Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: There are several major differences
in study design as well as reported results between our study and that of
Hemilä et al.1 Their study was designed
to determine the effect of vitamin E and beta-carotene on lung cancer in middle-aged
and elderly (50-69 years) male smokers; our study was limited to the elderly
population (≥65 years), included both smokers and nonsmokers as well as
both men and women, and had incidence of respiratory tract infection as the
primary outcome. Our study used a higher daily dose of vitamin E than their
study (200 IU/d of DL-α-tocopherol vs 50 mg/d of α-tocopherol).
We used 200 IU/d because this dose had been demonstrated in an earlier study
to induce the most robust improvement in immune function in the elderly population.2 In their study, the common cold incidence data were
based on recall by the participants during thrice-annual visits; in contrast,
we prospectively collected data once a week by means of an interview, focused
physical examination, and chart review. Additionally, we assessed compliance
with vitamin E supplementation by 3 different methods. Finally, while their
study reported a reduction in the incidence of common colds only in elderly
male smokers who resided in cities, we found a reduction in risk of acquiring
common colds in the elderly regardless of sex or smoking status.
Hamer DH, Meydani SN. Vitamin E and Respiratory Tract Infections in Elderly Persons—Reply. JAMA. 2004;292(23):2834. doi:10.1001/jama.292.23.2834-b