Long term α tocopherol may yet prolong life

Editor—The study by Zino et al showed a lack of effect of increased consumption of fruit and vegetables on plasma concentrations of α tocopherol and lipoproteins.1 This supports the view that supplements of α tocopherol will be necessary to diminish the risk of atherosclerosis. This view is based on the belief that the populations who are at increased risk of atherosclerosis are not simply eating a diet deficient in α tocopherol. Rather, they are also consuming excessive amounts of oxidisable (polyunsaturated) fats and living in an environment that is excessively pro-oxidant—for example, because of industrial and engine emissions and cigarette smoke.

Zino et al conclude from the Cambridge heart antioxidant trial that α tocopherol supplementation “may reduce risk of subsequent myocardial infarction but does not prolong life.”2 As one of the authors of that trial, I suggest that this should read” … but had no effect on mortality within the short time scale of the trial.” Anyone who believes that α tocopherol helps to prevent myocardial infarction can hardly believe that it would not in the long term prolong life. The delay in recognising this might yet prove to be costly.