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December 15, 2004

Vitamin E and Respiratory Tract Infections in Elderly Persons—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(23):2834. doi:10.1001/jama.292.23.2834-b

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.

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