European Journal of Nutrition

, Volume 46, Issue 2, pp 118–124 | Cite as

Prospective study showing that dietary vitamin C reduced the risk of age-related cataracts in a middle-aged Japanese population

  • Masao Yoshida
  • Yutaka Takashima
  • Manami Inoue
  • Motoki Iwasaki
  • Tetsuya Otani
  • Satoshi Sasaki
  • Shoichiro TsuganeEmail author
  • for the JPHC Study Group



In Western countries, many epidemiological studies have demonstrated that specific dietary nutrients are associated with the risk of developing age-related cataracts. These reports have suggested that dietary antioxidant vitamins, in particular vitamin C, can play a role in preventing the onset or progression of age-related visual impairment. However, few prospective studies have examined this relationship in a general Asian population. Therefore, in this study, we investigated whether dietary vitamin C was associated with a lower incidence of age-related cataracts by performing a 5-year prospective population-based analysis using data from a cohort of over 30,000 Japanese residents recruited to the Japan Public Health Center-based Prospective Study (JPHC Study) cohort I.

Aim of the study

We carried out a prospective analysis of the association between vitamin C intake and age-related cataracts among middle-aged Japanese, to study the effects of dietary antioxidants in an Asian population.


This 5-year population-based study included 16,415 men and 18,771 women (aged 45–64 years), who were recruited onto the JPHC Study and had not reported cataracts in baseline surveys. Vitamin C was calculated from the nutrient intake assessed by self-administered food-frequency questionnaires (FFQ). Self-reported questionnaires were used to assess two endpoints: diagnosis or extraction of cataracts.


At follow-up, 216 men and 551 women reported new diagnoses, and 110 men and 187 women reported extractions of cataracts. For both endpoints, a higher vitamin C intake was associated with a reduced incidence of cataracts in both sexes. After adjusting for potential confounding factors, the multivariate odds ratios (ORs) for men and women in the highest quintiles of energy-adjusted vitamin C intake, relative to the lowest quintiles, were 0.65 (95% CI, 0.42–0.97) and 0.59 (95% CI, 0.43–0.89) for cataract diagnoses, and 0.70 (95% CI, 0.44–1.20) and 0.64 (95% CI, 0.41–0.94) for cataract extractions, respectively.


Dietary vitamin C intake might lower the risk of age-related cataracts among middle-aged Japanese.


cataract cataract extraction antioxidants vitamin C prospective studies 



This study was supported by Grants-in-Aid for Cancer Research and for the Third Term Comprehensive Ten-Year Strategy for Cancer Control from the Ministry of Health, Labor and Welfare of Japan. The authors thank all staff members in each study area for their efforts with baseline and follow-up surveys.


  1. 1.
    Lesk MC, Sperduto RD (1983) The epidemiology of senile cataracts: a review. Am J Epidemiol 118:152–165Google Scholar
  2. 2.
    Jacques PF, Taylor A (1991) Micronutrients and age-related cataracts. Micronutrients in health and in disease prevention. Marcel Dekker, New York, pp 359–379Google Scholar
  3. 3.
    Taylor A (1999) Nutritional and environmental influences on risk for cataract. Nutritional and Environmental Influences on Vision. CRC Press, Boca Raton, FL, pp 53–93Google Scholar
  4. 4.
    Jacques PF (1993) Antioxidant and cataracts. Epidemiology 4:191–193CrossRefGoogle Scholar
  5. 5.
    Varma SD, Srivastava VK, Richards RD (1982) Photoperoxidation in lens and cataract formation: preventive role of superoxide dismutase, catalase and vitamin C. Ophthalmic Res 14:167–175CrossRefGoogle Scholar
  6. 6.
    Varma SD (1991) Scientific basis for medical therapy of cataracts by antioxidants. Am J Clin Nutr 53(Suppl):335S–345SGoogle Scholar
  7. 7.
    Jacques PF, Chylack LT Jr (1991) Epidemiologic evidence of a role for the antioxidant vitamins and carotenoids in cataract prevention. Am J Clin Nutr 53(Suppl):352S–355SGoogle Scholar
  8. 8.
    Leske MC, Chylack LT Jr, Wu SY (1991) The lens opacities case-control study. Risk factors for cataract. Arch Ophthalmol 109:244–251Google Scholar
  9. 9.
    Mares-Perlman JA, Brady WE, Klein BE, Klein R, Haus GJ, Palta M, et al. (1995) Diet and nuclear lens opacities. Am J Epidemiol 141:322–334CrossRefGoogle Scholar
  10. 10.
    Lyle BJ, Mares-Perlman JA, Klein BE, Klein BE, Klein R, Greger JL (1999) Antioxidant intake and risk of incident age-related nuclear cataracts in the Beaver Dam Eye Study. Am J Epidemiol 149:801–809Google Scholar
  11. 11.
    Cumming RG, Mitchell P, Smith W (2000) Diet and cataract: the Blue Mountains Eye Study. Ophthalmology 107:450–456CrossRefGoogle Scholar
  12. 12.
    Jacques PF, Chylack LT Jr, Hankinson SE, Khu PM, Rogers G, Friend J, et al. (2001) Long term nutrient intake and early age-related nuclear lens opacities. Arch Ophthalmol 119:1009–1019Google Scholar
  13. 13.
    Taylor A, Jacques PF, Chylack Lt Jr, Hankinson SE, Khu PM, Rogers G, et al. (2002) Long-term intake of vitamins and carotenoids and odds of early age-related cortical and posterior subcapsular lens opacities. Am J Clin Nutr 75:540–549Google Scholar
  14. 14.
    Valero MP, Fletcher AE, De Savola BL, Vioque J, Alepuz VC (2002). Vitamin C is associated with reduced risk of cataract in a Mediterranean population. J Nutr 132:1299–1306Google Scholar
  15. 15.
    Vitale S, West S, Hallfrisch J, Alston C, Wang F, Moorman C, et al. (1993) Plasma antioxidants and risk of cortical and nuclear cataract. Epidemiology 4:195–203CrossRefGoogle Scholar
  16. 16.
    Tavani A, Negri E, La Vecchia C (1996) Food and nutrient intake and risk of cataract. Ann Epidemiol 6:41–46CrossRefGoogle Scholar
  17. 17.
    Taylor A, Hobbs M (2001) 2001 assessment of nutritional influences on risk for cataract. Nutrition 17:845–857CrossRefGoogle Scholar
  18. 18.
    Tsugane S, Gey F, Ishinowatari Y, Miyajima Y, Ishibashi T, Matsushima S, et al. (1992) Cross-sectional epidemiologic study for assessing cancer risk at the population level. I: study design and participation rate. J Epidemiol 2:75–81Google Scholar
  19. 19.
    Science and Technology Agency (1982) Standard Tables of Food Composition in Japan. The fourth revised edition. Tokyo, Printing Bureau, Ministry of Finances (in Japanese)Google Scholar
  20. 20.
    Kobayashi M, Sasaki S, Tsugane S (2003) Validity of self-administered food frequency questionnaire used in the 5-year follow-up study of the JPHC Study Cohort I to assess carotenoids and vitamin C intake: comparison with dietary records and blood level. J Epidemiol 13(Suppl):S82–S91Google Scholar
  21. 21.
    Takashima Y, Yoshida M, Yoshinaga A, Sasaki S, Tsugane S, for the JPHC Study Group (2002) Usefulness of the recall-based self-report as a means of case definition in epidemiological studies on senile cataracts. Jpn J Health Human Ecol 68:43–53Google Scholar
  22. 22.
    Willett W, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analysis. Am J Epidemiol 124:17–27Google Scholar
  23. 23.
    SAS Institute Inc (1999) SAS/STAT User’s Guide, Version 8.2. SAS Institute Inc., Cary, NCGoogle Scholar
  24. 24.
    Robertson JMD, Donner AP, Trevithick JR (1989) Vitamin E intake and risk for cataracts in humans. Ann NY Acad Sci 570:372–382CrossRefGoogle Scholar
  25. 25.
    Jacques PF, Taylor A, Hankinson SE, Willett WC, Mahnken B, Lee Y, et al. (1997) Long-term vitamin C supplement use and prevalence of age-related lens opacities. Am J Clin Nutr 66:911–916Google Scholar
  26. 26.
    Mares-Perlman JA, Lyle BJ, Klein R, Fisher AI, Brady WE, VandenLangenberg GM, et al. (2000) Vitamin supplement use and incident cataracts in a population-based study. Arch Ophthalmol 118:1556–1563Google Scholar
  27. 27.
    Hankinson SE, Stampfer MJ, Seddon LM, Colditz GA, Rosner B, Speizer FE, et al. (1992) Nutrient intake and cataract extraction in women: a prospective study. BMJ 305:335–339Google Scholar
  28. 28.
    Seddon JM, Christen WG, Manson JE, LaMotte FS, Glynn RJ, Buring JE, et al. (1994) The use of vitamin supplements and risk of cataract among US male physicians. Am J Public Health 84:788–792CrossRefGoogle Scholar
  29. 29.
    Mares-Perlman JA, Klein BEK, Klein R, Ritter LL (1994) Relationship between lens opacities and vitamin and mineral supplement use. Ophthalmology 101: 315–325Google Scholar
  30. 30.
    The Italian-American Cataract Study Group (2005) Associations between plasma levels of vitamins and cataract in the Italian–American clinical trial of nutritional supplements and age-related cataract (CTNS): CTNS report #2. Ophthalmic Epidemiol 12:71–80CrossRefGoogle Scholar
  31. 31.
    Sperduto RD, Hu TS, Milton RC, Zhao JL, Everett DF, Cheng QF, et al. (1993) The Linxian Cataract Studies: two nutrition intervention trials. Arch Ophthalmol 111:1246–1253Google Scholar
  32. 32.
    Age-Related Eye Disease Study Research Group (2001) A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamin C and E and beta carotene for age-related cataract and vision loss. Arch Ophthalmol 119:1439–1452Google Scholar
  33. 33.
    Gritz DC, Srinivasan M, Smith SD, Kim U, Lietman TM, Wilkins JH, et al. (2006) The Antioxidants in Prevention of Cataracts Study: effects of antioxidant supplements on cataract progression in South India. Br J Ophthalmol 90:847–851CrossRefGoogle Scholar
  34. 34.
    Simon JA, Hudes ES (1999) Serum ascorbic acid and other correlates of self-reported cataract among older Americans. J Clin Epidemiol 52:1207–1211CrossRefGoogle Scholar
  35. 35.
    Berger J, Shepard D, Morrow F, Taylor A (1989) Relationship between dietary intake and tissue levels of reduced and total vitamin C in the guinea pig. J Nutr 119:734Google Scholar
  36. 36.
    Blondin J, Baragi V, Schwartz E, Sadowski J, Taylor A (1986) Delay of UV-induced eye lens protein damage in guinea pig by dietary ascorbate. J Free Radic Biol Med 2:275CrossRefGoogle Scholar
  37. 37.
    Knekt P, Heliovaara M, Rissanen A, et al. (1992) Serum antioxidant vitamins and risk of cataract. BMJ 305:1392–1394CrossRefGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2007

Authors and Affiliations

  • Masao Yoshida
    • 1
  • Yutaka Takashima
    • 1
  • Manami Inoue
    • 2
  • Motoki Iwasaki
    • 2
  • Tetsuya Otani
    • 2
  • Satoshi Sasaki
    • 3
  • Shoichiro Tsugane
    • 2
    Email author
  • for the JPHC Study Group
  1. 1.Dept. of Public HealthKyorin University School of MedicineTokyoJapan
  2. 2.Epidemiology and Preventive DivisionResearch Center for Cancer Prevention and Screening, National Cancer CenterTokyoJapan
  3. 3.National Institute of Health and NutritionTokyoJapan

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