Among participants who had dietary vitamin C intake of 90 mg/day and above, vitamin E supplement increased mortality by 19% ( p = 0.006) in those aged 50–62 years, but decreased mortality by 41% ( p = 0.0003) in those aged 66–69 years. The effect of vitamin E supplement was estimated by Cox regression. ![]() The purpose of this study was to analyze the association between dietary vitamin E intake and the effect of 25 mg/day of vitamin E supplement on total mortality in Finnish male smokers aged 50–69 years in the Alpha-Tocopherol-Beta-Carotene (ATBC) Study. If vitamin E intake below the EAR is harmful, then vitamin E supplement should be beneficial to those people who have dietary vitamin E intake level below the EAR. Nevertheless, the effect of dietary vitamin E intake can be investigated indirectly from the effects of a fixed-level vitamin E supplement administered to participants on variable levels of dietary vitamin E intake. ![]() Investigating the effect of long-term dietary vitamin E intake level on mortality in a randomized trial is, however, not feasible. Total mortality is an outcome of direct clinical relevance. The validity of the EAR level is therefore questionable. ![]() The EAR is then extrapolated to females and older males. The EAR value is based on in vitro hemolysis in young males a surrogate endpoint without any direct validity. The Dietary Reference Intakes (DRI)-monograph (USA/Canada) states that the estimated average requirement (EAR) of vitamin E for men and women of any age is 12 mg/day. Department of Public Health, University of Helsinki, Helsinki, Finland.
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