Dietary intakes of fat soluble vitamins as predictors of mortality from heart failure in a large prospective cohort study

Objectives: A few reports have investigated the association of dietary vitamin intakes with risk of heart failure in Asia. Therefore, we examined the relation between dietary intakes of fat-soluble vitamins A, K, E, and D and mortality from heart failure in the Japanese population. Methods: A total of 23 099 men and 35 597 women ages 40 to 79 y participated in the Japan Collaborative Cohort Study and completed a food frequency questionnaire from which dietary intakes of vitamins A, K, E, and D were calculated. The Cox proportional hazard model was used to estimate the sex specific risks of heart failure mortality according to increasing quintiles of fat-soluble vitamin intakes. Results: During the median 19.3 y follow-up period, there were 567 deaths from heart failure (240 men. 327 women). Dietary vitamin A intake showed no association with heart failure mortality in both sexes; however, the reduced risk was observed in women but not in men with dietary intakes of vitamins K, E, and D. The multivariable hazard ratios (95% confidence interval) in the highest versus the lowest intake quintiles among women were 0.63 (0.45-0.87; P for trend = 0.006) for vitamin K, 0.55 (0.36-0.78: P for trend = 0.006) for vitamin E, and 0.66 (0.48-0.93; P for trend = 0.01) for vitamin D. The association for each vitamin was slightly attenuated but remained statistically significant after mutual adjustment for intakes of the other vitamins. Conclusions: High dietary intakes of fat-soluble vitamins K, E, and D were associated with a reduced risk of heart failure mortality in Japanese women but not men. (C) 2017 Elsevier Inc. All rights reserved.