Dietary Total Antioxidant Capacity and Cardiovascular Disease Risk Factors: A Systematic Review of Observational Studies

Associations between the New DNA-Methylation-Based Telomere Length Estimator, the Mediterranean Diet and Genetics in a Spanish Population at High Cardiovascular Risk

Biological aging is a relevant risk factor for chronic diseases, and several indicators for measuring this factor have been proposed, with telomere length (TL) among the most studied. Oxidative stress may regulate telomere shortening, which is implicated in the increased risk. Using a novel estimator for TL, we examined whether adherence to the Mediterranean diet (MedDiet), a highly antioxidant-rich dietary pattern, is associated with longer TL. We determined TL using DNA methylation algorithms (DNAmTL) in 414 subjects at high cardiovascular risk from Spain. Adherence to the MedDiet was assessed by a validated score, and genetic variants in candidate genes and at the genome-wide level were analyzed. We observed several significant associations (p < 0.05) between DNAmTL and candidate genes (TERT, TERF2, RTEL1, and DCAF4), contributing to the validity of DNAmTL as a biomarker in this population. Higher adherence to the MedDiet was associated with lower odds of having a shorter TL in the whole sample (OR = 0.93; 95% CI: 0.85-0.99; p = 0.049 after fully multivariate adjustment). Nevertheless, this association was stronger in women than in men. Likewise, in women, we observed a direct association between adherence to the MedDiet score and DNAmTL as a continuous variable (beta = 0.015; SE: 0.005; p = 0.003), indicating that a one-point increase in adherence was related to an average increase of 0.015 ± 0.005 kb in TL. Upon examination of specific dietary items within the global score, we found that fruits, fish, "sofrito", and whole grains exhibited the strongest associations in women. The novel score combining these items was significantly associated in the whole population. In the genome-wide association study (GWAS), we identified ten polymorphisms at the suggestive level of significance (p < 1 × 10-5) for DNAmTL (intergenics, in the IQSEC1, NCAPG2, and ABI3BP genes) and detected some gene-MedDiet modulations on DNAmTL. As this is the first study analyzing the DNAmTL estimator, genetics, and modulation by the MedDiet, more studies are needed to confirm these findings.

Dietary total antioxidant capacity and head and neck cancer: a large case-control study in Iran

Background

Data on the association between head and neck cancer (HNC) and dietary factors are inconclusive. No study has so far investigated the association between dietary total antioxidant capacity (dTAC) and HNC concerning interactions with other risk factors.

Method

Pathologically confirmed new diagnosed HNC patients were included in this study. The control group was healthy hospital visitors who were frequently matched with patients on age (5 years interval), gender, and province of residence. Trained interviewers administered a validated Food Frequency Questionnaire (FFQ) to assess the participants' food intake 1 year before the cancer diagnosis. Data on TAC scores of foods was collected by Ferric Reducing Antioxidant Power (FRAP) and Total Radical-trapping Antioxidant Parameters (TRAP) from published data. We applied logistic regression adjusted for age, sex, energy intake, socioeconomic status, province, opium use, alcohol use, physical activity, and dental health. We also studied the interaction of dTAC with tobacco smoking status, and opium use on the risk of HNC.

Results

We recruited 876 HNC patients and 3,409 healthy controls. We observed a significant decrease in the odds of HNC with increasing dTAC scores. The OR of HNC for the third vs. the first tertile was 0.49 (95%CI 0.39-0.61) for FRAP and 0.49 (95%CI 0.39-0.62) for TRAP. Both dTAC scores were inversely associated with lip and oral (T3 ver. T1 OR = 0.51; 95%CI 0.36-0.71 for FRAP and OR = 0.59; 95% CI 0.44-0.82 for TRAP) and larynx (T3 ver. T1 OR = 0.43; 95%CI 0.31-0.61 for FRAP and OR = 0.38; 95% CI 0.26-0.55 for TRAP) cancers. There was no interaction between tobacco smoking, opium use; and TRAP or FRAP on the risk of HNC.

Conclusion

An antioxidant-rich diet in terms of FRAP or TRAP could decrease the risk of HNC and its subtypes.

Association between the Composite Dietary Antioxidant Index and Atherosclerotic Cardiovascular Disease in Postmenopausal Women: A Cross-Sectional Study of NHANES Data, 2013-2018

The relationship between composite dietary antioxidant index (CDAI) levels and the risk of atherosclerotic cardiovascular disease (ASCVD) in postmenopausal women is unknown. In total, 3109 women from the National Health and Nutrition Examination Survey 2013-2018 were included in this cross-sectional study. We evaluated the association between CDAI levels and the risk of ASCVD by using three logistic regression models and restricted cubic splines. A stratified analysis and sensitivity analysis were also conducted. The restricted cubic splines exhibited an L-shaped dose-response association between CDAI levels and the ASCVD risk. Logistic regression analysis found that CDAI levels were negatively associated with the occurrence of ASCVD. The ORs associated with a per-SD increase in CDAI were 0.67 (95% CI: 0.51-0.88) for ASCVD risk. Similarly, women in the group with high CDAI levels were less likely to have ASCVD (OR = 0.71, 95% CI: 0.50-0.98) compared to those in the group with low CDAI levels. When the CDAI levels were divided into quartiles, it was found that the ORs for ASCVD with CDAI levels in Q2 (-1.04-1.11), Q3 (1.11-3.72), and Q4 (3.72-43.87) were 0.63 (0.44, 0.90), 0.64 (0.42, 0.94), and 0.51 (0.27, 0.97), respectively, compared to those with CDAI levels in Q1 (-6.83--1.04). In addition, age, high-density lipoprotein cholesterol levels, and smoking behaviors acted as potential modifiers, and ORs were more significant in women aged 40-69 years, in individuals with low high-density lipoprotein cholesterol levels, and in smokers (p for interaction <0.05). These findings may offer valuable insights into the role of CDAI levels in the development of ASCVD among postmenopausal women.

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

Background

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death and disability both in U.S. and worldwide. Antioxidants have been proved critical in mitigating the development of atherosclerosis. This study aimed to investigate the associations between composite dietary antioxidant index (CDAI) and estimated 10-year ASCVD risk among U.S. adults.

Methods

Data extracted from the National Health and Nutrition Examination Survey were analyzed. A total of 10,984 adults aged 18 years and above were included in this study. CDAI was calculated based on the dietary intake reported in their 24-h recall interviews. The estimated 10-year ASCVD risk was calculated via Pooled Cohort Equations (PCE).

Results

After adjusting potential confounders, it was indicated that CDAI score was negatively correlated with 10-year ASCVD risk (OR 0.97, 95% CI 0.95-0.99). Stratify CDAI score by quartile, results showed that participants in the second, third, and fourth quartiles had lower ASCVD odds ratio (Q2: OR 0.87, 95% CI 0.69-1.09; Q3: OR 0.78, 95% CI 0.62-0.98; Q4: OR 0.74, 95% CI 0.59-0.94) than those in the first quartile (Q1, lowest CDAI score group), which was confirmed by the trend test as well (p < 0.05). Subgroup analyses stratified by sex, age, race/ethnicity, and smoking status did not show significant effect modification.

Conclusion

Higher dietary antioxidants intake is associated with lower ASCVD risk among U.S. adults, for which policymakers and healthcare professionals may consider increasing the consumption of antioxidant-rich foods as a preventive strategy for ASCVD.

The effect of continuous positive airway pressure on total antioxidant capacity in obstructive sleep apnea: a systematic review and meta-analysis

BACKGROUND

Obstructive sleep apnea (OSA), a sleep-related disorder with high prevalence, is associated with an imbalance in oxidative stress and is linked to cardiovascular disease. There are conflicting reports regarding the effectiveness of continuous positive airway pressure (CPAP) therapy on oxidative stress/antioxidant markers in patients with OSA. This review was performed to evaluate the influence of therapy with CPAP on serum/plasma total antioxidant capacity (TAC) in patients with OSA.

METHODS

The Cochrane Library, Web of Science, Scopus, Embase, and PubMed were searched through June 2022 to obtain studies evaluating CPAP treatment on TAC in patients with OSA. Overall results were tested using standardized mean difference (SMD) with a 95% confidence interval (CI). Comprehensive Meta-Analysis V2 software was employed to perform analyses.

RESULTS

Ten studies with 12 effect sizes were eligible for inclusion in this analysis. The overall SMD revealed that CPAP therapy significantly increased TAC [SMD 0.497; 95% CI: 0.21 to 0.77; p: 0.00] in OSA. Analyses based on subgroups showed that the effect of CPAP therapy was significant in all subgroups according to therapy duration, age, BMI, and AHI. Whereas the meta-regression results indicated that the impact of therapy with CPAP on TAC is associated with AHI, BMI, and age in patients with OSA.

CONCLUSIONS

The finding of this meta-analysis demonstrated a favorable impact of CPAP therapy on TAC levels in patients suffering from OSA.

Association between dietary antioxidant capacity and atherosclerotic carotid stenosis in patients with ischemic stroke

BACKGROUND AND PURPOSE

The aim of this study was to evaluate the relationship between dietary total antioxidant capacity (DTAC) and atherosclerotic carotid stenosis in patients with ischemic stroke.

METHODS

Patients with acute ischemic stroke were consecutively enrolled. Daily food consumption was estimated by a semi-quantitative food frequency questionnaire (FFQ). DTAC was calculated based on classified food intake. Antioxidant potential value was measured by ferric-reducing antioxidant power (FRAP) and oxygen radical absorbance capacity (ORAC) methods. Evaluation of carotid artery stenosis was based on computed tomography angiography (CTA). Logistic regression was used to assess the relationship between DTAC and degree of carotid stenosis.

RESULTS

Of the 608 enrolled, 232 patients (38.2%) had moderate or severe carotid stenosis. After adjusting for major confounding factors, FRAP (OR =0.640; 95% CI: 0.410-0.998; P =0.049) and ORAC (OR =0.625; 95% CI: 0.400-0.976; P =0.039) were associated with lower degree of carotid artery stenosis (third vs first tertile). Spearman analysis indicated that FRAP (r =-0.121, P =0.003) and ORAC (r =-0.147, P <0.001) were correlated with degree of carotid stenosis.

CONCLUSIONS

DTAC may influence the initiation and development of atherosclerosis, and, therefore, the risk of ischemic stroke.

Associations of cumulative average dietary total antioxidant capacity and intake of antioxidants with metabolic syndrome risk in Korean adults aged 40 years and older: a prospective cohort study (KoGES_CAVAS)

OBJECTIVES

Limited and inconsistent prospective evidence exists regarding the relationship of dietary total antioxidant capacity (dTAC) and antioxidant intake with metabolic syndrome (MetS) risk. We evaluated the associations of the cumulative averages of dTAC and antioxidant intake (in 5 classes: retinol, vitamin C, vitamin E, carotenoids, and flavonoids, as well as 7 flavonoid subclasses) with the risk of MetS.

METHODS

This study included 11,379 participants without MetS, drawn from the Korean Genome and Epidemiology Study_CArdioVascular disease Association Study (KoGES_CAVAS). The cumulative average consumption was calculated using repeated food frequency questionnaires. Incidence rate ratios were estimated using a modified Poisson regression model with a robust error estimator.

RESULTS

The median follow-up period was 5.16 years, and 2,416 cases of MetS were recorded over 58,750 person-years. In men, significant inverse associations were observed in all 5 antioxidant classes, except for the highest quartile of dTAC. In women, dTAC and total flavonoids were not significantly associated with MetS; however, significant L-shaped associations were found for the remaining 4 antioxidant classes. Of the 7 flavonoid subclasses, only flavones in the highest quartile for men and flavan-3-ols in women lacked significant associations with MetS. The inverse associations were not sex-specific, but they were particularly pronounced among participants with a body mass index (BMI) of 23 kg/m2 or higher.

CONCLUSIONS

The findings suggest that most antioxidant classes and flavonoid subclasses, unlike dTAC, exhibit a clear beneficial association with MetS in an L-shaped pattern in both men and women, particularly those with a high BMI.

The Total Dietary Antioxidant Capacity, Its Seasonal Variability, and Dietary Sources in Cardiovascular Patients

The favourable role of dietary antioxidants in cardiovascular diseases (CVDs) and protection from them is widely discussed, and total dietary antioxidant capacity (TAOX) is perceived as a diet-quality marker. Data concerning TAOX and its dietary sources related to seasonal variability are limited. We aimed to analyse the TAOXs, seasonal variability, and sources in the daily diets of CVD patients. A total of 143 subjects (82 men, 61 women) since CVD problems were studied. Seasonal recalls were collected regarding dietary sources of antioxidant compounds in spring, summer, autumn, and winter. A food frequency questionnaire was used. The total dietary antioxidant capacity (in μmolTE/day) was calculated for each season. The primary sources of antioxidants in cardiovascular patients' diets were drinks (33%), fruits (28%), vegetables (16%), and black tea (14%). The TAOXs of CVD patients' diets significantly depended on the season (p < 0.001) and were highest in the summer and lowest in the spring. This seasonal variation in consumption was noted. Our findings suggest that a diet characterised with a TAOX might be subjected to fluctuations between seasons. We suggest considering modifications in the dietary recommendations for cardiovascular patients with a low antioxidant capacity between seasons.

Dietary total antioxidant capacity is inversely associated with the odds of non-alcoholic fatty liver disease in people with type-2 diabetes

BACKGROUND

This study was conducted to evaluate possible associations between Dietary Total Antioxidant Capacity (DTAC) and odds of non-alcoholic fatty liver disease (NAFLD) in people with type-2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

We recruited two hundred people with T2DM, and evaluated their liver steatosis using Fibroscan. Dietary intakes of participants were assessed using a validated food frequency questionnaire. DTAC was computed via ferric reducing antioxidant power (FRAP).

RESULTS

In the crude model, no statistically significant association was found between DTAC and the odds of NAFLD in people with diabetes. However, after adjustment for potential confounders including age, gender, diabetes duration, smoking status, physical activity, BMI, waist circumference, and energy, the most reduced adjusted OR was indicated for the third tertile vs. the first one (OR: 0.28, 95% CI: 0.09-0.81, P = 0.02), meaning that diabetic patients in the third tertile of DTAC had 72% decreased risk of NAFLD in comparison to those in the first one. The relationship was remained significant after additional adjustment for HOMA-IR, HbA1c, serum Triglyceride (TG), and low-density lipoprotein-cholesterol (LDL) levels (OR: 0.29, 95% CI: 0.09-0.93, P = 0.03). Importantly, a dose-response pattern was demonstrated for DTAC and risk of NAFLD (P = 0.04).

CONCLUSION

Higher DTAC was related with a decreased risk of NAFLD in individuals with diabetes.

Evaluation of The Antioxidant Capacity of Food Products: Methods, Applications and Limitations

Assays of total antioxidant capacity (TAC) are popular in the analysis of food products. This review presents the most popular assays of TAC and their limitations, databases of TAC of food products, their application in clinical studies, and the effect of processing on the TAC of food. The importance of sample preparation for TAC assays and striking effects of digestion in the gastrointestinal tract on the TAC of food are discussed. Critical opinions on the validity of food TAC assays are considered. It is concluded that TAC methods can be useful as screening assays for food quality control and as low-cost, high-throughput tools used to discover potential antioxidant sources and follow changes in the content of antioxidants during food processing. However, effects revealed by TAC assays should be followed and explained using more specific methods.

Stretching Training Rehabilitation Has Potential to Alleviate Ankylosing Spondylitis in Mice by Inactivating the Wnt/β-Catenin Pathway

Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by invasion of the joints of the central axis that involves soft tissues and joints surrounding the spine. Stretching training rehabilitation (STR) has been widely applied for the treatment of AS. The Wnt/β-catenin signalling pathway is closely related to AS. In this study, we aimed to explore the potential molecular mechanisms underlying the protective effect of STR on AS both in vitro and in vivo. Male DBA/1 mice were employed to establish an AS animal model. Hematoxylin-eosin staining showed that STR reversed pathological damages in bone tissues and the total antioxidant capacity of AS mice and increased the antioxidant capacity by upregulating superoxide dismutase and malondialdehyde expression in DBA/1 mice. The MTT, RT-qPCR, and Western blotting results further indicated that STR improved the survival rate of cells by downregulating the expression of target genes in the Wnt/β-catenin pathway and by inhibiting cell inflammation and apoptosis. In conclusion, our findings indicated that STR treatment might be an effective therapeutical strategy for AS.

Association of the Composite dietary antioxidant index with all-cause and cardiovascular mortality: A prospective cohort study

Background

According to epidemiological and experimental data, high individual dietary antioxidant intake is correlated with reduced cancer risk. The correlations between combined dietary antioxidants and the risk of all-cause and cardiovascular mortality remain unclear. Consequently, this study focused on evaluating the correlation between the food-derived Composite Dietary Antioxidant Index (CDAI) and all-cause and cardiovascular mortality.

Materials and methods

Two years of data collected from participants aged ≥20 years were included in this prospective cohort study, which was obtained from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The US NHANES adopted a complicated, multistage probability sampling method to collect health data representing the US population. Data collection was done through in-person interviews, virtual physical examinations, and laboratory tests. Mortality-related follow-up statistics from the start of the survey to 31 December 2019 were available. The shape of the correlation between CDAI and all-cause and cardiovascular mortality was inspected using a restricted cubic spline model. For CDAI and all-cause and cardiovascular mortality, the univariate- and multivariate-adjusted Cox proportional hazard models were estimated and presented as regression coefficients and 95% confidence intervals.

Results

In total, 44,031 NHANES participants represented 339.4 million non-institutionalized residents of the US (age, 47.2 ± 16.9 years; 52.5% women, 70.2% non-Hispanic whites, 10.8% non-Hispanic black people, and 7.5% Mexican Americans). In the 118-month follow-up, 9,249 deaths were reported, including 2,406 deaths resulting from heart disease and 519 deaths due to cerebrovascular disease. In the restricted cubic spline regression models, a linear relationship between CDAI and all-cause mortality was present. The weighted multivariate hazard ratios for all-cause mortality were computed to be 0.97 (0.87–1.07) for Q2, 0.88 (0.81–0.96) for Q3, and 0.90 (0.80–1.00) for Q4 (P for trend = 0.009) upon comparison with the lowest quartile of CDAI, and an identical trend was observed for cardiovascular mortality.

Conclusion

A high CDAI was linked to decreased all-cause and cardiovascular mortality risk. The intake of an antioxidant-rich diet significantly prevents cardiovascular mortality. To shed more light on these outcomes, more itemized investigations such as randomized control trials are required.

Relationship between Dietary Total Antioxidant Capacity and the Prognosis of Amyotrophic Lateral Sclerosis

Antioxidant intake has been suggested to be associated with the prognosis of amyotrophic lateral sclerosis (ALS). This study aimed to investigate whether dietary total antioxidant capacity (DTAC) and that of major food groups are related to disease progression rate (ΔFS) and survival time in ALS patients. A total of 301 participants diagnosed with sporadic ALS according to the revised El Escorial criteria were recruited from March 2011 and followed up to the event occurrence, or the end of October 2021. Events included percutaneous endoscopic gastrostomy, tracheostomy, and death. DTAC was estimated using task automation and an algorithm based on 24 h dietary recall. ΔFS was negatively correlated with the vegetable and legume DTAC, and event-free survival was different among the tertiles of vegetables and legumes DTAC. Consistently, the risk of events was negatively associated with DTAC from vegetables and legumes. These results suggest that the intake of antioxidants, especially those derived from vegetables and legumes, has a beneficial effect on delaying disease progression and prolonging survival in patients with ALS. Further studies with large prospective cohorts and clinical trials are needed to determine whether the consumption of foods with high DTAC improves the prognosis of ALS.

The association between dietary inflammatory index, dietary antioxidant index, and mental health in adolescent girls: an analytical study

BACKGROUND

Diet is considered as one of the modifiable factors that appears to exert a vital role in psychological status. In this way, we designed this study to examine the association between dietary inflammatory index (DII), dietary antioxidant index (DAI), and mental health in female adolescents.

METHODS

This cross-sectional study included 364 female adolescents selected from high schools in the five regions of Tabriz, Iran. A 3-day food record was used to extract the dietary data and calculate DII/DAI scores. DII and DAI were estimated to assess the odds of depression, anxiety, and stress based on the Depression Anxiety Stress Scales-21. Adjusted relationships of the DII and DAI with depression, anxiety, and stress were determined using multiple regression after adjusting for age, energy intake, BMI, family income and mother and father education. Overweight was defined as body mass index (BMI)-for-age >  + 1 z-score relative to world health organization standards.

RESULTS

Depression, anxiety, and stress were observed in 21.4%, 26.6%, and 25.7% of subjects, respectively. The percentage of overweight among adolescents was 19.4%. The association between DII and score of mental health profile was positive among subjects in the third tertile of DII compared to subjects in the first tertile. However, this association was not statistically significant after adjusting for confounding variables. Moreover, there was a significant inverse association between DAI and depression and anxiety; and a statistically insignificant association between DAI and stress after adjusting for confounders.

CONCLUSIONS

Our results highlighted the importance of a healthy and anti-inflammatory diet on mental health in female adolescents. Therefore, modifying unhealthy dietary habits are likely to be effective in the management of psychosocial disorders.

Interaction between Apo A-II -265T > C polymorphism and dietary total antioxidant capacity on some oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus

This work aims to examine the interaction between apo A2 (Apo A-II) -265T > C SNP and dietary total antioxidant capacity (DTAC) on inflammation and oxidative stress in patients with type 2 diabetes mellitus. The present cross-sectional study included 180 patients (35-65 years) with identified Apo A-II genotype. Dietary intakes were assessed by a FFQ. DTAC was computed using the international databases. IL-18 (IL18), high-sensitivity C-reactive protein (hs-CRP), pentraxin (PTX3), serum total antioxidant capacity (TAC), superoxide dismutase (SOD) activity and 8-isoprostaneF2α (PGF2α) markers were obtained according to standard protocols. General linear model was used to evaluate the interaction. The interaction of gene and DTAC (P_FRAP = 0·039 and P_ORAC = 0·042) on PGF2α level was significant after adjusting for confounders. A significant interaction was observed on IL18 level (P_ORAC = 0·018 and P_FRAP = 0·048) and SOD (P_TEAC = 0·037) in obese patients. Among patients whose DTAC was higher than the median intake, the levels of hs-CRP and PGF2α were significantly higher only in individuals with CC genotype. Serum TAC (P_FRAP = 0·030, P_ORAC = 0·049) and SOD were significantly lower in the CC genotype. There was a favourable relationship between the high-DTAC and SOD (obese: P_TEAC = 0·034, non-obese: P_FRAP = 0·001, P_TRAP < 0·0001, P_TEAC = 0·003 and P_ORAC = 0·001) and PGF2α (non-obese: P_ORAC = 0·024) in T-allele carriers. The rs5082 SNP interacts with DTAC to influence several cardiometabolic risk factors. Also, we found dietary recommendations for antioxidant-rich foods intake might be useful in the prevention of diabetes complications in the T carrier more effectively than the CC genotype. Future large studies are required to confirm these results.

Serum levels of vitamin A, selenium and better dietary total antioxidant capacity are related to lower oxidative DNA damage: a cross-sectional study of individuals at cardiovascular risk

The risk for cardiovascular diseases (CVR) has been associated with oxidative DNA damage, but the genetic and environmental factors involved in the antioxidant and DNA repair system contributing to this damage are unknown. The aim was to evaluate the levels of oxidative DNA damage in CVR subjects and how it is related with some genetic and nutritional factors. The cross-sectional study evaluated 136 individuals of both sexes, aged 20-59 years, with at least one cardiovascular risk factor. The global risk score was used to classify individuals at low, intermediate and high cardiovascular risk. The dietary total antioxidant capacity (DTAC) was calculated using table with FRAP values. The oxidative DNA damage was verified by the comet assay. The variants null of Glutathione-S-transferases Mu1 and Theta 1(GSTM1 and GSTT1) and rs25487 of X-Ray Repair Cross Complementing Protein 1 (XRCC1) were analyzed by real-time PCR and PCR-RFLP, respectively. The oxidative DNA damage was higher in patients with intermediate/high CVR than in patients with low CVR (p=0.01). Individuals with GSTT1/GSTM1 null genotypes or arg/gln + gln/gln genotypes of the XRCC1 (rs25487) gene showed similar levels of oxidative DNA damage compared wild genotype. Multivariate regression analysis demonstrated that oxidative DNA damage in individuals with CVR depends on serum levels of vitamin A, selenium and DTAC independently of the other factors [F(6.110)=8.213; p<0.001; R2=0.330]. These findings suggest that nutritional factors such as DTAC, vitamin A and selenium may have a protective effect against oxidative DNA damage in these individuals.

Dietary total antioxidant capacity and its association with renal function and kidney stones: Results of a RaNCD cohort study

There is evidence to support the hypothesis that dietary antioxidants have shown protective effects against chronic kidney disease (CKD). The purpose of this study was to determine the association between the dietary total antioxidant capacity (DTAC), renal function, and development of CKD and kidney stones in Ravansar Non‐Communicable Diseases (RaNCD) cohort study, Kermanshah, Iran. This cross‐sectional study was conducted using the recruitment baseline data of the RaNCD cohort study on 9,777 individuals aged 35–65 years. Food frequency questionnaire (FFQ) was performed to assess diet. DTAC scores were calculated using the ferric reducing antioxidant power (FRAP) of selected foods. Renal function was assessed by the estimated glomerular filtration rate (eGFR), blood urea nitrogen, and serum creatinine concentration. Prevalent CKD was based on an eGFR less than <60 ml/min per 1.73 m². Incidence of kidney stones was also assessed by self‐reporting. Out of 9,777 participants, 1,747 subjects (eGFR: 18.50 ml/min per 1.73 m²; 95% confidence interval (CI): 17.72–19.30) had CKD. The mean DTAC score in this study was 0.24 ± 0.16 µmol TE/100 g (micromole of Trolox Equivalents). We showed a significant trend for eGFR across quartiles of DTAC, i.e., participants in the fourth quartile had a higher glomerular filtration rate (GFR) than those in the first one (DTAC _{Q4 vs Q1} = 82.20 versus 72.20 ml/min per 1.73 m², p < .001). Another finding is that high DTAC scores were not associated with having kidney stones after adjusting for confounders. We revealed that higher DTAC scores have positive effects on the renal function. Interestingly, our findings showed that a high DTAC score had nonsignificant correlation with odds of kidney stones.

The relationship of dietary total antioxidant capacity with sarcopenia and cardiometabolic biomarkers in type 2 diabetes patients

Background

The aim of this study was to investigate the relationship of dietary total antioxidant capacity (DTAC) with sarcopenia and metabolic biomarkers in people with type 2 diabetes in the Kurdish race.

Methods

In this cross‐sectional study, data of 189 type 2 diabetic patients (35–65 years old) from RaNCD cohort study were evaluated. DTAC, fasting blood sugar, lipid profile, body composition, muscle strength, and sarcopenia were assessed. t and χ² tests to compare the variables between sarcopenic and non‐sarcopenic patients and one‐way analysis of variance to compare the variables in DTAC tertiles were used. The relationship between DTAC and different variables was evaluated using multiple logistic regression model.

Results

The mean age and body mass index were 49.7 ± 8.7 years and 27.1 ± 3.9 kg/m². Body mass index, waist circumference, and hip circumference were significantly different between diabetic patients with and without sarcopenia (p < 0.05). In crude (p = 0.010) and adjusted (p = 0.035) models, there was a significant relationship between DTAC and fasting blood sugar. Also, the relationship between DTAC with waist (p = 0.019) and hip (β = −4.25, p = 0.026) circumference was significant. Sarcopenia was significantly lower in the third tertile in comparison with the first tertile of DTAC (p = 0.016). 

Conclusion

Diet with higher DTAC can be associated with lower fasting blood sugar, abdominal obesity and sarcopenia in type 2 diabetic patients. However, further studies are required to confirm these relationships.

Dietary total antioxidant capacity and mortality outcomes: the Singapore Chinese Health Study

PURPOSE

To evaluate the relations of dietary total antioxidant capacity (DTAC) with mortality outcomes in a Chinese population.

METHODS

The study included 62,063 participants from the Singapore Chinese Health Study. The participants were 45-74 years at baseline (1993-1998) when dietary data were collected with a validated 165-item food frequency questionnaire. The DTAC was derived using two widely adopted scores of integrated dietary consumption of antioxidant nutrients, i.e., the Comprehensive Dietary Antioxidant Index (CDAI) and Vitamin C Equivalent Antioxidant Capacity (VCEAC). We used Cox proportional hazard model to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations with adjustment for potential confounders.

RESULTS

During 1,212,318 person-years of follow-up, 23,397 deaths [cardiovascular diseases (CVD): 7523; respiratory diseases: 4696; and cancer: 7713] occurred. In multivariable models, the HR (95% CI) comparing participants in the highest vs. lowest quartile of CDAI was 0.85 (0.82, 0.88) for all-cause mortality, 0.82 (0.76, 0.88) for CVD mortality, 0.76 (0.70, 0.83) for respiratory disease mortality (all P-trend < 0.001), and 0.94 (0.88, 1.00) for cancer mortality (P-trend = 0.16). Similar associations were found with the VCEAC index. Higher intakes of the DTAC components, i.e., vitamin C, vitamin E, carotenoids, and flavonoids, were all associated with lower mortality risk.

CONCLUSION

Diet with a higher antioxidant capacity in midlife was associated with a lower risk of all-cause, cardiovascular and respiratory disease mortality in the Singapore Chinese population, supporting the public health recommendation of consuming more plant-based foods that are rich in antioxidant nutrients.

The Association of Dietary Total Antioxidant Capacity with Inflammatory Biomarkers and Anthropometric Indices in Patients Who Candidate for Coronary Artery Bypass Graft Surgery: a Cross-sectional Study

Antioxidant compounds can attenuate inflammation and delay degenerative processes especially in the cardiovascular system. This study aimed to determine the relationship between dietary total antioxidant capacity (DTAC) and serum biomarkers in patients undergoing coronary artery bypass graft surgery. In this cross-sectional study, 146 patients who had referred to Imam Ali Hospital in Kermanshah were recruited and demographic, anthropometric, physical activity and dietary data were collected. Fasting blood glucose (FBG), serum levels of lipid profile, inflammatory markers (interleukin [IL]-17, intercellular and vascular cell adhesion molecules [ICAM, VCAM]), and total antioxidant capacity (TAC) were also measured. A regression model adjusted for confounding variables presented that the coefficients of ICAM and VCAM (ng/dL) in the third tertile of DTAC were lower than those in the first tertile (β = -417.2, 95% confidence interval [CI] = -509.9 to -324.5, p < 0.001; β = -293.2, 95% CI = -334.3, -252.1, p < 0.001, respectively). The β of serum TAC (ng/dL) in the third tertile was 0.86 (95% CI = 0.77, 0.95, p < 0.001) higher than that in the first tertile. DTAC had no statistically significant relationship with lipid profile, FBG, and IL-17 levels, and anthropometric indices. In this study DTAC was associated with increased serum TAC and decreased cell adhesion molecules. Therefore, diet antioxidants may be beneficial in attenuating of inflammation in coronary artery diseases.

Associations between dietary intake of B vitamins and cardiovascular risk factors in elderly men: A cross-sectional study

OBJECTIVE

Low intake of B vitamins can lead to hyperhomocysteinaemia, which is reported as a risk factor for cardiovascular disease (CVD). However, little is known about this relationship. Therefore, we decided to examine the association between dietary intake of B vitamins and cardiovascular risk factors in elderly men.

METHODS

The present cross-sectional study consisted of 357 elderly men. Dietary intake was assessed using a validated and reliable food frequency questionnaire. All biochemical factors [fasting blood sugar (FBS), triglyceride (TG), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α)], waist circumference (WC) and blood pressure (BP) were assessed using standard methods.

RESULTS

A significant inverse association was observed between high dietary intake of total B vitamins (OR_{Total B vitamins} : 0.30; 95% CI: 0.10, 0.86; P = .01) and vitamin B9 (OR_{vitamin B9} : 0.20; 95% CI: 0.02, 0.52; P = .002) with high WC. Furthermore, an inverse association was observed between high dietary intake of vitamin B6 (OR_{vitamin B6} : 0.28; 95% CI: 0.08, 1.00; P = .05) and vitamin B9 (OR_{vitamin B9} : 0.20; 95% CI: 0.06, 0.70; P = .01) with hs-CRP level.

CONCLUSIONS

In elderly men, a high dietary intake of total B vitamins and vitamin B9 was associated with lower odds of having a high WC. Similarly, high dietary intake of vitamin B6 and B9 was associated with lower odds of having a high hs-CRP level.

Interaction between dietary total antioxidant capacity and BDNF Val66Met polymorphism on lipid profiles and atherogenic indices among diabetic patients

Brain-derived neurotrophic factor (BDNF) belongs to the "neurotrophin" family of growth factors, and it has recently been associated to cardiovascular disease (CVD). We anticipated that BDNF Val66Met polymorphisms may alter CVD risk markers such as serum lipid profile differences, and interaction with total antioxidant capacity of diet (DTAC) could alter these clinical parameters. This cross-sectional study consisted of 667 diabetic patients (39.7% male and 60.3% female). DTAC was calculated by international databases. Biochemical markers including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), superoxide dismutase (SOD), C-reactive protein (CRP), total antioxidant capacity (TAC), pentraxin-3 (PTX3), isoprostaneF2α (PGF2α). interleukin 18 (IL18), leptin and ghrelin were measured by standard protocol. Atherogenic indices (AIP, AC, CR-I, CR-II) were calculated. Genotyping of the BDNF Val66Met polymorphisms was conducted by the real-time PCR-RFLP method. The gene-diet interactions were evaluated using a generalized linear mode (GLMs). Carriers of the Val/Met genotype who were in the higher median intake of FRAP had lower HDL (P:0.04) and higher TG (P:0.005), AIP (P:0.02) and AC (P:0.02) index compared to Val/Val genotypes with lower median intake. Moreover, diabetic patients with Val/Met genotype who consumed higher ORAC intake had increased odds for anthropometric indices (BMI (P:0.01) and WC (P:0.03)), lipid profiles (TG) (P:0.01), and atherogenic index (AIP) (P:0.02), also decreased odds for HDL (P:0.03) concentration compared to reference group whit lower ORAC intake. Individuals with Val/Met genotype who consumed higher TRAP intake had increased odds for WC (P:0.04), TC (P:0.001), TG (P < 0.001), AIP (P < 0.001) and AC (P < 0.001). Finally, Val/Met patients with a higher median intake of TEAC had higher TG (P:0.02), AIP (P:0.009) and AC (P:0.03) compared to the reference group whit lower TEAC intake. Our study showed that Val/Met genotype had also the highest lipid profile and atherogenic indices even in the highest adherence to DTAC. While it seems that the presence of the Val/Val wild-type and BDNF Met/Met homozygotes in diabetic patients with a high DTAC is a protective factor.

Healthy Eating Index-2015 and Dietary Total Antioxidant Capacity as Predictors of Prediabetes: A Case-Control Study

BACKGROUND

The overall dietary quality, as well as the dietary total antioxidant capacity (DTAC), deserves central attention in the management of borderline high glucose levels since nonpharmacological strategies are imperative in this regard. Thus, we aimed to investigate the association between prediabetes with dietary quality and DTAC.

METHODS

A case-control study was conducted on 49 patients with prediabetes and 98 controls. Demographics, anthropometric measures, and fasting blood glucose levels of all participants were obtained. Participants completed a validated 80-item food frequency questionnaire (FFQ). DTAC scores were generated using FFQ data, and Healthy Eating Index-2015 (HEI-2015) was used as a diet quality index. The lowest tertile of HEI-2015 and DTAC was considered as the reference category, and logistic regression was used to estimate the relationship between prediabetes with HEI-215 and DTAC.

RESULTS

Mean age and body mass index of participants were 47.42 ± 15.98 years and 27.90 ± 4.96 kg/m2. Patients with prediabetes had lower DTAC scores when compared to controls (11.86 ± 5.77 and 17.81 ± 12.08, P = 0.01). There was a significant inverse association between the highest tertile of the DTAC score when compared with the lowest tertile in crude (OR = 0.11; 95% CI: 0.03-0.43), age-adjusted (OR = 0.13; 95% CI: 0.03-0.48), and fully adjusted (OR = 0.09; 95% CI: 0.02-0.53) models. In contrast, there was no difference between HEI-2015 in patients with prediabetes when compared to controls (74.41 ± 8.91 and 74.41 ± 9.35, respectively; P = 0.85). Correspondingly, no difference was observed between the highest tertile of the HEI-2015 score when compared with the lowest tertile in crude (OR = 1.23; 95% CI: 0.53-2.86), age-adjusted (OR = 1.17; 95% CI: 0.48-2.82), and fully adjusted (OR = 1.53; 95% CI: 0.56-4.16) models.

CONCLUSION

This study demonstrates a clear association between prediabetes with less DTAC, but not with HEI-2015.

The effect of dietary total antioxidant capacity (DTAC) and Caveolin-1 gene variant interaction on cardiovascular risk factors among overweight and obese women: A cross-sectional investigation

BACKGROUND

Previous studies have shown that the Caveolin-1 (CAV-1) gene variant may be associated with Cardiovascular disease (CVD) risk. Moreover, dietary total antioxidant capacity (DTAC) has been shown to potentially elicit favorable effects on CVD risk. Therefore, this study sought to investigate the effect of DTAC and CAV-1 interaction on CVD risk factors.

METHODS

This cross-sectional study consisted of 352 women, with overweight and/or obesity, aged 18-48years from Iran. A food frequency questionnaire (FFQ), with 147 items, was used to assess dietary intake. The CAV-1 rs 3807992 and anthropometric data were measured by the PCR-RFLP method and bioelectrical impedance analysis (BIA), respectively. Serum profiles were measured by standard protocols. Participants were also divided into two groups based on DTAC score and rs3807992 genotype.

RESULTS

The mean age of the participants was 37.34 ± 9.11 and 36.01 ± 9.12 years for homozygous (GG) and minor allele carriers (AG + AA) respectively.The mean ± SD of insulin, total cholesterol (TC),high-density lipoprotein (HDL), low-density lipoprotein (LDL) and TG of participants were 1.21 ± 0.23, 185.3 ± 35.77, 46.58 ± 10.86, 95.3 ± 24.12 and 118.1 ± 58.88, respectively. There was a significant difference between genotypes for physical activity (P = 0.05), HDL (P < 0.001), insulin (P = 0.04), CRI-I (TC/HDL-C) (P = 0.01), and CRI-II (LDL-C/HDL-C) (P = 0.04). Our findings also showed, after controlling for confounding factors, significant interactions between DTAC score and the A allele carrier group on TC (Pinteraction = 0.001), LDL (Pinteraction = 0.001), insulin (Pinteraction = 0.08), HOMA-IR (Pinteraction = 0.03), AC ((TC - HDL - C)/HDL - C) (Pinteraction = 0.001), and CHOLINDEX (LDL-C-HDL-C) (Pinteraction = 0.02).

CONCLUSION

The results of the present study indicate that high DTAC intake may modify the odds of risk factors for CVD in AA and AG genotypes of rs 3807992. These results highlight that diet, gene variants, and their interaction, should be considered in CVD risk assessment.

Habitual coffee and caffeinated beverages consumption is inversely associated with arterial stiffness and central and peripheral blood pressure

The effects of chronic coffee consumption on the cardiovascular system are still under debate. Aortic stiffness, wave reflections, and central and peripheral blood pressure (BP) are milestone indicators of cardiovascular-risk. We sought to investigate the association between coffee and caffeine consumption, arterial stiffness, and central/peripheral BP. Aortic stiffness was evaluated via pulse wave velocity (PWV); wave reflections with the augmentation index (AIx);peripheral systolic BP (SBP), diastolic BP (DBP), and central BP (cSBP/cDBP) were non-invasively assessed. Coffee and caffeine consumption was ascertained using a questionnaire. A linear inverse relationship between coffee and caffeine consumption and arterial stiffness and central and peripheral BP was found.Light coffee and caffeine consumers showed β-coefficients for PWV-0.15, SBP-3.61, DBP-2.48, cSBP-3.21, and cDBP-2.18 (all p values < 0.05).Present findings suggest that coffee and caffeine consumption is inversely associated with arterial stiffness and central and peripheral BP in a large population sample. Interventional prospective studies are needed to demonstrate the causal association.

Association of Dietary Total Antioxidant Capacity with Bone Mass and Osteoporosis Risk in Korean Women: Analysis of the Korea National Health and Nutrition Examination Survey 2008-2011

Antioxidant intake has been suggested to be associated with a reduced osteoporosis risk, but the effect of dietary total antioxidant capacity (TAC) on bone health and the risk of osteoporosis remains unclear. We aimed to assess the hypothesis that dietary TAC is positively associated with bone mass and negatively related to the risk of osteoporosis in Korean women. This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. Dietary TAC was estimated using task automation and an algorithm with 24-h recall data. In total, 8230 pre- and postmenopausal women were divided into four groups according to quartiles of dietary TAC. Dietary TAC was negatively associated with the risk of osteoporosis (odds ratio, 0.73; 95% confidence interval, 0.54-0.99; p-value = 0.045) in postmenopausal women, but not in premenopausal women. Dietary TAC was positively associated with bone mineral content (BMC) and bone mineral density of the femoral neck and lumbar spine in postmenopausal women and BMC of the total femur and lumbar spine in premenopausal women. Our study suggests that dietary TAC is inversely associated with the risk of osteoporosis in postmenopausal women and positively associated with bone mass in both pre- and postmenopausal women.

Anthropometric and Biochemical Measures in Bariatric Surgery Candidates: What Is the Role of Inflammatory Potential of Diet?

BACKGROUND

The present study aimed to assess dietary total antioxidant capacity (TAC), dietary phytochemical intake (PI), and dietary inflammatory index (DII) in patients with morbid obesity who are candidates of bariatric surgery and their association with anthropometric and biochemical parameters.

METHODS AND MATERIALS

One hundred seventy patients with morbid obesity who were referred to surgery clinic of Firoozgar Hospital were enrolled in the study. Ideal body weight and adjusted ideal body weight were calculated. The dietary data were collected using a food frequency questionnaire. Anthropometrics and biochemical parameters were assessed. A p-value of <0.05 was considered significant.

RESULTS

The strongest correlations of DII with dietary intakes and anthropometric and biochemical biomarkers were found for iron (p<0.0001). Significant association was also observed for ferritin (p=0.02) and transferrin (p=0.02). In terms of PI, The strongest associations were also found for iron (p<0.0001). Additionally, the value of body mass index (BMI) showed significant correlation with PI (p=0.04). The correlations of dietary total antioxidant indices with dietary intakes and anthropometric and biochemical biomarkers were assessed. Non-significant correlation was found between fasting blood sugar (FBS), hemoglobin A1C (HbA1C), vitamin B12, and vitamin D3 with ORAC index. Significant strong correlation showed for the value of iron in both ferric reducing ability of plasma (FRAP) and Oxygen Radical Absorbance Capacity (ORAC) indices (p<0.0001).

CONCLUSION

We find statistical significance correlation for dietary PI and BMI. The inflammatory and antioxidant properties of diet were not related to biochemical markers associated with obesity. Graphical abstract.

Dietary total antioxidant capacity is inversely associated with cardiovascular events and cardiometabolic risk factors: A cross-sectional study

OBJECTIVES

Dietary total antioxidant capacity (dTAC) has been introduced as a useful tool to quantify the antioxidant content of a diet. However, few studies have evaluated the association of dTAC with cardiovascular disease (CVD) occurrence and cardiometabolic risk factors in people with established CVD events. Thus, we aimed to investigate the presence of an association between dTAC values, cardiovascular events, and cardiometabolic risk factors in individuals with previous CVD in a Brazilian multicenter study.

METHODS

This study has a cross-sectional design. We evaluated baseline data from the Brazilian Cardioprotective Nutritional Program Trial. Sociodemographic, anthropometric, clinical, and food-consumption data were collected in face-to-face interviews. We estimated dTAC from the mean of two 24-h dietary recalls by values of ferric-reducing antioxidant power.

RESULTS

We evaluated 2346 participants, most of whom were men (58.4%), older adults (64.2%), and overweight (68.6%), and had coronary artery disease (92.4%). The mean dTAC was equal to 5.6 (interquartile range, 3.9-7.8) mmol/1000 kcal. Participants in the third dTAC tertile (9.2 mmol/1000 kcal) had a 22%, 59%, and 69% lower chance, respectively, of having hypertriglyceridemic waist phenotype, abdominal aortic aneurysm, and amputation due to arterial disease in comparison to the first tertile (3.4 mmol/1000 kcal).

CONCLUSIONS

The dTAC was inversely associated with hypertriglyceridemic waist phenotype, abdominal aortic aneurysm, and amputation due to arterial disease in individuals undergoing secondary care for CVD. Our results can guide strategies for the prevention of new CVD and its consequences.

Interaction between Apo A-II -265T>C polymorphism and dietary total antioxidant capacity on some anthropometric indices and serum lipid profile in patients with type 2 diabetes mellitus

The present study aimed to investigate the interaction of Apo A-II polymorphism and dietary total antioxidant capacity (DTAC) with lipid profile and anthropometric markers in patients with type 2 diabetes (T2DM) that are at risk for atherosclerosis. This cross-sectional study was conducted on 778 patients with T2DM (35–65 years). Dietary intakes were assessed by a 147-item food frequency questionnaire. DTAC was computed using international databases. Participants were categorised into two groups based on rs5082 genotypes. The gene–diet interaction was analysed by an ANCOVA multivariate interaction model. Total cholesterol, TC; triacylglycerol, TG; high- and low-density lipoprotein, HDL and LDL; TC–HDL ratio; waist circumference, WC and body mass index, BMI were obtained according to standard protocols. Overall, the frequency of CC homozygous was 12⋅1 % among study participants. We found that a significant interaction between rs5082 variants and DTAC on mean WC (P_TEAC = 0⋅044), TC concentration (P_FRAP = 0⋅049 and P_TEAC = 0⋅031) and TC/HDL (P_FRAP = 0⋅031 and P_TRAP = 0⋅040). Among patients whose DTAC was higher than the median intake, the mean of weight, WC and TC/HDL were significantly higher only in individuals with CC genotype. Also, the high DTAC was associated with a lower TC concentration only in T-allele carriers (P_FRAP = 0⋅042). We found that adherence to a diet with high total antioxidant capacity can improve the complications of diabetes and atherosclerosis in the T carrier genotype more effectively than the CC genotype. These results could indicate the anti-atherogenic properties of Apo A-II. However, further studies are needed to shed light on this issue.

Microbial biotransformation of Pericarpium Citri Reticulatae (PCR) by Aspergillus niger and effects on antioxidant activity

Pericarpium Citri Reticulatae (PCR), the mature fruit peel of Citrus reticulata Blanco and its different cultivars, is an important citrus by-product with beneficial health and nutritive properties. However, due to the lack of value-added methods for its development and utilization, a large amount of PCR is discarded or wasted. To explore a possibly more effective method to utilize PCR, we compared the chemical and biological differences before (CK) and after (CP) microbial transformation of PCR by Aspergillus niger. UPLC-ESI-MS/MS, HPLC, and LC-MS methods were used to compare the chemical profiles of CK and CP. The results demonstrated that microbial biotransformation by A. niger could transform flavonoid compounds by utilizing the carbohydrate and amino acid nutrients in PCR. This could also promote the accumulation of polyhydroxyflavones compounds in CP. The antioxidant assay demonstrated that CP had significantly greater free radical-scavenging activity than CK. The higher antioxidant activity of CP may result from the high level of flavonoids with associated phenolic hydroxyl groups. Microbial biotransformation is an effective method for improving the antioxidant capacity of PCR and may be effective and useful in other natural product situations.

Assessment of Peripheral Blood Mononuclear Cells Senescence and Endothelial Dysfunction among Adults with High Cardiovascular Risk

BACKGROUND

Cardiovascular diseases (CVD) are one of the leading causes of mortality and morbidity worldwide. Biological aging has been associated with the occurrence of adverse cardiovascular outcomes; however, the underlying mechanism of this process remains unknown.

OBJECTIVES

This study sought to evaluate if peripheral blood mononuclear cell (PBMC) senescence and endothelial biomarkers could influence cardiovascular (CV) risk and be suitable markers for the early detection of cardiovascular diseases in adults.

METHODS

In this cross-sectional study patients free of CVD were classified as lower (n=32) and higher Interheart Risk (IHR) scores (n=28). PBMC senescence was assessed by estimating the telomerase activity (TA) and detecting the presence of senescent cells and endothelial dysfunction by estimating the concentration of nitrite and nitrate and of total antioxidant capacity (TAC). Statistical analysis was performed with SPSS version 16.0 (SPSS Inc., Chicago, IL). All p-values <0.05 were considered statistically significant.

RESULTS

PBMC senescence 0.95 [p-value = 0.0001; 95% CI (0.874-1.026)] was a significant predictor of patients with higher IHR scores with a cut-off value of 21.65 with a sensitivity and specificity of 92% and 88% respectively. PBMC senescence, nitrite and nitrate and TA were found to be independently associated with high IHR scores.

CONCLUSION

PBMC senescence, TA and nitrite, and nitrate status are suitable measures to predict high cardiovascular risk in adults with CV risk. Nevertheless, long-term follow-up studies are needed to confirm these findings. (Arq Bras Cardiol. 2021; 116(1):37-47).

Dietary Total Antioxidant Capacity and Gestational Diabetes Mellitus: A Case-Control Study

Background

Elevated oxidative stress status has been reported among pregnant women with gestational diabetes mellitus (GDM). In diabetic condition, glucose and lipid peroxidation, and alteration in antioxidant defense lead to increased free radicals. The objective of this study was to investigate the association between dietary total antioxidant capacity (DTAC) and GDM.

Methods

This hospital-based case-control study was conducted in 463 pregnant women (healthy, n = 263; GDM, n = 200). Anthropometric indices, blood pressure, and biochemical analyses were measured. Dietary intake was assessed by the average of three 24-hour dietary intake records. DTAC was calculated by three indices: ferric reducing ability of plasma (FRAP), total radical-trapping antioxidant parameter (TRAP), and Trolox equivalent antioxidant capacity (TEAC). Multivariable logistic regression was performed to examine the relationship between DTAC and GDM risk in crude and adjusted models.

Results

The mean age and BMI were 28.33 ± 6.23 years and 29.67 ± 4.73 kg/m², respectively. Total energy, protein, and selenium intakes were significantly higher in cases than controls (P < 0.05). Moreover, intakes of carbohydrate, vitamins C, B6, and A, manganese, fruits, fruit juices, vegetables, legumes, and FRAP were significantly lower in cases than controls (P < 0.05). The risk of gestational diabetes mellitus was 85% lower among those in the highest tertile of FRAP (OR: 0.15; 95% CI: 0.08-0.29). There was no significant association between the risk of GDM and TRAP (OR: 1.62; 95% CI: 0.94-2.79) as well as TEAC (OR: 1.56; 95% CI: 0.89-2.72).

Conclusion

Pregnant women who were in the highest tertile of FRAP were at lower risk of GDM. However, larger prospective studies are needed to confirm our findings.

Association between Serum Uric Acid Levels, Nutritional and Antioxidant Status in Patients on Hemodialysis

Purpose: To determine the relationship between uric acid (UA) and nutritional and antioxidant status in hemodialysis (HD) patients, given that hyperuricemia could be an indicator of good nutritional status possibly because of the antioxidant properties of UA. Methods: Cross-sectional study with 93 patients on HD. Hyperuricemia was considered as UA ≥6.0 mg/dL in females and ≥7.0 mg/dL in males. Nutritional variables were registered. Blood samples were taken before the dialysis session to determine oxidative damage as plasma malondialdehyde (MDA) content, and antioxidant capacity measuring 2,2-diphenyl-piclrylhidrazil radical (DPPH^●) scavenging activity and oxygen radical absorbance capacity (ORAC) value. Results: Patients with hyperuricemia had higher creatinine (11.9 vs. 10.5 mg/dL; p = 0.004), potassium (5.5 vs. 5.0 mg/dL; p = 0.014) levels; phase angle (5.8 vs. 4.9; p = 0.005), protein consumption (normalized protein nitrogen appearance, nPNA, 1.03 vs. 0.83; p = 0.013) than normouricemic patients. DPPH^● scavenging activity was higher in hyperuricemic subjects (1.139 vs. 1.049 mM Trolox equivalents; p = 0.007); likewise, hyperuricemic subjects had less oxidant damage measured by MDA (10.6 vs. 12.7 nmol/mL; p = 0.020). Subjects with normouricemia were at higher risk of having a reactance to height (Xc/H) ratio less than 35 (OR 2.79; 95% CI, 1.1–7.017, p = 0.028); nPNA < 1.0 (OR 3.78; 95% CI, 1.4–10.2, p = 0.007), diagnosis of cachexia (OR 2.95; 95% CI, 1156–7.518, p = 0.021), potassium levels <5 (OR 2.97; 95% CI, 1.136–7.772, p = 0.023) and PA < 5.5° (OR 3.38; 95% CI, 1.309–8.749, p = 0.012.) Conclusions: Patients with hyperuricemia had higher antioxidant capacity and better nutritional status. Purines and protein restrictions in HD patients with hyperuricemia need to be reviewed individually for each patient. More studies are needed to stablish a cut point of UA levels in renal population.

Total Dietary Antioxidant Capacity and Longitudinal Trajectories of Body Composition

Although there is some evidence that total dietary antioxidant capacity (TDAC) is inversely associated with the presence of obesity, no longitudinal studies have been performed investigating the effect of TDAC on comprehensive measures of body composition over time. In this study, we included 4595 middle-aged and elderly participants from the Rotterdam Study, a population-based cohort. We estimated TDAC among these individuals by calculating a ferric reducing ability of plasma (FRAP) score based on data from food-frequency questionnaires. Body composition was assessed by means of dual X-ray absorptiometry at baseline and every subsequent 3–5 years. From these data, we calculated fat mass index (FMI), fat-free mass index (FFMI), android-to-gynoid fat ratio (AGR), body fat percentage (BF%) and body mass index (BMI). We also assessed hand grip strength at two time points and prevalence of sarcopenia at one time point in a subset of participants. Data were analyzed using linear mixed models or multinomial logistic regression models with multivariable adjustment. We found that higher FRAP score was associated with higher FFMI (0.091 kg/m² per standard deviation (SD) higher FRAP score, 95% CI 0.031; 0.150), lower AGR (−0.028, 95% CI −0.053; −0.003), higher BMI (0.115, 95% CI 0.020; 0.209) and lower BF% (−0.223, 95% CI −0.383; −0.064) across follow-up after multivariable adjustment. FRAP score was not associated with hand grip strength or sarcopenia. Additional adjustment for adherence to dietary guidelines and exclusion of individuals with comorbid disease at baseline did not change our results. In conclusion, dietary intake of antioxidants may positively affect the amount of lean mass and overall body composition among the middle-aged and elderly.

Dietary total antioxidant capacity during pregnancy and birth outcomes

PURPOSE

To investigate the effect of maternal dietary total antioxidant capacity (DTAC) and main food sources on the risk of preterm birth (PB) and offspring birth size.

METHODS

Cohort study that included 733 Brazilian mother-child pairs. Two 24 h dietary recalls were obtained during pregnancy and the usual intake was estimated through the Multiple Source Method. Data of the offspring were extracted from the national live births information system. Adjusted multivariable logistic regression models were used to investigate the relationship that energy-adjusted DTAC and food sources have with the outcomes.

RESULTS

In total, 9.7% of the children were PBs, 6.0% were born with low birth weight (LBW), 6.7% with macrosomia, 9.3% were small for gestational age (SGA) and 16.4% large for gestational age (LGA). The mean energy-adjusted DTAC ± SD was 4.7 ± 2.1 mmol. The adjusted OR (95%CI) of PB for each increasing tertile of maternal DTAC were 0.71 (0.41, 1.30) and 0.54 (0.29, 0.98), when compared with the lowest intake. For LBW, these were 0.25 (0.09, 0.65) and 0.63 (0.28, 1.41). A likelihood of lower odds for PB was found for a higher intake of fruits [0.66 (0.39, 1.09)]. Women with a higher consumption of milk were less likely to have a child with LBW [0.48 (0.23, 1.01)], and children whose mothers reported a higher intake of beans had lower odds of being born LGA [0.61 (0.39, 0.93)].

CONCLUSION

The data suggest that a higher intake of foods with antioxidant activity during pregnancy might reduce the chance of adverse birth outcomes.

Association between dietary total antioxidant capacity and breast cancer: a case-control study in a Middle Eastern country

OBJECTIVE

The aim of this study was to determine the relationship between dietary total antioxidant capacity (dTAC) and risk of breast cancer among Iranian women.

DESIGN

In this hospital-based case-control study, dietary intake of participants was collected using a 168-item validated FFQ. Dietary TAC was assessed using FRAP assay considering. Logistic regression was used to obtain ORs for breast cancer across quartiles of dTAC.

SETTING

Cancer Institute, Iran.

PARTICIPANTS

We included 412 women with pathologically confirmed breast cancer and 456 apparently healthy controls.

RESULTS

Mean dTAC was 11·3 ± 5·8 for cases and 12·1 ± 7·9 for controls. A trend towards significant inverse association was seen between dTAC and odds of breast cancer in the whole population; such that after controlling for several potential confounders, individuals in the highest quartile of dTAC were 0·39 times less likely to have breast cancer than those in the lowest quartile (0·61; 95 % CI: 0·38, 0·99, P < 0·05). In the stratified analysis by menopausal status, we found that postmenopausal women with the greatest dTAC had lower odds for breast cancer, compared with those with the lowest dTAC (0·47; 95 % CI: 0·24, 0·93, P < 0·05). This association strengthened after additional adjustment for BMI (0·28; 95 % CI: 0·11, 0·72, P < 0·05). No significant association was seen between dTAC and odds of breast cancer in premenopausal women.

CONCLUSIONS

We found that dietary TAC was inversely associated with risk of breast cancer, in particular among postmenopausal women. Prospective cohort studies are needed to confirm these findings.

Dietary total antioxidant capacity and its association with sleep, stress, anxiety, and depression score: A cross-sectional study among diabetic women

BACKGROUND

Diabetes as a common chronic disease leads to several serious disabilities and complications. Patients with type 2 diabetes are involved with psychological and sleep disorders which diet can be effective in the management of these problems. The present study aimed to investigate the association of Dietary Total Antioxidant Capacity (DTAC) and sleep, stress, anxiety, and depression among diabetic women.

METHODS

This cross-sectional study conducted on 265 women with type 2 diabetes. A validated food frequency questionnaire was filled to evaluate dietary intakes. We calculated DTAC based on amounts of antioxidant in each dietary item using the ferric reducing ability of plasma (FRAP) and oxygen radical absorbance capacity (ORAC) databases. Pittsburgh Sleep Quality Index was used to assess sleep quality. Moreover, 21 items Depression, Anxiety, and Stress Scale was used to assess mental disorders.

RESULTS

Subjects in the highest tertile of FRAP and ORAC score compared to those in the lowest tertile of these scores had 94% and 87% lower risk of poor sleep, respectively. The odds of depression were negatively related to the highest tertile of FRAP and ORAC score (OR: 0.21, 95%CI: 0.09-0.50 and OR: 0.21, 95%CI: 0.10-0.48, respectively). Participants with the highest tertile of FRAP compared to those within the lowest tertile of FRAP score had a 59% lower risk of anxiety. The odds of stress were negatively related to the highest tertile of FRAP and ORAC score (OR: 0.10, 95%CI: 0.04-0.23 and OR: 0.13, 95%CI: 0.06-0.29, respectively).

CONCLUSION

There is a significant association between DTAC, sleep status and psychological disorders. However, prospective studies in both genders should be conducted to confirm the actual relationship.

Effects of the Mediterranean diet on cardiovascular risk factors in non-alcoholic fatty liver disease patients: A systematic review and meta-analysis

BACKGROUND & AIMS

We aimed to investigate the effect of the Mediterranean diet (MedDiet) on cardiovascular risk factors in patients with non-alcoholic fatty liver disease (NAFLD).

METHOD

A systematic search was performed in Scopus, Web of Science, Cochrane library and PubMed databases to find randomized controlled trials (RCTs) related to the effect of the MedDiet in patients with NAFLD, up to July, 2019. There was no language and time limitation. Meta-analyses were performed using both the random and fixed effects model where appropriate, and I2 index was used to evaluate the heterogeneity.

RESULTS

Primary search yielded 467 publications. Five RCTs were eligible. Our meta-analysis indicated that the MedDiet resulted in a significant decrease in serum levels of triglyceride and total cholesterol, and a decrease in body weight and HOMA-IR in comparison to a control diet, in NAFLD patients. Whereas, there were no significant improvement in the MedDiet group compared with the control group regarding other variables such as liver enzymes and blood pressure.

CONCLUSIONS

This meta-analysis indicated the advantageous effects of the MedDiet on some cardiovascular risks factors, as compared with a control diet. It seems that the MedDiet can be considered as an appropriate strategy to reduce cardiovascular risk factors in NAFLD patients.

Rapeseed oil fortified with micronutrients improves cognitive alterations associated with metabolic syndrome

Metabolic syndrome represents a major risk factor for severe comorbidities such as cardiovascular diseases or diabetes. It is also associated with an increased prevalence of emotional and cognitive alterations that in turn aggravate the disease and related outcomes. Identifying therapeutic strategies able to improve those alterations is therefore a major socioeconomical and public health challenge. We previously reported that both hippocampal inflammatory processes and neuronal plasticity contribute to the development of emotional and cognitive alterations in db/db mice, an experimental model of metabolic syndrome that displays most of the classical features of the syndrome. In that context, nutritional interventions with known impact on those neurobiological processes appear as a promising alternative to limit the development of neurobiological comorbidities of metabolic syndrome. We therefore tested here whether n-3 polyunsaturated fatty acids (n-3 PUFAs) associated with a cocktail of antioxidants can protect against the development of behavioral alterations that accompany the metabolic syndrome. Thus, this study aimed: 1) to evaluate if a diet supplemented with the plant-derived n-3 PUFA α-linolenic acid (ALA) and antioxidants (provided by n-3 PUFAs-rich rapeseed oil fortified with a mix of naturally constituting antioxidant micronutrients, including coenzyme Q10, tocopherol, and the phenolic compound canolol) improved behavioral alterations in db/db mice, and 2) to decipher the biological mechanisms underlying this behavioral effect. Although the supplemented diet did not improve anxiety-like behavior and inflammatory abnormalities, it reversed hippocampus-dependent spatial memory deficits displayed by db/db mice in a water maze task. It concomitantly changed subunit composition of glutamatergic AMPA and NMDA receptors in the hippocampus that has been shown to modulate synaptic function related to spatial memory. These data suggest that changes in local neuronal plasticity may underlie cognitive improvements in db/db mice fed the supplemented diet. The current findings might therefore provide valuable data for introducing new nutritional strategies for the treatment of behavioral complications associated with MetS.

Association of dietary total antioxidant capacity to anthropometry in healthy women: A cross-sectional study

OBJECTIVES

Reactive oxygen species level is a fundamental component in the pathogenesis of obesity that might be reduced by dietary antioxidants. Measurement of dietary total antioxidant capacity (DTAC) is regarded as a new holistic dietary index. Given the limited research on DTAC, the aim of this study was to examine the association of DTAC with obesity-related features in women.

METHODS

The present cross-sectional study included 627 female participants. Data on dietary intake were assessed using a validated food frequency questionnaire. DTAC was estimated through total reactive antioxidant potential (TRAP), Trolox equivalent antioxidant capacity (TEAC), and ferric reducing ability of plasma (FRAP). Anthropometric parameters (body mass index and waist circumference), were investigated using standard methods.

RESULTS

After adjustment for possible covariates, both TRAP and TEAC were significantly positively associated with obesity (TRAP: OR, 1.65; 95% confidence interval [CI], 1.04-2.63; P_trend, 0.03; TEAC: OR, 1.63; 95% CI, 1.01-2.63; P_trend, 0.04). However, there was no association between FRAP and obesity (OR_, 1.11; 95% CI, 0.64-1.93; P_trend, 0.68). Moreover, no relationship was found between different DTAC indices and waist circumference (TRAP: OR, 1.13; 95% CI, 0.70-1.80; P_trend, 0.60; TEAC: OR, 1.04; 95% CI, 0.64-1.69; P_trend, 0.87; FRAP: OR, 0.86; 95% CI, 0.49-1.51; P_trend, 0.62).

CONCLUSION

Women with higher DTAC scores had higher risk for obesity. No association was found between DTAC and waist circumference.

Dietary total antioxidant capacity is inversely associated with depression, anxiety and some oxidative stress biomarkers in postmenopausal women: a cross-sectional study

BACKGROUND

Postmenopausal women are at higher risk of mental disorders. Oxidative stress has implication in the development of these disorders. Dietary total antioxidant capacity (DTAC) has been proposed as a tool for assessing dietary antioxidants intake. The relationship between DTAC with depression, anxiety and stress has not been investigated in postmenopausal women. Thus, we aimed to assess the association between DTAC and depression, stress and anxiety as well as oxidative stress biomarkers.

METHODS

This cross-sectional study was carried out on 175 postmenopausal women. Data on dietary intake and mental health were collected by 147-item semi-quantitative food frequency questionnaires (FFQ) and Depression Anxiety Stress Scales (DASS-42), respectively. Dietary and serum total antioxidant capacity (TAC), malondialdehyde (MDA), oxidized-LDL, and superoxide dismutase (SOD) were measured. ANOVA test was applied to compare the mean of variables across the tertiles of DTAC. The relationship between DTAC and oxidative stress biomarkers was determined through ANCOVA method. Simple and multivariate linear regression tests were performed to measure the relationship between DTAC and mental health.

RESULTS

Serum MDA level was significantly lower in the subjects at the highest tertiles of DTAC (P-value < 0.001). In addition, serum TAC level was significantly higher in subjects at the second tertile of DTAC (P-value = 0.04). DTAC was inversely and independently related to depression (β = - 0.16, P-value = 0.03) and anxiety scores (β = - 0.21, P-value = 0.007). There was no significant association between DTAC and stress score (β = - 0.10, P-value = 0.1).

CONCLUSION

An inverse relationship was found between DTAC with depression, anxiety scores and some oxidative stress biomarkers in postmenopausal women. These findings indicate DTAC may be used for developing effective dietary measures for reducing depression and anxiety in these women.