Association of oxidative balance score with sleep quality: NHANES 2007-2014

Association between suicidal ideation and oxidative balance score (OBS): National Health and Nutrition Examination Survey (NHANES) 2005-2018

BACKGROUND

The oxidative balance score (OBS) serves as an indicator of systemic oxidative stress status, where a higher OBS indicates significant exposure to antioxidants through dietary and lifestyle choices. Studies exploring the relationship between OBS and suicidal ideation are limited. Therefore, this study aimed to examine the association between OBS and suicidal ideation.

METHODS

This cross-sectional study selected 28,598 individuals aged ≥20 years from the 2005-2018 National Health and Nutrition Examination Survey dataset. The OBS was determined using 16 dietary components and 4 lifestyle components. Item 9 of the Patient Health Questionnaire-9 was used to evaluate suicidal ideation. The association between suicidal ideation and OBS, dietary OBS, and lifestyle OBS was examined using weighted logistic regression and restricted cubic spline. The subgroup analyses and interaction tests were further conducted to assess the robustness of these associations across different populations.

RESULTS

The prevalence of suicidal ideation was 3.35 %. OBS, dietary OBS, and lifestyle OBS were substantially and inversely linked with suicidal ideation in Models 1, 2, and 3 (p < 0.05). The odds ratio for the highest quartile (Q4) of these variables and suicidal ideation in Model 3 was 0.44 [95 % confidence interval (CI): 0.30-0.65], 0.54 (95 % CI: 0.37-0.78), and 0.50 (95 % CI, 0.34-0.74), respectively, compared with the lowest quartile (Q1). The subgroup analyses revealed consistent connections between the three oxidative stress indices and suicidal ideation. The lifestyle OBS was negatively correlated with suicidal ideation, especially in women (p for interaction < 0.05).

CONCLUSIONS

The dietary and lifestyle OBSs may influence suicidal ideation by modulating oxidative balance. An antioxidant diet and lifestyle are crucial in mitigating suicidal ideation. These findings suggest a potential sex-specific suicide ideation risk, which significantly correlates with suicidal ideation in women but not in men.

Association of frailty index with all-cause and cardiovascular mortality with different diabetic status: NHANES 1999-2018

AIMS

The relationship between frailty and mortality among individuals with varying diabetic statuses represents a burgeoning area of concern and scholarly interest within the medical community. However, there are limited studies that explore the relationship between frailty and mortality, as well as cause-specific mortality among individuals with non-diabetes, prediabetes, and diabetes patients. Hence, this study aims to investigate the relationship between the frailty statues and all-cause mortality, as well as cause-specific mortality in individuals with varying diabetic statuses using the data in the NHANES database.

METHODS

The study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, incorporating a final sample size of 57, 098 participants. Both univariable and multivariable-adjusted logistic regression analyses, as well as Cox regression analysis were employed to examine the relationship between frailty index (FI) and mortality.

RESULTS

This study, found a significant positive correlation between the frailty and the increased risk of all-cause mortality non-diabetic [OR 4.277, 95%CI (3.982, 4.594), P < 0.001], prediabetic [OR 2.312, 95%CI (2.133, 2.506), P < 0.001], and diabetic patients [OR 3.947, 95%CI (3.378, 4.611), P < 0.001]. This correlation still existed even after adjusting for confounding factors including age, sex, BMI, poverty, fasting insulin, education, smoke, alcohol drink, waist, hypertension, hyperlipidemia, fasting glucose, HbA1c, eGFR, creatinine and total bilirubin. Our result also suggested a significant positive correlation between the frailty index and the increased risk of CVD mortality among non-diabetic [OR 3.095, 95%CI (2.858, 3.352), P < 0.001] and prediabetic [OR 5.985, 95%CI (5.188, 6.904), P < 0.001] individuals. However, in patients with diabetes, the correlation between frailty and CVD mortality lost significance after adjusting for possible confounding factors [OR 1.139, 95%CI (0.794, 1.634), P > 0.05].

CONCLUSION

A nonlinear relationship has been identified between the FI and all-cause mortality, as well as CVD mortality in non-diabetic and pre-diabetic population. In diabetic patients, there was a significant positive correlation between the frailty and the increased risk of all-cause mortality, but not with CVD mortality. Renal function and liver function might potentially acted as an intermediary factor that elevated the risk of CVD mortality in frail patients with diabetes.

Association of oxidative balance score with all-cause and cardiovascular mortality in overweight and obese

Background

The oxidative balance score (OBS) combines diverse dietary components with lifestyle factors to comprehensively evaluate oxidative stress. The investigation focuses on the link between the OBS and mortality outcomes, including cardiovascular and all-cause deaths, in overweight and obese individuals.

Methods

The analysis utilized data from the National Health and Nutrition Examination Survey (NHANES), covering the period from 1999 to 2018. Mortality information, categorized into all-cause and cardiovascular deaths, was gathered from the National Death Index (NDI). Kaplan-Meier survival analysis, along with multivariate Cox regression and restricted cubic spline (RCS) modeling, were utilized to explore the link between OBS and mortality risks. Subgroup analysis and sensitivity analysis were used to assess the robustness of the results and possible effect modifiers. Mediation analysis identifies pathways through which the independent variable affects the dependent variable.

Results

In this study, 26,219 participants with overweight or obesity were enrolled, with an average age of 49.8 ± 17.4 years. During a median follow-up duration of 115 months, 2,239 participants (8.5%) died, including 837 (3.2%) from cardiovascular disease. According to Kaplan-Meier analysis, mortality was highest among participants in the lowest OBS quartile (Q1) and lowest among those in the highest quartile (Q4). Participants in the fourth OBS quartile experienced a 21.7% decrease in the risk of mortality from all causes and a 29.5% decrease in cardiovascular mortality risk, according to fully adjusted results, compared to those in the first quartile. These results were validated through subgroup analyses. The analysis of RCS revealed a notable inverse association between OBS and mortality outcomes. Mediation analysis indicates that white blood cell count (WBC) and gamma-glutamyl transferase (GGT) serve as significant mediators in the association between OBS and mortality risk.

Conclusion

Elevated levels of OBS were strongly linked to reduced potential for both cardiovascular and all-cause mortality among individuals who are overweight or obese.

Associations of dietary oxidative balance score with sarcopenia in adults: an NHANES-based cross-sectional study

BACKGROUND

Sarcopenia, a prevalent muscle disorder in the older adults, is characterized by accelerated loss of muscle mass and function, contributing to increased risks of falls, functional decline, and mortality. The relationship between dietary oxidative balance score (DOBS) and sarcopenia, however, remains unclear.

METHODS

We conducted a cross-sectional analysis of the National Health and Nutritional Examination Survey (NHANES) 2011-2018 cohort, which included 8,240 participants, aged 47.2 ± 17.6 years (48.6% male, 51.4% female). The participants were selected from geographic locations across all 50 states and the District of Columbia, using a stratified, multistage probability sampling design to collect health and nutritional data representative of the civilian, non-institutionalized U.S.

POPULATION

We employed the generalized additive model to identify potential non-linear relationships and utilized the two-piecewise linear regression model to investigate the association between DOBS and sarcopenia in American adults.

RESULTS

Participants were categorized into quartiles based on their DOBS, and sarcopenia was diagnosed in 702 individuals (8.5%). In the unadjusted model, DOBS exhibited a significant negative correlation with sarcopenia (β = 0.97, 95% Confidence Interval (CI): 0.96 to 0.99, P < 0.001). This association remained consistent in the model with minimal adjustment for age and gender (β = 0.97, 95% CI: 0.96 to 0.98, P < 0.001) and in the fully adjusted model including additional covariates (β = 0.97, 95% CI: 0.96 to 0.99, P < 0.001). After adjusting for potential confounders, we identified a non-linear association DOBS and sarcopenia, with an inflection point at 23. The effect sizes and CIs to the left and right of the inflection point were 1.62 (95% CI: 1.09 to 2.41, P = 0.016) and 0.97 (95% CI: 0.95 to 0.98, P < 0.001), respectively. Subgroup analyses confirmed the stability of this relationship across various demographic and health-related variables.

CONCLUSIONS

This research provides new insights into the association between diet quality, as assessed by DOBS, and sarcopenia, reinforcing the critical role of a balanced, antioxidant-rich diet in adult muscle.

Associations between oxidation balance score and abdominal aortic calcification, and the mediating role of glycohemoglobin: a nationally representative cross-sectional study from NHANES

Background

Abdominal aortic calcification (AAC) is prevalent among middle-aged and elderly populations, elevating the risk of cardiovascular and cerebrovascular events. Leveraging data from the National Health and Nutrition Examination Survey (NHANES), we conducted a nationally representative cross-sectional study. Our aim was to evaluate whether subjective interventions could influence AAC scores by modifying the antioxidant/pro-oxidant status of individuals and to investigate the role of glycohemoglobin in this relationship.

Methods

The study analyzed data from 1,600 U.S. adults. The study used oxidation balance score (OBS) as an exposure variable derived from 16 dietary and 4 lifestyle factors, as well as glycohemoglobin obtained from blood tests. The main outcome measure was AAC, which was evaluated by dual-energy X-ray absorption and quantified by Kauppila scoring system.

Results

The mean (SD) age of the 1,600 patients was 56.53 (10.90) years, with a female predominance (50.22%). According to weighted linear regressions not adjusted for covariates, the AAC scores were lower in the third and fourth quartile groups of OBS than in the first quartile group of OBS (Q3: coefficients [coef], -0.92 [95% CI, -1.64 to-0.20], p = 0.017; Q4: coefficients [coef], -0.97 [95% CI, -1.86 ~ -0.08; p < 0.035]). According to the weighted linear regression subgroup analyses, there were no significant OBS-AAC correlations among males (p > 0.05), but there were significant correlations among females (p < 0.05). Smooth fitting curves showed a more significant trend of change in the negative correlation between OBS and AAC scores in postmenopausal women than in premenopausal women. In further mediation analyses, glycohemoglobin was identified as a mediator of the relationship between the oxidative balance score and AAC.

Conclusion

This study revealed a significant negative correlation between OBS and AAC scores, particularly in postmenopausal women. The negative correlation between OBS and AAC is partly mediated by glycohemoglobin.

Association between oxidative balance scores and peripheral artery disease in US adults: a cross-sectional study

Background

The Oxidative Balance Score (OBS) quantifies the overall oxidative stress burden, with higher scores indicating greater antioxidant (relative to prooxidant) activity. This study aimed to examine the association between peripheral arterial disease (PAD) and OBS.

Methods and materials

Data from the National Health and Nutrition Examination Survey (NHANES, 1999-2004) were analyzed for participants with ankle-brachial index (ABI) measurements. The total Oxidative Balance Score (OBS) comprised a lifestyle OBS (four lifestyle categories) and a dietary OBS (16 dietary factors). Logistic regression analyses evaluated associations between PAD and total OBS, lifestyle OBS, and dietary OBS. Restricted cubic spline (RCS) analyses assessed dose-response relationships between ABI, PAD, and OBS. Mediation analyses investigated the roles of glucolipid metabolism and renal function in the OBS-PAD association. Sensitivity and stratification analyses were conducted to ensure robustness.

Results

This study included 2,437 eligible adult participants. Logistic regression analysis, adjusted for multiple potential confounders, revealed negative associations between lifestyle OBS (OR = 0.88; 95% CI: 0.79, 1.00), total OBS (OR = 0.97; 95% CI: 0.94, 0.99), and the likelihood of PAD (all p < 0.05). Restricted cubic spline (RCS) analysis demonstrated a linear relationship between total OBS and PAD, with the likelihood of PAD decreasing as total OBS increased p for nonlinearity = 0.736. Dietary OBS, lifestyle OBS, and total OBS all showed positive linear correlations with ABI levels (all p < 0.05). Mediation analysis indicated that fasting plasma glucose (FPG) and creatinine (CREA) mediated 5.9 and 0.8% of the association between total OBS and PAD, respectively (all p < 0.05). Sensitivity analyses confirmed the negative association between total OBS and PAD p < 0.05, supporting the stability of the results. Stratified analyses highlighted the significant influence of Age, particularly in the younger population aged 20-44 years, a group warranting greater attention.

Conclusion

Our study demonstrated that higher total OBS is associated with a lower likelihood of PAD. Adopting an antioxidant-rich diet alongside a healthy lifestyle may help mitigate PAD risk. Additionally, modulating FPG and CREA levels could offer potential value in addressing the link between low OBS and PAD.

The genetic and observational nexus between diabetes and arthritis: a national health survey and mendelian randomization analysis

BACKGROUND

Diabetes mellitus (DM) and arthritis are prevalent conditions worldwide. The intricate relationship between these two conditions, especially in the context of various subtypes of arthritis, remains a topic of interest.

OBJECTIVE

To investigate the relationship between diabetes and arthritis, with a focus on Rheumatoid Arthritis (RA), using data from the National Health and Nutrition Examination Survey (NHANES) and Mendelian Randomization (MR) analysis.

METHODS

Data from six consecutive NHANES cycles from 2007 to 2018 were analyzed, involving 30,062 participants after applying exclusion criteria. The association between diabetes and arthritis was assessed using logistic regression. MR was employed to determine the causal relationship between the two conditions using Genome-Wide Association Study (GWAS) data.

RESULTS

The prevalence of arthritis in diabetic patients was almost twice that of non-diabetic patients. Logistic regression showed a significant gross association between arthritis and diabetes with an OR of 2.90 (95% CI: 2.66-3.16). After adjusting for age, gender, race, and other factors, the association yielded an OR of 1.14 (95% CI: 1.00-1.29, p < 0.05). MR analyses indicated a significant association between Type 1 Diabetes and RA (OR = 1.407, p = 0.002), but no significant correlation was observed for Type 2 Diabetes.

CONCLUSION

There is an association between diabetes and arthritis, with potential genetic links between Type 1 Diabetes and RA.

The interaction between sleep patterns and oxidative balance scores on the risk of cognitive function decline: Results from the national health and nutrition examination survey 2011-2014

BACKGROUND

Unhealthy sleep and exposures to oxidative factors are both associated with poor cognitive performance (PCP), but limited evidence has been found regarding the relationship between sleep patterns and oxidative factor exposures independently or jointly with the risk of PCP.

METHODS

We analyzed data from 2249 adults aged ≥60 years in the National Health and Nutrition Examination Survey (NHANES) database (2011-2014). Self-reported questionnaires were used to collect data on sleep duration and sleep disorder, categorizing sleep duration into three groups based on responses: short (6 hours or less per night), normal (7-8 hours per night), or long (9 hours or more per night). Sleep disorder were categorized into two groups: sleep disorder, non-sleep disorder. Oxidative balance score (OBS) was calculated based on 20 oxidative stress exposures related to diet and lifestyle factors, with higher scores indicating greater antioxidant exposures. Survey-based multivariable adjusted regression analyses were conducted to examine the associations between sleep patterns or OBS alone and in combination with overall and PCP risks.

RESULTS

Compared to the normal sleep duration group, the long sleep duration group had a higher risk of PCP (DSST<34) (OR = 1.91, 95% CI = 1.05-3.48, P = 0.021); while OBS was negatively correlated with the risk of PCP (DSST<34) [Q4 vs Q1 (OR = 0.50, 95% CI = 0.29-0.92, P = 0.004)]. There was an interaction effect between sleep patterns (sleep duration, sleep disturbances) and OBS on PCP (DSST<34) (P = 0.002). Further stratified analysis showed that in individuals with normal sleep duration, long sleep duration, or no sleep disturbances, antioxidant exposures, compared to pro-oxidant exposures, reduced the risk of low cognitive function occurrence.

CONCLUSIONS

In older populations, unhealthy sleep patterns (especially excessive sleep duration) and low OBS alone or in combination increase the risk of cognitive decline. Healthy sleep and lifestyle habits rich in antioxidant factors are crucial for protecting cognitive function in older adults.

Association between oxidative balance score and serum cobalt level in population with metal implants: a cross-sectional study from NHANES 2015-2020

Background

Growing evidence indicates that metal implants influence the body's oxidative stress status, which in turn affects the degradation and stability of metal implants. The oxidative balance score (OBS) is a composite indicator, reflecting the overall oxidative balance of pro-and antioxidants of the human body. However, the associations between OBS and the level of metal ions on the population with metal implants remain to be elucidated.

Methods

We conducted a cross-sectional study using data from 2015 to 2020 National Health and Nutrition Examination Survey (NHANES). Dietary and lifestyle factors closely associated with oxidative stress were quantified to calculate the OBS. Weighted multivariate logistic regression and smooth curve fittings were performed to examine the relationship between OBS and serum cobalt levels. Subgroup analyses were stratified by age and gender. In cases where non-linearity was detected, threshold effects were assessed using a two-piecewise linear regression model.

Results

A total of 549 participants were included in this analysis. The dietary OBS was negatively associated with serum cobalt level in fully adjusted model (β = -0.179, 95%CI: -0.358 to -0.001, P: 0.04918). Stratified by age and gender, negative correlation of OBS and dietary OBS with serum cobalt level was observed only in men and age over 70 years participants. Threshold effect analysis showed linear relationships between OBS, dietary OBS and cobalt level in males. There were non-linear relationships between OBS, dietary OBS and cobalt level in age over 70 years participants, with inflection points identified at 16.3 and 8.7 for OBS and dietary OBS, respectively.

Conclusion

Our study confirms the inverse relationships between oxidative stress and serum cobalt level in individuals with metal implants, highlighting the significance of optimizing OBS to mitigate the risk of metal ion toxicity. These findings emphasize the importance of maintaining an antioxidant diet and lifestyle, particularly as they offer greater protective effect for males and the elderly population.

Higher oxidative balance score is associated with lower female infertility: a cross-sectional study

Background

An imbalance of the pro-oxidant and antioxidant profiles in the body contributes to the development of diseases, including female infertility.

Methods

In this study, we performed a secondary analysis of the National Health and Nutrition Examination Survey and calculated the values of oxidative balance score (OBS). A weighted logistic regression model was used to explore the potential relationship between OBS (continuous factor and quartile set) and female infertility, and the P for trend was calculated. Subgroup analyses were also carried out further to explore the association between OBS and female infertility, and the P for interactions were obtained.

Results

There were 1,626 females (aged 18 to 45) included in the study, including 198 with infertility and a prevalence of approximately 13.28%. Multifactorial logistic regression showed a 5% decrease in infertility for each unit increased in OBS (OR, 0.95; 95% CI, 0.92 to 0.98). When OBS was used as a categorical variable, female infertility decreased by 60% in the highest OBS group compared with the lowest OBS group (OR, 0.40; 95% CI, 0.21 to 0.74). In addition, subgroup analyses showed that the negative association between OBS and infertility was significant in the non-chronic disease (hypertension and diabetes) population, those with less than a high school educational background, poverty-to-income ratio (1 to 3), and those with more than 30 years of age.

Conclusion

Higher OBS was negatively associated with female infertility. Further prospective studies are needed to determine causality and to provide new perspectives on female infertility in the context of diet and lifestyle.

Combined effects of nutrition, inflammatory status, and sleep quality on mortality in cancer survivors

BACKGROUND

Cancer survivors face many challenges in long-term health management, including malnutrition, systemic inflammation, and sleep issues, which significantly affect their survival and quality of life.

METHODS

A prospective cohort study was derived from the National Health and Nutrition Examination Survey from 2005-2018 harboring 1,908 cancer survivors (weighted population, 11,453,293), of whom 688 deaths (220 from cancer mortality, 468 from non-cancer mortality). The Advanced Lung Cancer Inflammation Index (ALI) was used as a measure of nutritional status and systemic inflammation in cancer patients. Weighted multivariable Cox proportional hazards regression models were utilized to explore the independent and combined effects of ALI and sleep quality on mortality outcomes.

RESULTS

The participants with a high ALI were more likely to be female, aged 40 to 64 years, non-Hispanic white, and have a higher BMI. We observed that elevated ALI levels were associated with decreased risks of all-cause mortality (Hazard ratio [HR] = 0.601, 95% Confidence interval [CI] = 0.521-0.695, P < 0.001), cancer-specific mortality (HR = 0.659, 95% CI = 0.497-0.870, P = 3.34 × 10-3) and non-cancer-specific mortality (HR = 0.579, 95% CI = 0.478-0.701, P < 0.001). Similarly, better sleep quality (e.g., without sleep troubles) was associated with lower risks of all-cause mortality (HR = 0.761, 95% CI = 0.620-0.933, P = 8.79 × 10-3) and non-cancer-specific mortality (HR = 0.713, 95% CI = 0.572-0.890, P = 2.80 × 10-3). Notably, the joint analysis showed that cancer survivors with higher ALI levels and better sleep quality (e.g., standard sleep duration) had the lowest risks of all-cause (HR = 0.468, 95% CI = 0.352-0.622, P < 0.001), cancer-specific mortality (HR = 0.631, 95% CI = 0.333-0.672, P = 7.59 × 10-3) and non-cancer-specific mortality (HR = 0.440, 95% CI = 0.315-0.615, P < 0.001).

CONCLUSIONS

This study suggests that better nutritional and inflammatory status, combined with good sleep quality, may contribute to improved survival among cancer survivors. These results underscore the potential clinical importance of integrating nutritional and sleep quality assessments into the long-term care of cancer survivors to enhance their overall prognosis.

Relationship between oxidative balance score and post-stroke depression: insights from the NHANES 2005-2018 cross-sectional study

Introduction

The Oxidative Balance Score (OBS) represents an integrated measure of oxidative-reductive homeostasis. Despite the established role of oxidative stress in the development of post-stroke depression (PSD), the association between OBS and PSD in the general population remains unclear. This study aims to explore this relationship using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018.

Methods

The OBS was calculated using validated methods that incorporate dietary and lifestyle factors, whereas PSD status was determined using self-reported data and the Patient Health Questionnaire-9 (PHQ-9) scores. Multivariable logistic regression was employed to evaluate the associations of total OBS, dietary OBS, and lifestyle OBS with PSD prevalence, adjusting for potential confounders. Dose-response relationships were further assessed using restricted cubic splines (RCS).

Results

Among the 26,668 participants included in the analysis, 201 were diagnosed with PSD. After adjusting for confounding variables, higher total OBS, dietary OBS, and lifestyle OBS were each significantly associated with reduced odds of PSD. The adjusted odds ratios (OR) and 95% confidence intervals (CI) for the highest versus lowest quartiles were 0.31 (95% CI: 0.15-0.67) for total OBS, 0.45 (0.27-0.73) for dietary OBS, and 0.28 (0.13-0.60) for lifestyle OBS. RCS analyses indicated a linear dose-response relationship for all three OBS categories with PSD risk. In sex-stratified analyses, significant inverse associations were observed between all OBS categories and PSD in females, whereas only lifestyle OBS was significantly associated with PSD in males.

Conclusion

Higher OBS was associated with reduced odds of PSD, with a particularly pronounced effect in females. These findings suggest that adherence to an antioxidant-rich diet and lifestyle may mitigate PSD risk.

Depressive symptoms and its relation to all-cause and cardiovascular mortality among United States adults with different diabetic status

OBJECTIVE

The relationship between diabetes, depressive symptoms, and mortality is well established. However, the effect of depressive symptoms on prediabetes and its relationship with mortality remains unclear. This study seeks to investigate the effects of depressive symptoms on mortality across different diabetic statuses.

METHODS

The study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, with a final sample size of 36,246 participants. Mortality status and cause of death were determined by cross-referencing records with the publicly accessible National Death Index through 2019. Kaplan-Meier survival curves and Cox regression analysis were utilized to assess the relationship between depressive symptoms and mortality across different diabetic statuses from nondiabetic to prediabetic to diabetic.

RESULTS

In the non-diabetic group, no effect of depression severity on all-cause mortality or cardiovascular mortality was found in the final models. In the prediabetic group, however, the hazard ratios were increased for both mild depressive symptoms (HR = 1.349, 95% CI = 1.138-1.600) and moderate-to-severe depressive symptoms (HR = 1.651, 95% CI = 1.309-2.082). In the diabetic group, surprisingly, the risk was somewhat lower than in the pre-diabetic group (HR = 1.279, 95% CI = 1.084-1.509 for mild and HR = 1.285, 95% CI = 1.056-1.563 for moderate-to-severe depressive symptoms). Similar risk patterns were noted for cardiovascular disease (CVD) mortality, where risk of moderate-severe symptoms was even greater in the prediabetic group (HR = 1.834, 95% CI = 1.180-2.851).

CONCLUSION

In this prospective cohort study of a nationally representative sample of U.S. adults, a positive association was found between depressive symptoms and mortality across different diabetic statuses. These findings highlight the importance of evaluating depressive symptoms across the glycemic spectrum, especially among individuals with prediabetes.

The associations between oxidative balance score and serum Klotho level in the U.S. population aged 40-79 years

The relationship between the oxidative balance score (OBS) and the serum Klotho level has yet to be defined. We sought to investigate the potential relationship between OBS and the serum Klotho level in the U.S. population aged 40-79 years. This study included 8,145 participants from the National Health and Nutrition Examination Surveys (NHANES) database spanning from 2007 to 2016. The OBS consisted of the dietary OBS and the lifestyle OBS, based on 16 dietary components and 4 lifestyle components. Weighted multiple linear regressions were performed to explore the association between OBS and serum Klotho level. Furthermore, nonlinear relationships were analyzed through the application of restricted cubic splines (RCS). In the multivariate linear regression model with adjustment for such as demographics, economic income and dietary intake, a higher OBS was associated with a higher serum Klotho, with the beta estimate and 95%CI of 2.85 (1.03-4.68, p < 0.01). Compared with the lowest tertile group, the highest group was associated with a higher Klotho level (30.35, 3.43-57.28, p < 0.05). Furthermore, higher dietary OBS and lifestyle OBS were similarly associated with higher Klotho level (beta (95%CI): 1.27 (0.79-3.32); 14.23 (9.53-18.92), respectively). The RCS exhibited a linear dose-response association between OBS, dietary OBS and lifestyle OBS with serum Klotho concentration (Pnon-linearity>0.05). The association between OBS and serum Klotho level was consistent across age, sex, education, marital status, energy intake and poverty income ratio (PIR) (Pinteraction>0.05). The study reported significant association between OBS and klotho, indicating that adherence to antioxidant behaviors may be linked to slower aging and better health.

Association between dietary inflammatory index and adolescent myopia based on the National Health and Nutrition Examination Survey

The prevalence of adolescent myopia is remarkably increasing. Previous studies have indicated that an unhealthy diet is a risk factor for myopia. However, the link between diet-related inflammation and myopia is unclear. To explore their correlation, we used dietary inflammation index (DII) that is a parameter to quantify the inflammatory potential of diet, to reveal the relationship between DII and myopia in adolescents. We extracted sociodemographic data, information of diets and eye refractive status of adolescents from National Health and Nutrition Examination Survey (NHANES) for period 1999-2008. Dietary intake data was used to calculate DII scores, which were then categorized into quartiles. Multivariable regression models and subgroup analyses were conducted to investigate the association between DII and myopia. Subsequently, smoothed curve analyses were conducted to discern the trend of correlation between DII and myopia across diverse population. A total of 7191 juveniles aged at 12 to 18 years with complete information were included in our study, consisting 3367 participants with diagnosis of myopia. Among these participants, a trend towards an increasing prevalence of myopia was observed with a higher DII. After adjusting for all covariates, stratified logistic regression analyses showed that among the population aged in 16 to 18 years old or with 9-11th grade educational level, the prevalence of myopia was significantly increased with higher DII score (OR = 1.06, 95% CI = 1.01, 1.11, P = 0.006; OR = 1.06, 95% CI = 1.01, 1.11, P = 0.010). In the two subgroups, participants in the highest quartile of DII had a 31.00% higher risk of myopia and a higher 27.00% risk of myopia respectively, compared to those in the lowest quartile of DII. Our results revealed an increasing trend in the prevalence of myopia with increased DII score in adolescents. Particularly, DII was positively associated with the risk of myopia among the population aged in 16 to 18 years old and with 9-11th grade educational level.

Relationships between oxidative balance score and asthma, COPD, with asthma-COPD overlap in American adults: findings from NHANES 2013-2018

BACKGROUND

Oxidative stress plays a crucial role in the development of multiple chronic respiratory diseases. Oxidative Balance Score (OBS) composing of 16 dietary factors and 4 lifestyle factors has been developed to evaluate the effect of oxidants/antioxidants produced by dietary intake and lifestyle habits on the overall oxidative balance. However, the relationships between OBS with asthma, COPD, and asthma-COPD overlap (ACO) are still unclear.

METHODS

A total of 10,942 adults aged 20 years and older from the 2013-2018 National Health and Nutrition Examination Survey were included in the analyses. ANOVA and chi-square tests were used to compare characteristics between different OBS subgroups. Multiple multivariate logistic regression was used to analyze the associations between OBS and asthma, COPD, and ACO.RCS curves were used to describe the dose-response effect of the associations. Subgroup analyses and interaction effects were employed to reflect the stability of the associations.

RESULTS

In the fully adjusted models, OBS was found to be negatively associated with asthma, COPD, and ACO. OBS at Q2, Q3, and Q4 (OR: 0.66, 95% CI: 0.46-0.97) were negatively associated with the risk of asthma. OBS at Q2 and Q4 were negatively associated with the risk of COPD. OBS at Q2 and Q4 were negatively associated with the risk of ACO. The RCS curves reflected the negative dose-response trend of association. Moreover, the associations were stable in various subgroups.

CONCLUSION

The negative associations between OBS and asthma, COPD, and ACO were found in American adults, providing evidence for dietary and lifestyle prevention.

Oxidative balance score and the potential for suffering rheumatoid arthritis: a cross-sectional study

Objective

Our study was conducted to explore the link between oxidative balance score (OBS) and rheumatoid arthritis (RA).

Methods

A total of 21,415 participants were included in our research from five cycles (2011-2012, 2013-2014, 2015-2016, 2017-2018, and 2017-2020) of the National Health and Nutrition Examination Survey (NHANES). Moreover, 20 elements related to diet as well as lifestyle were combined to calculate OBS. The relationship between OBS and RA was assessed by employing multivariable regression analysis, and further exploration was carried out through subgroup analysis, restricted cubic spline analysis, and sensitivity analysis. Multiple covariates were selected to adjust the model for more robust results.

Results

In our cross-sectional study, a higher OBS has a protective effect on the development of RA (OR = 0.98, 95% CI: 0.97 to 0.99). In contrast to individuals aged ≥60, the result is more prominent in the population aged 20-60 (OR = 0.97, 95% CI: 0.96 to 0.98). Marital status appears to introduce interference in the relationship between OBS and RA, and unmarried individuals exhibited different outcomes (OR = 1.02, 95% CI: 0.99 to 1.04) compared to others. The positive influence of OBS was more evident in patients with chronic kidney disease and cardiovascular disease, while it was stronger in individuals without diabetes and liver disease.

Conclusion

A higher OBS correlates with a reduced odd of RA. Further studies are needed to shoot more sights on improving dietary habits and lifestyles to gain proper OBS and explore whether OBS can be one of the measurements utilized to measure the risk of RA.

Association Between Chrononutrition Patterns and Multidimensional Sleep Health

BACKGROUND/OBJECTIVES

Sleep health has been associated with diet quality, but the relationship between chrononutrition patterns and multidimensional sleep health is unclear. This study identifies chrononutrition patterns among U.S. adults and examines their associations with multidimensional sleep health.

METHODS

This cross-sectional analysis used data from the 2017-2020 National Health and Nutrition Examination Survey. Chrononutrition behaviors were assessed using two 24 h dietary recalls. Latent profile analysis was used to identify chrononutrition profiles. Multivariable survey regression models determined the associations between chrononutrition patterns and sleep health dimensions.

RESULTS

The sample included 5228 subjects with a median age of 49 years. Of the sample, 52% of the participants were female, and 65% were White. In adjusted models, each additional hour between wake time and first instance of eating was associated with a 19% increase in the odds of poor timing (sleep midpoint < 2:00 a.m. or >4:00 a.m.; 95% CI: 1.07-1.33) and a 21% increase in poor duration (<7 or >9 h/night; 95% CI: 1.09-1.33). Each additional hour between last eating and bedtime was associated with 9% higher odds of poor duration (95% CI: 1.03-1.16). A one-hour longer eating window was associated with 10% lower odds of poor timing (95% CI: 0.84-0.98). We identified five chrononutrition profiles: Typical Eating (reference), Early Finished Eating, Later Heavy Eating, Extended Window Eating, and Restricted Window Eating. The Later Heavy Eating profile exhibited 96% higher odds of poor timing (95% CI: 1.09-3.51) and the Restricted Window Eating profile had 94% higher odds of poor duration (95% CI: 1.10-3.43).

CONCLUSIONS

These findings highlight the importance of unique chrononutrition patterns in relation to multidimensional sleep health. We provide a framework for future studies to identify personalized chrononutrition interventions and their role in improving sleep health.

Association of cardiometabolic index with sleep quality in adults: a population‑based study

The Cardiometabolic Index (CMI) represents an innovative metric that encompasses abdominal obesity and lipid levels, offering a comprehensive assessment of cardiometabolic health. It is derived through the multiplication of the waist-to-height ratio by the triglyceride-to-high-density lipoprotein cholesterol ratio. Although obesity and blood lipid levels are known factors affecting sleep quality, the direct correlation between CMI and sleep quality has yet to be elucidated. This study uses NHANES data to explore the potential correlation between CMI and sleep quality. Our research employed a cross-sectional design, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2014. CMI was used as the exposure variable, with sleep quality assessed through three self-reported measures: trouble sleeping, sleep disorders, and sleep duration. We employed multivariate logistic regression models and linear regression model as well as subgroup analyses to explore the independent relationship between CMI and sleep quality. Additionally, interaction tests were conducted to examine differences across various subgroups. The study included 4298 participants, comprising 2134 males and 2164 females. There was a positive correlation between CMI and trouble sleeping (OR = 1.63, 95% CI 1.28-2.08) and sleep disorders (OR = 1.96, 95% CI 1.43-2.67), while there was a negative correlation between CMI and sleep duration (β = - 0.17, 95% CI - 0.31 to - 0.03), indicating that a higher CMI was associated with shorter sleep duration. Subgroup analyses and interaction tests revealed a consistently positive association between CMI and sleep difficulty across various populations, including gender, age, hypertension, diabetes, and cardiovascular disease history. However, the relationship between CMI and sleep disorders was more prominent among participants aged 50 and above. In American adults, a higher CMI is linked to an increased prevalence of sleep disturbances. In clinical practice, CMI can be considered as a supplementary factor in the assessment and management of sleep problems. Our study also provided new insights for improving sleep quality.

The Association Between Dietary Vitamin C and Sleep Disorders: A Cohort Study Based on UK Biobank

Objective: Approximately 30% of adults globally suffer from sleep disorders. However, there are few longitudinal studies on the association between dietary vitamin C and sleep disorders. This study aimed to investigate the association between dietary vitamin C intake and various types of sleep disorders, including sleep apnea and insomnia. Methods: We enrolled 68,221 participants from the UK Biobank. Dietary vitamin C intake was assessed using a 24 h dietary recall questionnaire. We employed a Cox regression model to assess the association between dietary vitamin C and sleep disorders and used restricted cubic spline models to investigate potential nonlinear relationships. Stratified and sensitivity analyses were also conducted to validate the findings. Results: The results indicated that vitamin C intake at the Q4 level (132.88-191.51 mg/d) was significantly associated with a reduced risk of sleep disorders, with an HR (95% CI) of 0.78 (0.65-0.94), and against sleep apnea, with an HR (95% CI) of 0.75 (0.62-0.92). The protective effect persisted significant in stratified analyses of men and those aged ≤ 60 years; the results were consistent in the sensitivity analyses. Conclusions: Our findings suggest that sufficient dietary vitamin C intake may help to prevent sleep disorders.

Oxidative stress and inflammation mediate the association between elevated oxidative balance scores and improved sleep quality: evidence from NHANES

Background

The association between oxidative stress, as measured by the Oxidative Balance Score (OBS), and sleep quality remains unclear. The primary objective of this investigation was to clarify this relationship and to explore the potential involvement of oxidative stress and inflammation.

Methods

Data from 15,198 participants in the National Health and Nutrition Examination Survey 2007-2014 were analyzed. Sleep quality indicators, including sleep disorder, trouble, and duration, were assessed. The OBS, comprising information on 16 dietary nutrients and 4 lifestyle factors, was then calculated. Multivariable logistic and linear regression models were employed to investigate the correlation between OBS and sleep quality. Additionally, mediation analyses were conducted to evaluate the potential effects of oxidative stress and inflammation.

Results

We demonstrated a correlation between an elevated OBS and reduced sleep disorders (OR, 0.72; 95% CI, 0.58-0.91; p = 0.0055), reduced sleep trouble (OR, 0.81; 95% CI, 0.69-0.96; p = 0.0174), and prolonged sleep duration (β 0.009; 95% CI, 0.0002-0.0160; p = 0.015) when comparing the highest and lowest tertiles. Dietary factors exhibited autonomous correlations with sleep duration, whereas lifestyle factors displayed independent associations with sleep trouble and sleep disorders. Moreover, the relationships between OBS and both sleep disorders and trouble were influenced by albumin, γ-glutamyl transferase, total bilirubin, and white blood cells, with combined mediation effects of 34.66 and 29.54%, respectively (both p < 0.001). Sensitivity analyses revealed a significant association between OBS and sleep disorder (p < 0.001).

Conclusion

This study revealed a positive correlation between an elevated OBS and improved sleep quality, manifested by decreased sleep disorders, mitigated sleep trouble, and prolonged sleep duration. This is potentially mediated by oxidative stress and inflammation. Therefore, the study underscores the importance of adopting a diet rich in antioxidants and healthy lifestyle choices to address sleep-related concerns, providing a novel avenue for enhancing overall sleep quality.

The association between dietary carbohydrate intake and the risk of hyperlipidemia among reproductive-aged women in the US: A cross-sectional study

BACKGROUND

The association between dietary carbohydrate intake and hyperlipidemia remained incompletely understood. This study aimed to explore the association between dietary carbohydrate intake and the risk of hyperlipidemia among reproductive-aged women in the US.

METHODS

The study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted from 2005 to 2020. Dietary intake information was assessed via interviews using 24-hour dietary recall interviews, and hyperlipidemia diagnosis adhered to the National Cholesterol Education Program guidelines. Univariate and multivariate logistic regression analyses, along with restricted cubic splines (RCS) and stratified analyses, were conducted to investigate the association between dietary carbohydrate intake and the risk of hyperlipidemia.

RESULTS

A total of 6,791 women of reproductive age, with a mean age of 34.87 (±8.57) years, were included in the final analysis. In the multivariate logistic regression model adjusting for covariates, a higher percentage of energy from carbohydrate was positively correlated with the risk of hyperlipidemia (adjusted odds ratio (AOR): 1.014, 95% CI: 1.004-1.024). Analyzing the percentage of energy from carbohydrate as a categorical variable, compared to the lowest quartile, the third quartile (AOR: 1.263, 95% CI: 1.031-1.546) and the highest quartile (AOR: 1.411, 95% CI: 1.083-1.839) were associated with increased hyperlipidemia risk. Additionally, a linear relationship (P for nonlinearity = 0.088) existed between the percentage of energy from carbohydrate and the risk of hyperlipidemia, with an inflection point identified at 49.64.

CONCLUSIONS

This study found that elevated dietary carbohydrate intake was associated with an increased the risk of hyperlipidemia in reproductive-aged women. These findings implied that reproductive-aged women should pay closer attention to reducing their carbohydrate intake.

Development of a predictive model for the U-shaped relationship between the triglyceride glycemic index and depression using machine learning (NHANES 2009-2018)

Background

At present, the relationship between depression and the triglyceride glycemic (TyG) index remains a topic of debate. This study sought to elucidate the relationship between depression and the TyG index to create a predictive model that would help doctors diagnose patients.

Methods

We conducted a cross-sectional study utilizing the National Health and Nutrition Examination Survey (NHANES) dataset, which comprises data from 2009 to 2018. The analysis involved 11,222 adults with a Patient Health Questionnaire-9 (PHQ-9) score of 5 or higher, indicating the presence of depression. As part of the analysis, multiple regression models were used to test whether a linear relationship existed between the TyG index and depression. A threshold effects analysis was used to generate smoothed curves and detect nonlinear correlations. Additionally, the Least Absolute Shrinkage and Selection Operator (LASSO) regression were employed to identify the key risk factors associated with depression. The factors identified were then used to construct the risk prediction nomogram. Finally, Receiver Operating Characteristic (ROC) curves were used to evaluate the discriminative performance of the model.

Results

Multivariable linear regression analysis indicated a strong positive correlation between depression and the TyG index (β: 0.38, 95 % CI: 0.16-0.60, p = 0.0008). A U-shaped relationship with an inflection point was observed at a TyG index of 8.16. The nomogram model, constructed using risk factors identified by LASSO, exhibited a significant predictive value (AUC = 0.888).

Conclusions

The results of this investigation point to a U-shaped association between depression risk and the TyG index among Americans. Those with a TyG index of over 8.16 are significantly more likely to develop depression. These results suggest a possible causal relationship and emphasize the importance of monitoring the TyG index in depression risk assessment.

A clinical trial of the effects of cocoa rich chocolate on depression and sleep quality in menopausal women

In this triple-blind, randomized clinical trial, 60 menopausal women between the ages of 45 and 65 were randomized to receive 78% dark chocolate (12 g/day) or milk chocolate (12 g/day) for eight weeks. The primary outcome was depression scores. Secondary outcomes included sleep quality and anthropometric indices. ANCOVA with baseline adjustment showed that the mean depression score after the intervention in the group receiving dark chocolate was significantly reduced compared to the milk chocolate group (mean difference: -2.3; 95% confidence interval: -3.9 to -0.8; p = 0.003; Cohen's d = -0.54). However, no statistically significant difference in the overall sleep quality score and its subdomains was observed between the two groups after the intervention (p > 0.05). Furthermore, after the intervention, there was no statistically significant difference between the two groups in terms of anthropometric indices, including weight (p = 0.075), BMI (p = 0.137), waist circumference (p = 0.463), and hip circumference (p = 0.114). The study suggests that consuming 78% dark chocolate for eight weeks may contribute to improvements in depression scores, but it does not appear to improve sleep quality or anthropometric indices.Trial registration: IRCT20220926056046N1; December 2022.

The relationship between oxidative balance score and circadian syndrome: evidence from the NHANES 2005-2018

Background

The oxidative balance score (OBS) is a composite indicator that evaluates the balance between pro-oxidants and antioxidants in one's diet and lifestyle. However, the relationship between OBS and circadian syndrome (CircS) has remained unexplored. This investigation aimed to determine a correlation between OBS and CircS.

Methods

This population-based study examined 7,202 participants from the 2005 to 2018 National Health and Nutrition Examination Survey (NHANES), 1,433 of whom had CircS. We utilized weighted multivariate logistic regression, trend tests, subgroup analysis, and interaction tests to evaluate the correlation between OBS (total OBS, dietary OBS, and lifestyle OBS) and CircS. Restricted cubic splines (RCS) models and threshold effect analysis were used to explore nonlinear relationships.

Results

Multivariate logistic regression analysis indicated that the protective factor for CircS was a high OBS level (total OBS: Odds ratio (OR) = 0.95, 95% Confidence interval (CI): 0.93-0.97; dietary OBS: OR = 0.98, 95% CI: 0.96-1.00; lifestyle OBS: OR = 0.65, 95% CI: 0.61-0.69). Compared to the quartile 1 group, OBS (total OBS, dietary OBS, and lifestyle OBS) was negatively and statistically significantly associated with the risk of developing Circs in the quartile 4 group (total OBS: OR = 0.47, 95% CI: 0.32-0.70; dietary OBS: OR = 0.69, 95% CI: 0.48-0.99; lifestyle OBS: OR = 0.07, 95% CI: 0.04-0.11). According to subgroup analysis and interaction tests, there was an interaction effect between the association of lifestyle OBS and CircS in terms of education level (p for interaction = 0.01). Furthermore, we observed a nonlinear negative relationship between lifestyle OBS and CircS prevalence, with inflection points at 6 (p for nonlinearity = 0.002).

Conclusion

The results showed a substantial negative connection between OBS and CircS. Encouraging foods filled with antioxidants and antioxidant-rich lifestyles may reduce the risk of CircS.

Correlations between oxidative balance score and female asthma among U.S. adults

In order to explore the association of oxidative balance score (OBS) with female asthma among U.S. adults, we applied multiple logistic regression models, restricted cubic spline, and subgroup analysis using a cross-sectional study from the National Health and Nutrition Examination Survey (NHANES). 17,582 female out of the 91,351 participants from 2001 to 2018 in NHANES were enrolled in the analysis and 2,795 female participants had asthma. In three models, the OBS was negatively associated with female asthma incidence with the odds ratios (OR) = 0.99. When comparing the ratio of Q2, Q3, and Q4 of OBS quartiles against the Q1 quartile, the adjusted OR with 95% confidence intervals (95%CI) were 0.88 (0.75-1.03), 0.84 (0.73-0.97), and 0.82 (0.70-0.96) respectively, with p < 0.01 in the all covariates adjusted models. The restricted cubic splines indicated a linear relationship between OBS and female asthma. Subgroup analysis revealed no significant interaction effects except in the smoke group (p < 0.001), and there was a significant difference in the former smoker with OR 0.97 (0.96-0.99). We observed that there is negative relationship between OBS score and female asthma incidence, which suggests OBS probably is a protective factor for female on-set asthma. According to the subgroup analysis, smoking should be recommended to reduce asthma morbidity.

Association between dietary total antioxidant capacity and sleep problems and depressive symptoms among U.S. adults

Background

In this study, we aim to examine the impact of dietary total antioxidant capacity (TAC) on sleep problems and depressive symptoms (DS); besides, we seek to elucidate the potential mediating effect of dietary TAC on the relationships between sleep problems and DS.

Methods

Weighted Kruskal-Wallis tests for continuous variables and Chi-square tests for categorical variables were employed to discriminate between DS and non-DS participants. Multivariable logistic regression and restricted cubic spline analysis were applied to evaluate the associations of TAC with DS and sleep problems.

Results

Among the 21,805 participants, 1,947 participants suffered from DS. Weighted multivariable logistical regression indicated that shorter sleep hours were linked to an increased likelihood of risk of DS even after complete adjustments. Restricted cubic spline cure displayed that TAC was almost non-linearly correlated with DS and sleep problems. Mediation analysis indicated that sleep duration slightly mediated the association between TAC and DS (proportion of mediation: 3.12%, p < 0.001).

Conclusion

This study illustrated the inverse association between TAC value and sleep problems and DS. Furthermore, TAC slightly mediated the effect of sleep duration on the DS, and there was a nearly non-linear relationship between TAC and DS, and TAC and sleep problems.

Association between sleep duration and sleep quality with pre-sarcopenia in the 20-59-year-old population: evidence from the National Health and Nutrition Examination Surveys 2005-2014

BACKGROUND

Sarcopenia is a musculoskeletal disease characterized by a significant reduction in muscle mass, strength, and performance. As it mostly affects older adults, it is often recognized as a disease of old age. However, sleep is also closely related to its development. Hence, it becomes critical to explore the relationship between sleep and sarcopenia in populations under 60 years of age to develop strategies for preventing sarcopenia. We here aim to explore the specific association between sleep duration and sleep quality with pre-sarcopenia in the non-elderly population using large population samples.

METHODS

This study involved 7,187 participants aged 20-59 years from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2014. Pre-sarcopenia is defined based on the appendicular skeletal muscle mass (ASM) adjusted for body mass index (BMI). Self-reported sleep duration was categorized into three groups: <6 h (short sleep), 6-8 h (normal sleep), and > 8 h (long sleep). Sleep quality was assessed based on the Sleep Disorder and Trouble Sleeping Questionnaire. Univariate analysis and multivariate logistic regression were used to examine the relationship between sleep duration and sleep quality with pre-sarcopenia.

RESULTS

Sleep quality was significantly linked with the risk of pre-sarcopenia (OR 1.72, 95% CI 1.36-2.18, P < 0.01). Longer or shorter sleep duration did not affect the risk of pre-sarcopenia, in contrast to normal sleep duration. Subgroup analysis demonstrated a more pronounced association in individuals who are > 40 years old (P < 0.01), non-Hispanic (P ≤ 0.01), overweight (P < 0.01), have a higher income (P < 0.01), and are more educated (P ≤ 0.01). Moreover, this association was noted in populations with or without smoking (P < 0.01) and alcohol consumption (P < 0.01), hypertension (P < 0.01) and diabetes (P ≤ 0.02).

CONCLUSION

Sleep quality is associated with an increased risk of pre-sarcopenia, while sleep duration is not in the population aged 20-59 years. Further prospective cohort studies with a large sample size are needed to determine causality and develop effective interventions for preventing sarcopenia in the population aged 20-59 years.

Association of oxidative balance score, cardiovascular, and all-cause mortality among patients with type 2 diabetes mellitus

Background

To investigate the association between oxidative balance score (OBS), cardiovascular mortality (CVM), and all-cause mortality (ACM) in type 2 diabetes mellitus (T2DM) patients.

Methods

We included 6,119 participants with T2DM from the 2005-2020 National Health and Nutrition Examination Surveys (NHANES). The status of CVM and ACM of participants was followed through December 31, 2019. Multivariable Cox regression models, Kaplan-Meier curves, log-rank test, restricted cubic spline regression, and subgroup analysis, were used to evaluate the relationship between OBS, CVM, and ACM.

Results

During a median of 100.9 months follow-up, 1,790 ACM cases had occurred, 508 of which were due to cardiovascular disease. The T2DM participants were divided into four groups based on the quartiles of OBS. Participants with Q4 tended to be younger, financially better-off, married, highly educated, had lower alcohol consumption rates, were non-smokers, and exhibited a lower likelihood of ACM and CVM. In multivariate Cox regression models, compared with the patients with Q4, those with Q1 had a 30% increased risk for ACM (Q1, reference; Q4, HR: 0.70, 95%CI: 0.58-0.86) and a 43% increased risk for CVM (Q1, reference; Q4, HR: 0.57, 95%CI: 0.36-0.88). The restricted cubic spline regression models have no nonlinear relationship between OBS, CVM, and ACM. Kaplan-Meier survival curves showed that patients with Q4 had a lower risk of ACM and CVM (log-rank P < 0.05).

Conclusions

We find that ACM and CVM increase with higher OBS in T2DM patients. Moreover, there are linear relationships between OBS, ACM, and CVM.

Inflammatory diet, gut microbiota and sensorineural hearing loss: a cross-sectional and Mendelian randomization study

Aims

Inflammatory diets can trigger chronic inflammation and affect gut microbiota. However, the relationship between dietary preferences and sensorineural hearing loss (SNHL) remains unclear. This study aims to elucidate the relationship between different dietary preferences and sensorineural deafness.

Methods

The Dietary Inflammation Index (DII) and SNHL were defined by data from the National Health and Nutrition Examination Survey (NHANES), and exploring their relationship. Using Mendelian randomization (MR) to analyze the relationship between 34 dietary preferences, 211 gut microbiota, and SNHL.

Results

Smooth curve fitting indicated that the risk of SNHL increased with increasing DII score when the DII score was greater than 5.15. MR results suggest that a diet including both oily and non-oily fish can substantially reduce the risk of SNHL. Additionally, six specific gut microbiota were found to have significant causal relationship with SNHL.

Conclusion

An inflammatory diet may increase the risk of developing SNHL. The observed relationship between fish consumption, gut microbiota, and SNHL suggests the existence of a gut-inner ear axis.

Association of triglyceride-glucose index with helicobacter pylori infection and mortality among the US population

BACKGROUND

Limited research has explored the potential association between the Triglyceride-Glucose (TyG) and mortality, especially in individuals with Helicobacter pylori (H. pylori) infection. This study seeks to investigate the correlation between the TyG index and H. pylori infection and investigate whether the associations between the TyG index exposure and all-cause mortality are mediated by H. pylori infection.

METHODS

The study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, incorporating a final sample size of 2,187 participants. Both univariable and multivariable-adjusted logistic regression analyses were employed to examine the relationship between H. pylori infection and relevant covariates. To assess the association between TyG index, and all-cause mortality in individuals with or without H. pylori infection, Cox regression analysis, and restricted regression cubic spline analysis were implemented.

RESULTS

A significant positive correlation was observed between the TyG index and an elevated risk of H. pylori infection [OR 1.157, 95% CI (1.383 ~ 1.664)]. This correlation persisted even after adjusting for confounding factors [OR 1.189, 95% CI (1.003, 1.411), P < 0.05]. Furthermore, in patients with positive H. pylori infection, a noteworthy nonlinear correlation between the TyG index and all-cause mortality was identified (P = 0.0361). With an increase in the TyG index, all-cause mortality exhibited a corresponding rise, particularly following adjustment for all potential confounding factors. Conversely, in patients with negative H. pylori infection, no significant association was observed between the TyG index and all-cause mortality after adjusting for potential confounding factors.

CONCLUSION

A higher TyG index was linked to increased H. pylori infection risks. Participants in the higher quantile group of the TyG index are positively associated with higher all-cause mortality compared to the higher quantile group of the TyG index in H. pylori-positive participants instead of H. pylori-negative participants.

Oxidative balance score and associations with dyslipidemia and mortality among US adults: A mortality follow-up study of a cross-sectional cohort

BACKGROUND

Oxidative stress has been implicated in the pathogenesis and progression of dyslipidemia. We aimed to investigate the association between the oxidative balance score, and dyslipidemia, as well as to assess the mortality risk associated with oxidative balance score in patients with dyslipidemia.

METHODS

We performed a mortality follow-up study of a cross-sectional cohort of 26,118 adults from the National Health and Nutrition Examination Survey 1999-2018. The total oxidative balance score was calculated by 16 dietary nutrients (dietary oxidative balance score) and four lifestyle factors (lifestyle oxidative balance score). Weighted Cox proportional hazard model was applied to determine the relationship between oxidative balance score and all-cause or cardiovascular disease (CVD) mortality within the dyslipidemia group.

RESULTS

During a median follow-up of 118 months, 2448 all-cause deaths (766 CVD-related) occurred. A significant negative correlation was observed between total oxidative balance score, dietary oxidative balance score, lifestyle oxidative balance score, and dyslipidemia. The multivariable-adjusted odds ratios and 95% CIs for dyslipidemia were 0.86 (0.77-0.97), 0.80 (0.72-0.91), and 0.63 (0.56-0.70), respectively, when comparing the second, third, and fourth quartiles of total oxidative balance score to the reference lowest quartile (P for trend <0.0001). Increasing total oxidative balance score was inversely associated with all-cause (hazard ratio [HR] = 0.98, 95% CI 0.98-0.99) and CVD-specific mortality (HR = 0.98, 95% CI 0.97-0.99) in participants with dyslipidemia.

CONCLUSIONS

Oxidative balance score is inversely associated with dyslipidemia and linked to all-cause and CVD-related mortality, highlighting the potentially protective role of an antioxidant-rich diet against dyslipidemia.

Association between oxidative balance score and resistant hypertension and arterial stiffness among US adults: A population-based study

BACKGROUND AND AIMS

Prior studies have established the correlation between oxidative balance score (OBS) and hypertension (HTN). While the association between OBS and resistant hypertension (RHT) as well as arterial stiffness among individuals with hypertension remains undisclosed.

METHODS AND RESULTS

In this study, total of 15,910 adults diagnosed with hypertension were enrolled from NHANES 2001-2018. OBS was calculated and categorized into quartiles. Weighted regression model, stratified analyses and restricted cubic spline (RCS) were employed to evaluate the association between OBS and RHT, major adverse cardiovascular events (MACEs) and arterial stiffness in individuals with hypertension. Among enrolled participants, high OBS quartiles consistently demonstrated a negative association with resistant hypertension across all models (all p < 0.05), indicating robust stability. Compared with the lowest OBS quartile, the risk of resistant hypertension in the highest OBS quartile was decreased by 30.8% (95%CI 0.471-0.995, p = 0.049). After dividing OBS into dietary OBS and lifestyle OBS, a significant inverse association with lifestyle OBS and RHT was observed. With regard to MACEs, the inverse association was also found in participants with high OBS. Besides, the potential relation between OBS and arterial stiffness was explored and we found OBS was significantly associated with decreased arterial stiffness (β for ePWV, -0.014; 95%CI -0.026 to -0.001; p = 0.032). RCS analysis confirmed a nonlinear association between OBS and RHT, MACEs, cardiovascular death and nonfatal MI among participants with hypertension.

CONCLUSION

Elevated OBS was negatively associated with the risk of RHT and arterial stiffness among US adults with hypertension.

Associations between the oxidative balance score and constipation: a cross-sectional study of the NHANES, 2005-2010

OBJECTIVE

The oxidative balance score (OBS) reflects the overall burden of oxidative stress in an individual, with a higher OBS indicating greater antioxidant exposure. This study aimed to explore the association between constipation and OBS.

METHODS

Variables were extracted from participants who completed a constipation questionnaire as part of the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2010. The OBS was developed based on dietary and lifestyle factors, encompassing 16 nutrients and 4 lifestyle variables. Weighted logistic regression and restricted cubic spline (RCS) analyses were employed to evaluate the association between OBS and constipation.

RESULTS

After adjusting for all covariates, weighted multivariate logistic regression analysis revealed a 4% reduction in the incidence of constipation for each additional unit of OBS (OR: 0.96, 95% CI: 0.95-0.97, p < 0.001). In the OBS subgroup, the risk of constipation significantly decreased compared to that in the lowest quartile (Q2: 0.72, P = 0.024; Q3: 0.59, P < 0.001; Q4: 0.54, P < 0.001).

CONCLUSIONS

The present study demonstrated a significant association between constipation and the oxidative balance score (OBS), particularly dietary OBS, and that an increase in OBS may reduce the risk of developing constipation, in which oxidative stress may play an important role. This finding suggested that dietary modification could be an important approach for preventing constipation.

Association between oxidative balance score and risk of gout: The NHANES cross-sectional study, 2007-2018

BACKGROUND

The Oxidative Balance Score (OBS) is a systematic tool to assess the effects of diet and lifestyle in relation to oxidative stress. The association between OBS and gout has not been reported previously. We conducted a cross-sectional study to investigate the complex association between OBS and gout in US adults.

METHODS

In all, 10 492 participants were included in this study. The exposure variable was OBS, which was scored by 16 dietary and four lifestyle factors. Multivariate logistic regression, subgroup analysis, and restricted cubic spline (RCS) regression were used to analyze the association between OBS and gout.

RESULTS

Compared with the lowest OBS quartile group (Q1), the multivariate corrected odds ratio (OR) (95% confidence interval [C]) for the highest quartile of OBS (Q4) was 0.72 (0.52-1.00) (p = .13 for trend); furthermore, the RCS showed a negative linear relationship between OBS and gout (p-nonlinear = .606).

CONCLUSION

In conclusion, the risk of gout is higher with high OBS. The prevalence of gout decreased with higher OBS. Diabetes may alter this negative correlation.

Different gender of oxidative balance score on the risk of rheumatoid arthritis in the US population from NHANES

BACKGROUND

Oxidative stress is associated with risk of pathogenesis between rheumatoid arthritis. The Oxidative Balance Score (OBS) is a systematic tool to assess the effects of diet and lifestyle in relation to oxidative stress. However, the association between OBS and rheumatoid arthritis has not been reported previously. We conducted a cross-sectional study to investigate the complex association between OBS and rheumatoid arthritis in US adults.

METHODS

Overall, 9747 participants were included in this cross-sectional study. The exposure variable was OBS, which was scored by 16 dietary and four lifestyle factors. Multivariate logistic regression, subgroup analysis, and restricted cubic spline (RCS) regression were used to analyze the association between OBS and rheumatoid arthritis.

RESULTS

Compared to the lowest OBS quartile group (Q1), the multivariate corrected odds ratio (OR) (95% confidence interval [CI]) for the highest quartile of OBS (Q4) was 0.69 (0.52-0.90) (p = .013 for trend); furthermore, the RCS showed a negative linear relationship between OBS and rheumatoid arthritis. According to subgroup and RCS analyses, there was a significant difference between the association of OBS and with rheumatoid arthritis in terms of gender (p = .049).

CONCLUSION

In conclusion, high OBS was negatively associated with the risk of rheumatoid arthritis. Gender has an effect on OBS in RA. Our results suggest that OBS can be used as a biomarker to predict rheumatoid arthritis.

Association between oxidative balance score and serum uric acid and hyperuricemia: a population-based study from the NHANES (2011-2018)

Background

Oxidative Balance Score (OBS) is a novel indicator of the overall antioxidant/oxidant balance, providing a comprehensive reflection of the body's overall oxidative stress status, with higher OBS suggesting more substantial antioxidant exposures. We aimed to investigate the possible relationship between OBS with serum uric acid (SUA) and hyperuricemia.

Methods

Data utilized in this study were sourced from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Participants under 18 years old, those with ≤16 complete data out of 20 OBS components, incomplete serum uric acid data, and missing covariates were excluded from the analysis. OBS was computed by evaluating 16 nutrients and 4 lifestyle factors, encompassing 5 pro-oxidants and 15 antioxidants, guided by a priori knowledge of their relationship with oxidative stress.

Results

A total of 1,5096 individuals were included in our analysis with 49.7% being male, and an average age of 49.05 ± 17.56 years. The mean OBS was 19.76 ± 7.17. Hyperuricemia was present in 19.28% of participants. Due to the right-skewed distribution of the OBS, a natural log transformation was applied to address this issue, and Quartiles of lnOBS 1, 2, 3, and 4 were 1.10-2.56 (N=3526), 2.64-2.94 (N=3748), 3.00-3.22 (N=4026), and 3.26-3.61 (N=3796), respectively. Multivariable logistic regression showed that higher lnOBS quantiles were correlated with lower serum uric acid levels. Compared with the lowest lnOBS quantile, participants in the highest lnOBS quantile had a significant serum uric acid decrease of 16.94 μmol/L for each unit increase in lnOBS (β=-16.94, 95% CI: -20.44, -13.45). Similar negative associations were observed in the second-highest (β=-8.07, 95% CI: -11.45, -4.69) and third-highest (β=-11.69, 95% CI: -15.05, -8.34) lnOBS quantiles. The adjusted odds ratios (ORs) for hyperuricemia in Quartiles 1, 2, 3, and 4 were 1.00, 0.84 (95% CI: 0.75, 0.95), 0.78 (95% CI: 0.69, 0.88), and 0.62 (95% CI: 0.55, 0.71), respectively. Compared to Quartile 1, participants in Quartile 4 had a 38% lower prevalence of hyperuricemia. Subgroup analysis and interaction test showed that there was a significant dependence of sex between OBS and serum uric acid (p for interaction <0.05), but not hyperuricemia (p for interaction >0.05). Subgroup analysis stratified by age, BMI, hypertension, diabetes, and hyperlipidemia showed there is no significant dependence on these negative correlations (all p for interaction >0.05).

Conclusions

The serum uric acid levels and prevalence of hyperuricemia in US adults exhibited a negative association with OBS. By exploring this connection, our research aims to gain a better understanding of how oxidative balance affects the prevalence of hyperuricemia. This could provide valuable insights for developing preventive strategies and interventions for hyperuricemia. Additional large-scale prospective studies are required to explore the role of OBS in hyperuricemia further.

Association of oxidative balance score with hearing loss and tinnitus: NHANES 1999-2018

Background

Oxidative stress is associated with the occurrence of hearing loss and tinnitus. The oxidative balance score (OBS), a composite indicator evaluating the balance between antioxidant and pro-oxidative components across various dietary and lifestyle factors, indicates the overall oxidative balance status. However, the association of OBS with hearing loss and tinnitus has not been reported previously.

Methods

Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were analyzed. Weighted multivariable logistic regression, weighted multivariable linear regression, and restricted cubic spline curve (RCS) regression were employed to explore the relationship between OBS and hearing loss at speech, low, and high frequencies, along with tinnitus. Subgroup analysis and sensitivity analysis were used to ascertain the consistency across subgroups and stability of the results.

Results

We included 13,715 and 21,644 individuals to investigate the association between OBS and hearing loss, as well as between OBS and tinnitus, respectively. The second, third, and fourth quartiles of OBS were significantly associated with a lower risk of hearing loss at speech, low, and high frequencies, as well as tinnitus, compared to the lowest quartile. The RCS regression analysis indicated a negative linear association of OBS with hearing loss and tinnitus. Most associations were maintained in subgroup analysis and sensitivity analysis. Additionally, the dietary and lifestyle OBS independently contribute to the protection against hearing loss and tinnitus.

Conclusion

OBS is negatively correlated with the risk of hearing loss and tinnitus. The findings suggest that combined antioxidant diet and lifestyle hold promise as potential strategies for reducing the prevalence of hearing loss and tinnitus.

Association of oxidative balance score with chronic kidney disease: NHANES 1999-2018

Background

The Oxidative Balance Score (OBS), which quantifies the balance between antioxidants and pro-oxidants influenced by diet and lifestyle, is crucial given oxidative stress's significant role in Chronic Kidney Disease (CKD). This study aims to determine the association between OBS and CKD using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018.

Methods

We analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018. OBS was constructed from a detailed array of 20 factors, including dietary nutrients and lifestyle behaviors. The relationship between OBS and CKD risk was evaluated using weighted logistic regression models, adjusted for potential confounders, with a generalized additive model (GAM) examining non-linear associations. Subgroup analyses and interaction effects across diverse demographic and clinical groups, along with sensitivity analyses, were performed to validate the findings.

Results

Among 32,120 participants analyzed, 4,786 were identified with CKD. Fully adjusted weighted logistic regression analysis revealed that each unit increase in OBS was associated with a 2% reduction in CKD prevalence [OR: 0.98 (0.98-0.99), P < 0.001]. Higher OBS quartiles were significantly correlated with a decreased CKD risk [Q4 vs. Q1: OR: 0.82 (0.68-0.98), P = 0.03; P for trend = 0.01]. The GAM and smoothed curve fit indicated a linear relationship between OBS and the risk of CKD. Stratified and sensitivity analyses further substantiated the inverse relationship between OBS and CKD prevalence.

Conclusions

Our findings from the NHANES data affirm a significant inverse association between OBS and CKD risk in the U.S. population, underscoring the role of optimizing dietary and lifestyle factors in managing CKD risk. These results advocate for incorporating OBS considerations into CKD prevention and treatment strategies.

Maternal Oxidative Balance Score during Pregnancy and Congenital Heart Defects

The relationship between maternal oxidative balance score (OBS) in pregnancy, representing overall oxidative balance status by integrating dietary and lifestyle factors, and congenital heart defects (CHD) remains unclear; therefore, this study attempted to explore their associations among the Chinese population. We conducted a case-control study including 474 cases and 948 controls in Northwest China. Pregnant women were interviewed to report diets and lifestyles in pregnancy by structured questionnaires. Logistic regression models were used to estimate the adjusted ORs (95%CIs). Maternal OBS ranged from 6 to 34 among cases, and 5 to 37 among controls. Comparing the highest with the lowest tertile group, the adjusted OR for CHD was 0.31 (0.19-0.50). The CHD risk was reduced by 7% (OR = 0.93, 95%CI = 0.90-0.95) in association with per 1 higher score of OBS during pregnancy. The inverse relationship between maternal OBS and CHD risk appeared to be more pronounced among participants in urban areas (OR = 0.89, 95%CI = 0.86-0.93). Maternal OBS during pregnancy showed good predictive values for fetal CHD, with the areas under the receiver operating characteristic curve 0.78 (0.76-0.81). These findings highlighted the importance of reducing oxidative stress through antioxidant-rich diets and healthy lifestyles among pregnant women to prevent fetal CHD.

Association between oxidative balance score, systemic inflammatory response index, and cardiovascular disease risk: a cross-sectional analysis based on NHANES 2007-2018 data

Background

There is limited research on the relationship between Systemic Oxidative Stress (SOS) status and inflammatory indices. Adding onto existing literature, this study aimed to examine the association between dietary Oxidative Balance Score (OBS) and lifestyle OBS (which make up the overall OBS), and Cardiovascular Disease (CVD) prevalence at different Systemic Immune Inflammation Index (SII) and Systemic Inflammatory Response Index (SIRI) levels.

Methods

This study involved 9,451 subjects selected from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. The OBS comprised 20 dietary and lifestyle factors. Statistical methods included Weighted Linear Regression Analysis (WLRA), Logistic Regression Analysis (LRA), Sensitivity Analysis (SA), and Restricted Cubic Spline (RCS) analysis.

Results

The multivariate WLRA revealed that OBS was significantly negatively correlated with both SII (β = -5.36, p < 0.001) and SIRI (β = -0.013, p < 0.001) levels. In SA, removing any single OBS component had no significant effect on the WLRA results of SII and SIRI. Further subgroup analyses revealed that OBS was more impactful in lowering SII in women than in men. Additionally, OBS was more significantly negatively correlated with SII and SIRI in the low-age group than in the high-age group. Moreover, RCS analysis confirmed this linear relationship. Compared to dietary OBS, lifestyle OBS exerted a more significant effect on Coronary Artery Disease (CAD) (OR: 0.794, p = 0.002), hypertension (OR: 0.738, p < 0.001), Congestive Heart Failure (CHF) (OR: 0.736, p = 0.005), Myocardial Infarction (MI) (OR: 0.785, p = 0.002), and stroke (OR: 0.807, p = 0.029) prevalence. Furthermore, SIRI exhibited a significant interaction in the relationship between overall OBS, dietary OBS, and CHF (P for interaction < 0.001). On the other hand, SII had a significant interaction in the relationship between overall OBS, dietary OBS, and MI (P for interaction < 0.05).

Conclusion

OBS, including lifestyle and dietary OBS, were significantly negatively associated with SII and SIRI. Higher lifestyle OBS was associated with reduced risks of CAD, hypertension, CHF, MI, and stroke.

Analysis of the association between high antioxidant diet and lifestyle habits and diabetic retinopathy based on NHANES cross-sectional study

Oxidative stress plays a crucial role in increasing the risk of developing diabetic retinopathy (DR). The oxidative balance score (OBS) and the composite dietary antioxidant index (CDAI) are two tools for assessing the effects of diet and lifestyle on oxidative stress. The aim of this study was to investigate the association between OBS, CDAI and the occurrence of DR. After controlling for potential confounders, OBS was negatively associated with DR with an odds ratio (OR) of 0.976 and a 95% confidence interval (CI) of 0.956-0.996, suggesting that for every unit increase in OBS, the risk of DR was reduced by 2.4%. In contrast, the relationship between OBS and CDAI was not significant (P > 0.05), suggesting that it was OBS, not CDAI, that contributed to the reduced risk of diabetic retinopathy. After adjusting for potential confounders, OBS was negatively associated with DR (OR: 0.976; 95% CI 0.956-0.996), but this association was not found in CDAI (P > 0.05), suggesting that for every one-unit increase in OBS, there was a 2.4% reduction in the risk of developing DR. This study suggests that a diet and lifestyle high in OBS reduces the risk of developing DR, which provides a rationale for nutritional interventions to prevent DR.

The relationship between oxidative balance scores and chronic diarrhea and constipation: a population-based study

BACKGROUND

Oxidative stress is closely related to gut health. Exposures to oxidative stress in one's diet and lifestyle can be evaluated by the oxidative balance score (OBS). However, the relationship between OBS and intestinal habits is unknown. This study aimed to investigate the relationships between OBS and intestinal habits (chronic diarrhea and chronic constipation) and the underlying mechanisms involved.

METHODS

Using data from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2010, we included a total of 8065 participants. Twenty dietary and lifestyle factors were selected for the OBS calculates. Chronic constipation and chronic diarrhea were defined using the Bristol stool form scale (BSFS) types 1 and 2 and the BSFS 6 and 7, respectively. Multivariate logistic regression, subgroup analysis, and restricted cubic splines (RCS) analysis were used to evaluate the relationship between OBS and defecation habits. Finally, we used mediation analysis to explore the indirect effects of oxidative stress and inflammatory markers on these associations.

RESULTS

After adjusting for all the covariates, multivariate logistic regression analysis revealed that OBS was negatively correlated with diarrhea (OR = 0.57; 95%CI = 0.39-0.83; P = 0.008)and positively correlated with constipation (OR = 1.75; 95%CI = 1.19-2.25; P = 0.008). The RCS showed a nonlinear relationship between OBS and diarrhea (P for nonlinearity = 0.02) and a linear relationship between OBS and constipation (P for nonlinearity = 0.19). Mediation analysis showed that the C-reactive protein (CRP) concentration and white blood cell (WBC) count mediated the correlation between OBS and diarrhea by 6.28% and 6.53%, respectively (P < 0.05).

CONCLUSIONS

OBS is closely related to changes in patients' defecation habits. Oxidative stress and inflammation may play a role in the relationship between the two. This result emphasizes the importance of the public adjusting their lifestyle and dietary habits according to their own situation. However, further prospective studies are needed to analyze the relationship between oxidative stress and changes in defecation habits.

The association between oxidative balance score and frailty in adults across a wide age spectrum: NHANES 2007-2018

Background: Frailty has been one of the most serious global public health challenges we will ever face. Oxidative stress is associated with the pathogenesis of frailty, and may be accurately reflected by the oxidative balance score (OBS). However, there have been no studies examining the effect of OBS on frailty. Therefore, we aimed to explore the association between OBS and frailty and whether there was an interaction between the outcomes. Methods: 22 914 participants aged over 20 years taking part in the National Health and Nutrition Examination Survey (NHANES) in 2007-2018 were involved in the study. Sixteen dietary factors and four lifestyle factors were selected to score the OBS. A modified 36-item deficit cumulative frailty index (FI) was used to assess the degree of frailty. The association between OBS and frailty was analyzed using binary logistic regression. Subgroup analysis and interaction tests were used to investigate whether this association was stable across populations. Results: A negative association between OBS and the prevalence of frailty was found in this study. There was also an interaction between OBS and age in their association with frailty. High OBS was significantly and negatively associated with the prevalence of frailty in the 20-39 and 40-64 age groups. In addition, higher OBS combined with a population in the 20-39 age group resulted in a stronger negative association with frailty. Conclusion: High OBS was significantly associated with lower odds of frailty. An interaction existed between OBS and age. Individuals, especially in relatively young populations, are advised to increase OBS through greater intake of antioxidant nutrients and healthier lifestyles, thereby reducing the adverse effects of frailty.

Association Between Home Renovation and Sleeping Problems Among Children Aged 6-18 Years: A Nationwide Survey in China

BACKGROUND

Although the indoor environment has been proposed to be associated with childhood sleep health, to our knowledge no study has investigated the association between home renovation and childhood sleep problems.

METHODS

The study included 186,470 children aged 6-18 years from the National Chinese Children Health Study (2012-2018). We measured childhood sleeping problems via the Chinese version of the Sleep Disturbance Scale for Children (C-SDSC). Information on home renovation exposure within the recent 2 years was collected via parent report. We estimated associations between home renovation and various sleeping problems, defined using both continuous and categorized (binary) C-SDSC t-scores, using generalized mixed models. We fitted models with city as a random effect variable, and other covariates as fixed effects.

RESULTS

Out of the overall participants, 89,732 (48%) were exposed to recent home renovations. Compared to the unexposed group, children exposed to home renovations had higher odds of total sleep disorder (odd ratios [OR] = 1.3; 95% confidence interval [CI] = 1.2, 1.4). Associations varied when we considered different types of home renovation materials. Children exposed to multiple types of home renovation had higher odds of sleeping problems. We observed similar findings when considering continuous C-SDSC t-scores. Additionally, sex and age of children modified the associations of home renovation exposure with some of the sleeping problem subtypes.

CONCLUSIONS

We found that home renovation was associated with higher odds of having sleeping problems and that they varied when considering the type of renovation, cumulative exposure, sex, and age differences.

Association of the oxidative balance score with obesity and body composition among young and middle-aged adults

Objective

The oxidative balance score (OBS) is important for determining the cause of obesity and its complications. We aimed to evaluate the association between OBS and obesity and other segmental body composition parameters among young and middle-aged U.S. adults.

Methods

9,998 participants from the National Health and Nutrition Examination Survey 2011-2018 were included. Lean mass percentage (LM%) and FM% were evaluated by dual-energy x-ray absorptiometry. Obesity was defined as body FM% ≥25% in men and ≥ 35% in women. The OBS was scored by 5 pro-oxidant and 21 antioxidant factors. Associations of quartiles of OBS with obesity risk were estimated using multivariable logistic regression models. Multivariable linear regression was conducted to estimate the association between OBS and segmental body composition measures including the arm LM%, leg LM%, torso LM%, whole LM%, arm FM%, leg FM%, torso FM% and total FM%.

Results

Compared to participants in the lowest quartile of OBS, those in the highest quartile of OBS were associated with a lower risk of BMI-defined obesity BMI-defined obesity [0.43 (0.36, 0.50)] and FM%-related obesity [0.43 (0.35, 0.52)]. Additionally, OBS was negatively associated with FM% of the limb and torso but positively associated with the percentage of lean mass (LM%) of the limb and trunk.

Conclusion

OBS was negatively associated with the risk of obesity and segmental FM%, but was positively associated with segmental LM% among US adults, indicating that adhering to an anti-oxidative diet and lifestyle management may be beneficial for preventing segmental obesity.

Higher oxidative balance score is associated with lower kidney stone disease in US adults: a population-based cross-sectional study

PURPOSE

Oxidative balance stress (OBS) was an important indicator for assessing exposure to oxidative stress related to diet and lifestyle. The purpose of this study was to explore the relationship between OBS and kidney stone disease (KSD).

METHODS

Secondary dataset analysis was performed by the study from six survey cycles (2007-2018) in the National Health and Nutrition Examination Survey (NHANES). OBS was the exposure factor and ever had kidney stone (yes or no) was the outcome. Weighted univariate or multivariate logistic regression models were used to estimate the associations.

RESULTS

The prevalence of KSD among participants was 8.6%. OBS showed a significant negative correlation with KSD (OR: 0.98, 95% CI 0.96-0.999), 35% reduction in KSD in the highest OBS quartile compared to the lowest OBS quartile. Dietary OBS was significantly negatively correlated with KSD (OR: 0.98, 95% CI 0.96-0.9998), but not with lifestyle OBS. In addition, OBS had a negative correlation with KSD in females (OR: 0.97, 95% CI 0.94-0.996), non-diabetic participants (OR: 0.98, 95% CI 0.96-0.99), and hypertensive participants (OR: 0.96, 95% CI 0.93-0.99), but OBS was not observed to be associated with KSD in gout participants. Interestingly, this relationship existed in participants aged 30-60 years and a ratio of family income to poverty (PIR) of 1.3-3.5 (all P value < 0.05).

CONCLUSION

Our study revealed that OBS was negative associated with KSD, and high OBS might be a protective factor in KSD. Targeting one of the components of OBS might be beneficial.

Adherence to an antioxidant diet and lifestyle is associated with reduced risk of cardiovascular disease and mortality among adults with nonalcoholic fatty liver disease: evidence from NHANES 1999-2018

Background

Nonalcoholic fatty liver disease (NAFLD) stands a prevalent chronic liver condition significantly influenced by oxidative stress. We investigated the unclear relationship between antioxidant-rich diet and lifestyle and cardiovascular disease (CVD) prevalence rate and mortality in adult patients with NAFLD.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHAENS) spanning from 1999 to 2018 to investigate the association between adherence to an antioxidant-rich diet and lifestyle and the cardiovascular disease (CVD) prevalence rate and mortality in adult patients with NAFLD. The study employed the Oxidative Balance Score (OBS) to define antioxidant diet and lifestyle.

Results

Including 8,670 adult patients with NAFLD, the study revealed an inverse association between OBS and the prevalence of most CVD conditions. Fully adjusted models demonstrated that each unit increase in diet OBS, lifestyle OBS, and overall OBS corresponded to a 2, 7, and 2% reduction in all-cause mortality, respectively. In models 2, findings revealed that lifestyle Q2 and Q3 were linked to reduced cancer mortality, whereas diet and overall OBS did not exhibit an association. Additionally, Stratified analysis revealed that age (<45 years) and education level (> high school) significantly influenced the association between the OBS and the prevalence of CVD.

Conclusion

These results underscore the protective link between adherence to an antioxidant diet and lifestyle and a diminished prevalence of CVD and mortality in adults with NAFLD, particularly among younger and higher-educated populations.

Association between oxidative balance score and rheumatoid arthritis in female: a cross-sectional study

OBJECTIVE

Although oxidative stress is a recognized factor of inflammation, the correlation between oxidative balance score (OBS), a biomarker indicating the balance of oxidation and antioxidant, and rheumatoid arthritis (RA), an immune system disease that tends to occur in women, remains unexplored. Hence, the aim of this study was to investigate the potential association between OBS and RA in women.

METHODS

Observational surveys were performed by employing information extracted from the National Health and Nutrition Examination Survey (NHANES) for the period 2007-2018. Various statistical techniques were employed to investigate the association between OBS and RA, encompassing multivariable logistic regression analysis, subgroup analyses, smooth curve fitting, and threshold effect analysis.

RESULTS

The study included 8219 female participants, including 597 patients with RA. The results showed that higher Total OBS (TOBS) significantly correlated with lower RA prevalence in the entirely modified model [odd ratio (OR) = 0.968; 95% confidence interval (CI) = 0.952 to 0.984; P = 0.0001]. Dietary OBS (DOBS) and lifestyle OBS (LOBS) also negatively correlated with RA. This association was remarkably consistent across TOBS subgroups by age, race, education level, family poverty-to-income ratio (PIR), hypertension and diabetes. Smooth curve fitting and threshold effect analysis also revealed the linear relationship between OBS and RA.

CONCLUSIONS

Overall, OBS was negatively associated with RA in female. This study suggested that an antioxidant diet and lifestyle may be promising measures to prevent RA in female.

Association between the oxidative balance score and low muscle mass in middle-aged US adults

Background

Oxidative Balance Score (OBS) is a tool for assessing the oxidative stress-related exposures of diet and lifestyle. The study aimed to investigate the association between OBS and low muscle mass.

Methods

Overall, 6,307 individuals over the age of 18 were assessed using data from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression and models were used, together with adjusted models.

Results

There was a negative relationship between OBS and low muscle mass [odds ratio (OR): 0.96, 95% confidence interval (CI): 0.94-0.97, p< 0.0001] using the first OBS level as reference. The values (all 95% CI) were 0.745 (0.527-1.054) for the second level, 0.650 (0.456-0.927) for the third level, and 0.326 (0.206-0.514) for the fourth level (P for trend <0.0001). Independent links with low muscle mass were found for diet and lifestyle factors. A restricted cubic spline model indicated a non-linear association between OBS and low muscle mass risk (P for non-linearity<0.05). In addition, the inflection points of the nonlinear curves for the relationship between OBS and risk of low muscle mass were 20.

Conclusion

OBS and low muscle mass were found to be significantly negatively correlated. By modulating oxidative balance, a healthy lifestyle and antioxidant rich diet could be a preventive strategy for low muscle mass.