Associations between composite dietary antioxidant index and estimated 10-year atherosclerotic cardiovascular disease risk among U.S. adults

Abstract

BackgroundAtherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death and disability both in U.S. and worldwide. Antioxidants have been proved critical in mitigating the development of atherosclerosis. This study aimed to investigate the associations between composite dietary antioxidant index (CDAI) and estimated 10-year ASCVD risk among U.S. adults.MethodsData extracted from the National Health and Nutrition Examination Survey were analyzed. A total of 10,984 adults aged 18 years and above were included in this study. CDAI was calculated based on the dietary intake reported in their 24-h recall interviews. The estimated 10-year ASCVD risk was calculated via Pooled Cohort Equations (PCE).ResultsAfter adjusting potential confounders, it was indicated that CDAI score was negatively correlated with 10-year ASCVD risk (OR 0.97, 95% CI 0.95–0.99). Stratify CDAI score by quartile, results showed that participants in the second, third, and fourth quartiles had lower ASCVD odds ratio (Q2: OR 0.87, 95% CI 0.69–1.09; Q3: OR 0.78, 95% CI 0.62–0.98; Q4: OR 0.74, 95% CI 0.59–0.94) than those in the first quartile (Q1, lowest CDAI score group), which was confirmed by the trend test as well (p < 0.05). Subgroup analyses stratified by sex, age, race/ethnicity, and smoking status did not show significant effect modification.ConclusionHigher dietary antioxidants intake is associated with lower ASCVD risk among U.S. adults, for which policymakers and healthcare professionals may consider increasing the consumption of antioxidant-rich foods as a preventive strategy for ASCVD.

Linear association of compound dietary antioxidant index with hyperlipidemia: a cross-sectional study

“…This study also found that the prevalence of hypertension, diabetes mellitus, and coronary heart disease decreased progressively with increasing CDAI. Previous analyses of the NHANES database found that the prevalence of hypertension, coronary heart disease, and diabetes mellitus were negatively correlated with CDAI ( 18 , 23 , 40 ), which is consistent with our findings. Control variables such as energy, carbohydrates, total fat, and cholesterol, which may affect the results of the study, were added to the previous ones.…”

“…CDAI was proposed by Wright et al ( 21 ) as a composite score reflecting antioxidant capacity of one’s diet, which includes vitamins A, C, and E, zinc, selenium, and carotenoids. Previous studies have found that CDAI improves heart failure, hypertension, depression, and atherosclerotic cardiovascular disease and reduces the risk of morbidity ( 18 , 22–24 ). However, there are no studies on the relationship between CDAI and hyperlipidemia.…”

“…In recent years, the role of antioxidants has become prominent in global dietary patterns, and the impact of total nutritional antioxidant capacity on health has become increasingly common in all sectors ( 18 ). Dietary antioxidant supplementation through consuming fruits, vegetables, whole grains, nuts, and legumes has been suggested ( 19 ), and the intake of adequate antioxidants may help reduce the burden of oxidative stress ( 20 ).…”

A cross-sectional study exploring the relationship between oxidative balance score and 10-year atherosclerotic cardiovascular disease risk based on the National Health and Nutrition Examination Survey (2011–2020)

“… 8 Therefore, a balanced dietary pattern, such as the Mediterranean diet, which emphasizes the consumption of vegetables, fruits, fish, whole grains, legumes, and olive oil, offers the body an optimal balance to maintain antioxidative capacity, reducing the risk of cardiovascular diseases. 29 – 31 Several studies have shown that an antioxidant-rich dietary pattern can lower the risk of ASCVD, 32 – 34 which aligns with our research findings.…”

Interactive association of the dietary oxidative balance score and cardiovascular disease with mortality in older adults: evidence from NHANES

“…18,37–40 The CDAI score is derived from a limited set of six dietary nutrients, specifically vitamins A, C, and E, along with manganese, selenium, and zinc, all of which possess antioxidant properties. 41 However, it should be noted that our diet not only provides us with antioxidant nutrients but also pro-oxidant ones. DOBS not only encompasses a greater abundance of 14 antioxidant nutrients in total but also incorporates 2 pro-oxidant nutrients, making it the sole scoring system that comprehensively evaluates both anti- and pro-oxidative exposures.…”