
| FULL TEXT
Essential Nutrients: Food or Supplements?: Where Should the Emphasis Be?
Lichtenstein and Russell
JAMA 2005;294:351-358.
ABSTRACT
| FULL TEXT
High-Dosage Vitamin E Supplementation and All-Cause Mortality
Meydani et al.
ANN INTERN MED 2005;143:153-153.
FULL TEXT
{alpha}-Tocopherol and Selenium Facilitate Recovery from Lipopolysaccharide-Induced Sickness in Aged Mice
Berg et al.
J. Nutr. 2005;135:1157-1163.
ABSTRACT
| FULL TEXT
T cell aging: naive but not young
Nikolich-Zugich
J. Exp. Med. 2005;201:837-840.
ABSTRACT
| FULL TEXT
Designing the Selenium and Vitamin E Cancer Prevention Trial (SELECT)
Lippman et al.
JNCI J Natl Cancer Inst 2005;97:94-102.
ABSTRACT
| FULL TEXT
Vitamin E and Respiratory Tract Infections in Elderly Persons
Hemila and Kaprio
JAMA 2004;292:2834-2834.
FULL TEXT
Antibiotic prescribing for respiratory tract infections in Dutch primary care in relation to patient age and clinical entities
Akkerman et al.
J Antimicrob Chemother 2004;54:1116-1121.
ABSTRACT
| FULL TEXT
Vitamin E Has Limited Benefit in Preventing Infections in the Elderly
JWatch Infect. Diseases 2004;2004:9-9.
FULL TEXT
Vitamin E Does Not Prevent Lower Respiratory-Tract Infections in Nursing Home Residents
JWatch General 2004;2004:3-3.
FULL TEXT
|
