Plasma vitamin C concentrations and risk of incident respiratory diseases and mortality in the European Prospective Investigation into Cancer-Norfolk Cohort

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Background: Cancerous and non-cancerous respiratory diseases are common and contribute significantly to global disease burden. We aim to quantify the association between plasma vitamin C concentrations as an indicator of high fruit and vegetable consumption and the risk of incident respiratory diseases and associated mortality in a general population. Methods: 19,357 men and women aged 40-79 years without prevalent respiratory diseases at the baseline (1993-1997) and participating in the European Prospective Investigation into Cancer (EPIC)-Norfolk study in the UK were followed through March 2015 for both incidence and mortality from respiratory diseases. Results: There were a total of 3914 incident events and 407 deaths due to any respiratory diseases (excluding lung cancers), 367 incident lung cancers and 280 lung cancer deaths during the follow up (total person years >300,000 years). Cox proportional hazards models showed, persons in the top quartiles of baseline plasma vitamin C concentrations had a 43% lower risk of lung cancer (HR 0.57; 95%CI:0.41-0.81) than did those in the bottom quartile, independently of potential confounders. The results are similar for non-cancerous any respiratory disease (HR 0.85;0.77-0.95), chronic respiratory diseases (HR0.81;0.69-0.96), and pneumonia (HR0.70;0.59-0.83). The corresponding values for mortality were 0.54(0.35- 0.81), 0.81(0.59-1.12), 0.85(0.44-1.66), and 0.61(0.37-1.01), respectively. Confining analyses to non-smokers showed 42% and 53% risk reduction of non-smoking related lung cancers incidence and death. Conclusions: Higher levels of vitamin C concentrations as a marker of high fruit and vegetable consumption reduces the risk of cancerous and non-cancerous respiratory illnesses including non-smoking related cancers incidence and deaths.


Original languageEnglish
JournalEuropean Journal of Clinical Nutrition
Publication statusPublished - 31 Jan 2019

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