{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T02:46:13Z","timestamp":1773888373223,"version":"3.50.1"},"reference-count":40,"publisher":"BMJ","issue":"4","funder":[{"name":"National Research Foundation of Korea Grant funded by Korean Government"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,2,6]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Cigarette smoke-induced oxidative stress plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Dietary antioxidants are thought to prevent smoke-induced oxidative damage. The aim of this study was to investigate associations between lung function and the consumption of antioxidant vitamins in Korean adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 21\u2009148 participants from the Korean National Health and Nutrition Examination Survey (2007\u20132014) were divided into four groups based on smoking history and gender. Multivariate regression models were used to evaluate associations between lung function and intake of dietary antioxidants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Subjects in the highest intake quintile (Q5) of vitamin A, carotene and vitamin C intake had mean forced expiratory volume in 1\u2009s (FEV<jats:sub>1<\/jats:sub>) measurements that were 30\u2009mL, 32\u2009mL and 36\u2009mL higher than those of individuals in the lowest intake quintile (Q1), respectively (p for trend; p=0.008, p=0.010 and p&lt;0.001, respectively). The risks of COPD for male smokers in Q1 increased 7.60-fold (95% CI 5.92 to 9.76), 7.16-fold (95% CI 5.58 to 9.19) and 7.79-fold (95% CI 6.12 to 9.92), for vitamin A, carotene and vitamin C, respectively, compared with those of female non-smokers in Q5. Among patients with COPD, men who smoked &gt;20\u2009pack-years had mean FEV<jats:sub>1<\/jats:sub>measurements that were 192\u2009mL, 149\u2009mL and 177\u2009mL higher than those of patients in Q1 (p for trend; p=0.018, p=0.024 and p=0.043, for vitamin A, carotene and vitamin C, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings indicate that the influence of antioxidant vitamins on lung function depends on gender and smoking status in the Korean COPD population.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2017-020656","type":"journal-article","created":{"date-parts":[[2018,4,7]],"date-time":"2018-04-07T13:20:46Z","timestamp":1523107246000},"page":"e020656","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Effects of dietary antioxidant vitamins on lung functions according to gender and smoking status in Korea: a population-based cross-sectional study"],"prefix":"10.1136","volume":"8","author":[{"given":"Ji Young","family":"Hong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang Youl","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myung Goo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Sam","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,4,7]]},"reference":[{"key":"2024051711521938000_8.4.e020656.1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00082507"},{"key":"2024051711521938000_8.4.e020656.2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00053180"},{"key":"2024051711521938000_8.4.e020656.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2006.08.028"},{"key":"2024051711521938000_8.4.e020656.4","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm343"},{"key":"2024051711521938000_8.4.e020656.5","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.151.5.7735589"},{"key":"2024051711521938000_8.4.e020656.6","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.epirev.a000805"},{"key":"2024051711521938000_8.4.e020656.7","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1017\/S0007114514002669","article-title":"Associations between antioxidants and all-cause mortality among US adults with obstructive lung function","volume":"112","author":"Ford","year":"2014","journal-title":"Br J Nutr"},{"key":"2024051711521938000_8.4.e020656.8","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1017\/S0007114516000878","article-title":"Antioxidant status in a group of institutionalised elderly people with chronic obstructive pulmonary disease","volume":"115","author":"Rodr\u00edguez-Rodr\u00edguez","year":"2016","journal-title":"Br J Nutr"},{"key":"2024051711521938000_8.4.e020656.9","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1024\/0300-9831.77.4.272","article-title":"Vitamin E and vitamin C supplementation in patients with chronic obstructive pulmonary disease","volume":"77","author":"Wu","year":"2007","journal-title":"Int J Vitam Nutr Res"},{"key":"2024051711521938000_8.4.e020656.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09328-5"},{"key":"2024051711521938000_8.4.e020656.11","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1164\/ajrccm\/140.5.1312","article-title":"Vitamin A, cigarette smoking, and airway obstruction","volume":"140","author":"Morabia","year":"1989","journal-title":"Am Rev Respir Dis"},{"key":"2024051711521938000_8.4.e020656.12","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a010141"},{"key":"2024051711521938000_8.4.e020656.13","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00034805"},{"key":"2024051711521938000_8.4.e020656.14","doi-asserted-by":"crossref","first-page":"230","DOI":"10.4046\/trd.2005.58.3.230","article-title":"Normal predictive values of spirometry in Korean population","volume":"58","author":"Choi","year":"2005","journal-title":"Tuberc Respir Dis"},{"key":"2024051711521938000_8.4.e020656.15","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200703-456SO"},{"key":"2024051711521938000_8.4.e020656.16","unstructured":"RRD I. Food composition table. 7th ed. Suwon, Korea: Rural Resource Development Institute, 2006."},{"key":"2024051711521938000_8.4.e020656.17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2011.01951.x"},{"key":"2024051711521938000_8.4.e020656.18","doi-asserted-by":"crossref","first-page":"2549","DOI":"10.1007\/s11136-015-0979-6","article-title":"Factors associated with the quality of life of Korean COPD patients as measured by the EQ-5D","volume":"24","author":"Hong","year":"2015","journal-title":"Qual Life Res"},{"key":"2024051711521938000_8.4.e020656.19","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00055702"},{"key":"2024051711521938000_8.4.e020656.20","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-9-67"},{"key":"2024051711521938000_8.4.e020656.21","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1093\/oxfordjournals.aje.a116775","article-title":"Dietary determinants of long-term incidence of chronic nonspecific lung diseases. The Zutphen Study","volume":"138","author":"Miedema","year":"1993","journal-title":"Am J Epidemiol"},{"key":"2024051711521938000_8.4.e020656.22","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2109030"},{"key":"2024051711521938000_8.4.e020656.23","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1164\/ajrccm.150.4.7921473","article-title":"Does dietary vitamin A protect against airway obstruction? The Atherosclerosis Risk in Communities (ARIC) Study Investigators","volume":"150","author":"Shahar","year":"1994","journal-title":"Am J Respir Crit Care Med"},{"key":"2024051711521938000_8.4.e020656.24","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00113809"},{"key":"2024051711521938000_8.4.e020656.25","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1093\/ajcn\/72.6.1576","article-title":"Household exposure to passive cigarette smoking and serum micronutrient concentrations","volume":"72","author":"Alberg","year":"2000","journal-title":"Am J Clin Nutr"},{"key":"2024051711521938000_8.4.e020656.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1993.tb39148.x"},{"key":"2024051711521938000_8.4.e020656.27","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1165\/rcmb.2013-0121OC","article-title":"Vitamin C prevents cigarette smoke-induced pulmonary emphysema in mice and provides pulmonary restoration","volume":"50","author":"Koike","year":"2014","journal-title":"Am J Respir Cell\u00a0MolBiol"},{"key":"2024051711521938000_8.4.e020656.28","first-page":"61","article-title":"Effect of vitamin A deficiency on surfactants and enzymes of xenobiotic metabolism in the rat lung]","volume":"4","author":"Iakovleva","year":"1987","journal-title":"Vopr Pitan"},{"key":"2024051711521938000_8.4.e020656.29","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1289\/ehp.792989","article-title":"Vitamin A and the susceptibility of respiratory tract tissues to carcinogenic insult","volume":"29","author":"Nettesheim","year":"1979","journal-title":"Environ Health Perspect"},{"key":"2024051711521938000_8.4.e020656.30","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1093\/ajcn\/34.7.1347","article-title":"On the requirements of ascorbic acid in man: steady-state turnover and body pool in smokers","volume":"34","author":"Kallner","year":"1981","journal-title":"Am J Clin Nutr"},{"key":"2024051711521938000_8.4.e020656.31","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1093\/ajcn\/65.4.959","article-title":"Ascorbic acid and dehydroascorbic acid as biomarkers of oxidative stress caused by smoking","volume":"65","author":"Lykkesfeldt","year":"1997","journal-title":"Am J Clin Nutr"},{"key":"2024051711521938000_8.4.e020656.32","doi-asserted-by":"publisher","DOI":"10.1159\/000078379"},{"key":"2024051711521938000_8.4.e020656.33","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1016\/S0140-6736(03)15099-4","article-title":"Effects of subclinical infection on plasma retinol concentrations and assessment of prevalence of vitamin A deficiency: meta-analysis","volume":"362","author":"Thurnham","year":"2003","journal-title":"The Lancet"},{"key":"2024051711521938000_8.4.e020656.34","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1093\/ajcn\/21.11.1259","article-title":"Smoking and vitamin C levels in humans","volume":"21","author":"Pelletier","year":"1968","journal-title":"Am J Clin Nutr"},{"key":"2024051711521938000_8.4.e020656.35","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.2000.016003397.x"},{"key":"2024051711521938000_8.4.e020656.36","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1080\/07315724.2014.926152","article-title":"Smokers with adequate vitamin C intake show a preferable pulmonary function test","volume":"34","author":"Shin","year":"2015","journal-title":"J Am Coll Nutr"},{"key":"2024051711521938000_8.4.e020656.37","doi-asserted-by":"crossref","first-page":"2721","DOI":"10.2147\/COPD.S119448","article-title":"Dietary vitamin C intake protects against COPD: the Korea National Health and Nutrition Examination Survey in 2012","volume":"11","author":"Park","year":"2016","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2024051711521938000_8.4.e020656.38","first-page":"2159","article-title":"The effect of dietary antioxidant on the COPD risk: the community-based KoGES (Ansan-Anseong) cohort","volume":"10","author":"Joshi","year":"2015","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2024051711521938000_8.4.e020656.39","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/1476-511X-11-41","article-title":"Gender difference following high cholesterol diet induced renal injury and the protective role of rutin and ascorbic acid combination in Wistar albino rats","volume":"11","author":"Al-Rejaie","year":"2012","journal-title":"Lipids Health Dis"},{"key":"2024051711521938000_8.4.e020656.40","doi-asserted-by":"crossref","first-page":"10042","DOI":"10.3390\/ijms140510042","article-title":"Genome-wide gene expression profiles in antioxidant pathways and their potential sex differences and connections to vitamin C in mice","volume":"14","author":"Jiao","year":"2013","journal-title":"Int J Mol Sci"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-020656","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T20:48:49Z","timestamp":1715978929000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-020656"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,4,7]]},"published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1136\/bmjopen-2017-020656"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-020656","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4]]}}}