Oxidative Balance Scores (OBSs) Integrating Nutrient, Food and Lifestyle Dimensions: Development of the NutrientL-OBS and FoodL-OBS

Abstract

Oxidative Balance Scores (OBS) are tools that allow us to assess the individual’s antioxidant state by ranking both antioxidant and pro-oxidant components of dietary and lifestyle factors. Our aim was to develop novel OBSs accounting for either the global supply of nutrient antioxidants in the diet, or the intake of antioxidant-rich foods, in combination with lifestyle factors. Pro-oxidant factors were also considered. Within two centers of the Spanish European Prospective Investigation into Cancer and Nutrition (EPIC) study, EPIC-Granada and EPIC-Gipuzkoa (N = 14,756 participants), we developed the Nurient, Food and Lifestyle OBS (NutrientL-OBS and FoodL-OBS), and their simplified versions (solely with dietary or lifestyle factors, the Nutrient-OBS, Food-OBS and L-OBS). Their antioxidant potential was evaluated considering their relationship with: (i) 20 scores of adherence to the Mediterranean Diet (MD); and, (ii) 25 biomarkers of antioxidant nutrients (ascorbic acid, β-carotene, etc.), inflammation (CRP, TNF-alpha, etc.) and oxidative stress (uric acid), among 210 participants. Spearman correlation and multivariate linear regression analyses were applied to analyze these associations. Some statistically significant relationships were encountered between the NutrientL-OBS and the FoodL-OBS with the MD scores, and with ascorbic acid (per one-unit increase in OBS: β = 0.012 and 0.015; p = 0.022 and 0.008, respectively) and CRP (per one-unit increase in both OBS: β = −0.02; p = 0.02); the latter appeared to be restricted to the OBS´s lifestyle components. In conclusion, the NutrientL- and FoodL-OBSs and their sub-versions are related to antioxidant-rich dietary patterns and to biomarkers of antioxidant nutrient intake and inflammation, supporting that these tools are valid to assess the individual´s oxidative/antioxidant status.

Association between an oxidative balance score and mortality: a prospective analysis in the SUN cohort

“…Regarding fat or fatty acids, polyunsaturated fatty acids (PUFAs) have been included as pro-oxidant component of previous OBS [13]. However, there is still controversy about the effect of omega-6 fatty acids and their lipid mediators, their mechanism of action and interaction with omega-3 fatty acids [58]. Third, our equally weighted OBS scoring system may be questionable; yet our findings are in line with those studies that used different weight OBS scoring systems [57].…”

“…Fourth, we did not collect information of biomarkers regarding patients' oxidative status. However, two recently published articles have assessed the possible relation of OBSs and these biomarkers in adult populations, finding an inverse association between OBSs and C-reactive protein [58], and plasma F 2 -isoprostanes [59]. Fifth, although we adjusted for aspirin use and other factors, certain endogenous and other exogenous factors such as medications may affect the oxidative balance of an individual.…”

Association between Oxidative Balance Score and Migraine among American Adults: National Health and Nutrition Examination Survey

“…The OBS is a comprehensive metric comprising 20 different dietary and lifestyle components [13]. It assesses an individual's antioxidant status by scoring the ranking of antioxidant and pro-oxidant components in diet and lifestyle factors.…”

Association of oxidative balance score and lung health from the National Health and Nutrition Examination Survey 2007–2012

“…The oxidative balance score (OBS), developed as a composite measure of individual oxidative homeostasis, was determined by a combination of pro-oxidant and antioxidant factors ( 19 ). OBS, which commonly involved dietary components and lifestyle-related components, was extensively used in epidemiological studies to evaluate the interaction between oxidative status and the risk of development of multiple chronic diseases ( 20 ).…”