Diet and 20-year chronic obstructive pulmonary disease mortality in middle-aged men from three European countries

Objective To investigate the relation of baseline antioxidant, fruit, vegetable and fish intake with 20 y chronic obstructive pulmonary disease (COPD) mortality in middle-aged men from three European countries.Design Prospective study (1970-1990).Setting Five population-based cohorts of middle-aged men from Finland, Italy and The Netherlands.Subjects A total of 2917 men aged 50-69 y at baseline.Methods Baseline information on diet was collected using the cross-check dietary history method. After 20 y of follow-up the underlying cause of death of those who died was established centrally. Survival analyses were performed using the Cox Proportional Hazards Model.Results After adjustment for age, smoking and country, we observed an inverse trend (P-trend Conclusions Our results suggest a protective effect of fruit and possibly vitamin E intake against COPD. No effect was observed for intake of vitamin C, beta-carotene, vegetables and fish.