All That Glitters Is Not Beta Carotene

After a long series of increasingly optimistic reports about the potential health benefits of dietary antioxidants, two reports of randomized trials considerably dampened the enthusiasm for these nutrients. The Finnish trial of beta carotene and vitamin E failed to show a reduction in lung cancer or cardiovascular disease among heavy smokers,¹and the Dartmouth trial showed no benefit of antioxidants for prevention of colon polyp recurrence.²Now, in this issue ofTHE JOURNAL, two reports appear that link high antioxidant intake with reduced risk of coronary disease and age-related macular degeneration (AMD).^3,4What are we to make of these findings? See also pp 1413 and 1439. Morris et al³observed a strong inverse association between total plasma carotenoids and subsequent risk of coronary heart disease (CHD) (relative risk, 0.64 between highest and lowest quartiles). Individual carotenoids were not assayed; thus, the authors appropriately caution against attributing