The Composite Dietary Antioxidant Index is Associated With Common Non-communicable Diseases: The Mediation and Joint Effects of Inflammatory Indices

Abstract

Purpose: To evaluate the associations between composite dietary antioxidant index (CDAI) and common non-communicable diseases (NCDs) and explore the potential effects of inflammatory indices in these associations. Methods: We included 20,097 adults from the National Health and Nutrition Examination Survey 2003–2018. Multivariable logistic regressions were applied to evaluate the associations between CDAI and common NCDs. Mediation analysis was used to explore the role of inflammatory indices in the associations. Results: Higher CDAI was associated with a downward trend in the incidence of obesity, cardiovascular disease (CVD), chronic respiratory diseases, and chronic kidney disease (CKD) (p for trend < 0.05). The association between CDAI and CVD was influenced by C-reactive protein (CRP), red blood cell width (RDW), and neutrophil to lymphocyte ratio (NLR), with mediated proportions of 3.490%, 5.173%, and 2.351%, respectively. NLR partially contributed to the link between CDAI and CKD, with a mediating ratio of 2.746%. Additionally, we observed additive interactions between CDAI and CRP (RERI (95% CI): 0.282 (0.070, 0.494), AP (95% CI): 0.539 (0.088, 0.991), as well as RDW on CVD (RERI (95% CI): 0.318 (0.124, 0.511), AP (95% CI): 0.717 (0.217, 1.218)). There also appeared to be a weak multiplicative interaction between CDAI and RDW on CVD (p-int = 0.049). Conclusion: Our investigation ascertained that CDAI was related to common NCDs. Moreover, inflammatory indices played an important role in the associations between CDAI and NCDs.

Keywords

dietary antioxidants national health and nutrition examination survey a cross-sectional study

Get full access to this article

View all access options for this article.

References

Ahluwalia

Dwyer

Terry

Moshfegh

Johnson

(2016). Update on NHANES dietary data: Focus on collection, release, analytical considerations, and uses to inform public policy. Advances in Nutrition, 7(1), 121–134. https://doi.org/10.3945/an.115.009258

Aune

(2019). Plant foods, antioxidant biomarkers, and the risk of cardiovascular disease, cancer, and mortality: A Review of the evidence. Advances in Nutrition, 10(Suppl_4), S404–S421. https://doi.org/10.1093/advances/nmz042

Ayoka

T. O.

Ezema

B. O.

Eze

C. N.

Nnadi

C. O.

(2022). Antioxidants for the prevention and treatment of non-communicable diseases. Journal of Exploratory Research in Pharmacology, 7(3), 179–189. https://doi.org/10.14218/jerp.2022.00028

Bennett

J. M.

Reeves

Billman

G. E.

Sturmberg

J. P.

(2018). Inflammation-Nature's way to efficiently respond to all types of challenges: Implications for understanding and managing “the epidemic” of chronic diseases. Frontiers of Medicine, 5, 316. https://doi.org/10.3389/fmed.2018.00316

Biswas

S. K.

Daiber

(2016). Does the interdependence between oxidative stress and inflammation explain the antioxidant paradox? Oxidative Medicine and Cellular Longevity, 2016(1), 5698931. https://doi.org/10.1155/2016/5698931

Budreviciute

Damiati

Sabir

D. K.

Onder

Schuller-Goetzburg

Plakys

Katileviciute

Khoja

Kodzius

(2020). Management and prevention strategies for non-communicable diseases (NCDs) and their risk factors. Frontiers in Public Health, 8, 574111. https://doi.org/10.3389/fpubh.2020.574111

Chen

X. J.

Chen

Y. W.

Sang

H. Q.

Tang

Zhao

Y. F.

(2023). Composite dietary antioxidant index was negatively associated with the prevalence of diabetes independent of cardiovascular diseases. Diabetology & Metabolic Syndrome, 15(1), 183. https://doi.org/10.1186/s13098-023-01150-6

Fioranelli

Roccia

M. G.

Flavin

Cota

(2021). Regulation of inflammatory reaction in health and disease. International Journal of Molecular Sciences, 22(10), 22. https://doi.org/10.3390/ijms22105277

Furman

Campisi

Verdin

Carrera-Bastos

Targ

Franceschi

Ferrucci

Gilroy

D. W.

Fasano

Miller

G. W.

Miller

A. H.

Mantovani

Weyand

C. M.

Barzilai

Goronzy

J. J.

Rando

T. A.

Effros

R. B.

Lucia

Kleinstreuer

Slavich

G. M.

(2019). Chronic inflammation in the etiology of disease across the life span. Nature Medicine, 25(12), 1822–1832. https://doi.org/10.1038/s41591-019-0675-0

10.

Grosso

(2018). Dietary antioxidants and prevention of non-communicable diseases. Antioxidants, 7(7). https://doi.org/10.3390/antiox7070094

11.

Halliwell

(2024). Understanding mechanisms of antioxidant action in health and disease. Nature Reviews Molecular Cell Biology, 25(1), 13–33. https://doi.org/10.1038/s41580-023-00645-4

12.

Henein

M. Y.

Vancheri

Longo

Vancheri

(2022). The role of inflammation in cardiovascular disease. International Journal of Molecular Sciences, 23(21), 22. https://doi.org/10.3390/ijms232112906

13.

Jomova

Raptova

Alomar

S. Y.

Alwasel

S. H.

Nepovimova

Kuca

Valko

(2023). Reactive oxygen species, toxicity, oxidative stress, and antioxidants: Chronic diseases and aging. Archives of Toxicology, 97(10), 2499–2574. https://doi.org/10.1007/s00204-023-03562-9

14.

Hong

Tan

H. Y.

Wang

Feng

Y. B.

(2016). Insights into the role and interdependence of oxidative stress and inflammation in liver diseases. Oxidative Medicine and Cellular Longevity, 2016, 4234061. https://doi.org/10.1155/2016/4234061

15.

You

(2024). Interactive effects of composite dietary antioxidant index with body mass index for the risk of stroke among U.S. Adults: Insight from NHANES 2001–2018. Frontiers in Nutrition, 11, 1378479. https://doi.org/10.3389/fnut.2024.1378479

16.

Liberale

Montecucco

Tardif

J. C.

Libby

Camici

G. G.

(2020). Inflamm-ageing: The role of inflammation in age-dependent cardiovascular disease. European Heart Journal, 41(31), 2974–2982. https://doi.org/10.1093/eurheartj/ehz961

17.

Liu

J. T.

Han

X. Y.

Zhang

T. Y.

Tian

K. Y.

Z. P.

Luo

(2023). Reactive oxygen species (ROS) scavenging biomaterials for anti-inflammatory diseases: From mechanism to therapy. Journal of Hematology & Oncology, 16(1), 116. https://doi.org/10.1186/s13045-023-01512-7

18.

Liu

S. S.

Zhu

Z. F.

Zhang

Tang

Z. G.

Liu

F. Q.

Sun

Y. Q.

(2024). The association between composite dietary antioxidant index and diabetic retinopathy in type 2 diabetic patients: Evidence from the NHANES. Frontiers in Nutrition, 11, 1399763. https://doi.org/10.3389/fnut.2024.1399763

19.

R. C.

Zhou

X. Y.

Zhang

G. L.

H. Y.

Liu

F. Y.

Chang

Y. T.

Ding

Y. C.

(2023). Association between composite dietary antioxidant index and coronary heart disease among US adults: A cross-sectional analysis. BMC Public Health, 23(1), 2426. https://doi.org/10.1186/s12889-023-17373-1

20.

Mathieu

Soubrier

Peirs

Monfoulet

L. E.

Boirie

Tournadre

(2022). A meta-analysis of the impact of nutritional supplementation on osteoarthritis symptoms. Nutrients, 14(8). https://doi.org/10.3390/nu14081607

21.

Murata

(2018). Inflammation and cancer. Environmental Health and Preventive Medicine, 23(1), 50. https://doi.org/10.1186/s12199-018-0740-1

22.

Obesity: preventing and managing the global epidemic. Report of a WHO consultation . (2000). World health organ tech rep ser (894, pp. 1–253). https://www.ncbi.nlm.nih.gov/pubmed/11234459

23.

Patel

C. J.

Pho

McDuffie

Easton-Marks

Kothari

Kohane

I. S.

Avillach

(2016). A database of human exposomes and phenomes from the US national health and nutrition examination survey. Scientific Data, 3, 160096. https://doi.org/10.1038/sdata.2016.96

24.

Rodriguez-Meira

Norfo

Wen

Chédeville

A. L.

Rahman

O'Sullivan

Wang

G. L.

Louka

Kretzschmar

W. W.

Paterson

Brierley

Martin

J. E.

Demeule

Bashton

Sousos

Moralli

Subha Meem

L. S.

Carrelha

Mead (2023). Single-cell multi-omics identifies chronic inflammation as a driver of TP53-mutant leukemic evolution. Nature Genetics, 55(9), 1531, 1541-+. https://doi.org/10.1038/s41588-023-01480-1

25.

Sharifi-Rad

Anil Kumar

N. V. A.

Zucca

Varoni

E. M.

Dini

Panzarini

Rajkovic

Tsouh Fokou

P. V. T.

Azzini

Peluso

Prakash Mishra

A. P.

Nigam

El Rayess

Beyrouthy

Polito

Iriti

Martins

Martorell

Docea

A. O.

Sharifi-Rad

(2020). Lifestyle, oxidative stress, and antioxidants: Back and forth in the pathophysiology of chronic diseases. Frontiers in Physiology, 11, 694. https://doi.org/10.3389/fphys.2020.00694

26.

Steven

Frenis

Oelze

Kalinovic

Kuntic

Jimenez

M. T. B.

Vujacic-Mirski

Helmstädter

Kröller-Schön

Münzel

Daiber

(2019). Vascular inflammation and oxidative stress: Major triggers for cardiovascular disease. Oxidative Medicine and Cellular Longevity, 2019, 7092151. https://doi.org/10.1155/2019/7092151

27.

Stevenson

Nunes

Sanchez

Thornton

Sebastiani

(2013). EpiR: An R package for the analysis of epidemiological data.

28.

Tingley

Yamamoto

Hirose

Keele

Imai

(2014). Mediation: R package for causal mediation analysis. Journal of Statistical Software, 59(5), 1–38. https://doi.org/10.18637/jss.v059.i05

29.

Tun

Spainhower

C. J.

Cottrill

C. L.

Lakhani

H. V.

Pillai

S. S.

Dilip

Chaudhry

Shapiro

J. I.

Sodhi

(2020). Therapeutic efficacy of antioxidants in Ameliorating obesity phenotype and associated comorbidities. Frontiers in Pharmacology, 11, 1234. https://doi.org/10.3389/fphar.2020.01234

30.

Vanderweele

T. J.

Knol

M. J.

(2014). A tutorial on interaction. Epidemiologic Methods, 3(1), 22. https://doi.org/10.1515/em-2013-0005

31.

Veen

Hantikainen

Bellocco

Serafini

Ponzano

Grotta

Trolle Lagerros

(2021). Dietary antioxidants, non-enzymatic antioxidant capacity and the risk of osteoarthritis in the Swedish National March Cohort. European Journal of Nutrition, 60(1), 169–178. https://doi.org/10.1007/s00394-020-02239-8

32.

Vollset

S. E.

Ababneh

H. S.

Abate

Y. H.

Abbafati

Abbasgholizadeh

Abbasian

Abbastabar

Abd Al Magied

A. H. A.

Abd ElHafeez

Abdelkader

Abdelmasseh

Abd-Elsalam

Abdi

Abdollahi

Abdoun

Abdullahi

Abebe

Abiodun

Aboagye

R. G.

Murray

C. J. L.

(2024). Burden of disease scenarios for 204 countries and territories, 2022-2050: A forecasting analysis for the global burden of disease study 2021. Lancet, 403(10440), 2204–2256. https://doi.org/10.1016/s0140-6736(24)00685-8

33.

Wang

Huang

Z. H.

Zhu

Y. H.

Fan

Q. L.

(2023). Association between the composite dietary antioxidant index and chronic kidney disease: Evidence from NHANES 2011-2018. Food & Function, 14(20), 9279–9286. https://doi.org/10.1039/d3fo01157g

34.

Wang

Tao

W. J.

Cheng

X. B.

(2024). Association of composite dietary antioxidant index with cardiovascular disease in adults: Results from 2011 to 2020 NHANES. Frontiers in Cardiovascular Medicine, 11, 1379871. https://doi.org/10.3389/fcvm.2024.1379871

35.

Wang

S. D.

Teng

Zhang

(2024). Association between dietary antioxidant intakes and chronic respiratory diseases in adults. World Allergy Organization Journal, 17(1), 100851. https://doi.org/10.1016/j.waojou.2023.100851

36.

World Health Organizatio . (2020). WHO reveals leading causes of death and disability worldwide: 2000-2019. https://www.who.int/news/item/09-12-2020-who-reveals-leading-causes-of-death-and-disability-worldwide-2000-2019

37.

World Health Organizatio . (2023). Noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

38.

Wright

M. E.

Mayne

S. T.

Stolzenberg-Solomon

R. Z.

Z. H.

Pietinen

Taylor

P. R.

Virtamo

Albanes

(2004). Development of a comprehensive dietary antioxidant index and application to lung cancer risk in a cohort of male smokers. American Journal of Epidemiology, 160(1), 68–76. https://doi.org/10.1093/aje/kwh173

39.

M. Y.

J. Y.

Liu

Y. H.

Kang

L. N.

(2023). Association between composite dietary antioxidant index and hypertension: Insights from NHANES. Clinical and Experimental Hypertension, 45(1), 2233712. https://doi.org/10.1080/10641963.2023.2233712

40.

Yang

Song

Yuan

(2024). Association between the composite dietary antioxidant index and metabolic dysfunction-associated steatotic liver disease in adults: A cross-sectional study from NHANES 2017–2020. Scientific Reports, 14(1), 13801. https://doi.org/10.1038/s41598-024-63965-1

41.

Zhang

Dhalla

N. S.

(2024). The role of pro-inflammatory cytokines in the pathogenesis of cardiovascular disease. International Journal of Molecular Sciences, 25(2), 1. https://doi.org/10.3390/ijms25021082

42.

Zhang

L. L.

Yin

D. F.

Zhu

T. T.

Geng

Gan

L. W.

S. T.

Fan

(2024). Composite dietary antioxidant index is associated with renal anemia: A cross-sectional study. International Urology and Nephrology. https://doi.org/10.1007/s11255-024-04157-8

43.

Zhao

Zhang

Liu

Huang

Liu

Jin

Zhu

Zhang

(2024). Inflammation in diabetes complications: Molecular mechanisms and therapeutic interventions. MedComm, 5(4), Article e516. https://doi.org/10.1002/mco2.516

44.

Zhou

Chen

Q. Y.

Hao

(2024). Independent and combined associations of dietary antioxidant intake with bone mineral density and risk of osteoporosis among elderly population in United States. Journal of Orthopaedic Science, 29(4), 1064–1072. https://doi.org/10.1016/j.jos.2023.07.014

45.

Zhou

Chen

Hao

(2024). Composite dietary antioxidant index is associated with reduced prevalence of metabolic syndrome but not mortality in metabolic syndrome: Results from NHANES 2001–2018. Preventive Medicine Reports, 41, 102704. https://doi.org/10.1016/j.pmedr.2024.102704

46.

Zhao

M. L.

Zhang

D. W.

Zhang

Q. P.

Lin

Cao

(2024). Association between composite dietary antioxidant index and hyperlipidemia: A cross-sectional study from NHANES (2005-2020). Scientific Reports, 14(1), 15935. https://doi.org/10.1038/s41598-024-66922-0

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.79 MB