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

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.

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.

Association between oxidative balance score and abdominal aortic calcification among middle-aged and elderly population

BACKGROUND

The Oxidative Balance Score (OBS) was created to evaluate an individual's overall antioxidant status. The objective of this study was to examine the association between OBS and abdominal aortic calcification (AAC) among individuals aged ≥ 40 years.

METHODS

This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2013-2014 and included adults aged ≥ 40 years. Survey-weighted multivariable logistic and restricted cubic spline models were used to assess the association between OBS and AAC.

RESULTS

Among 2520 participants, 744 were diagnosed with AAC (weighted percentage, 28.13%). Survey-weighted multivariable logistic revealed an inverse association between OBS and AAC [0.98 (0.96, 1.00)], and the nonlinear dose-response relationship was observed. Subgroup analysis and interaction tests revealed that this inverse relationship was consistent across different populations (all P for interaction > 0.05).

CONCLUSIONS

OBS was inversely associated with the prevalence of AAC among individuals aged ≥ 40 years. Maintaining a higher OBS may be beneficial in reducing the burden of AAC.

Association between the oxidative balance score and all-cause and cardiovascular mortality in patients with diabetes and prediabetes

BACKGROUND

Few studies have examined the link between systemic oxidative stress and mortality risk in diabetes and prediabetes patients. The Oxidative Balance Score (OBS) is a novel measure of systemic oxidative stress, with higher scores indicating greater antioxidant exposure. This study investigates the relationship between OBS and all-cause and cardiovascular mortality in these patients.

METHODS

This study analyzed 10,591 diabetes and prediabetes patients from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). The endpoints were all-cause and cardiovascular mortality, determined from the National Death Index (NDI). OBS was calculated using 20 dietary and lifestyle factors. Kaplan-Meier survival analysis, multivariable Cox regression models, restricted cubic splines (RCS), and subgroup analyses were used to assess the relationship between OBS and mortality risks.

RESULTS

Over an average follow-up of 99.8 months, 2900 (26.4 %) participants died, including 765 (8.9 %) from cardiovascular diseases. Kaplan-Meier analysis showed the lowest all-cause and cardiovascular mortality in the highest OBS quartile (Q4) and the highest mortality in the lowest quartile (Q1) (p < 0.001). In the fully adjusted model, multivariable Cox regression revealed that each unit increase in OBS was linked to a 1.8 % decrease in all-cause mortality risk (HR 0.982, 95 % CI 0.976-0.987, p < 0.0001) and a 4 % decrease in cardiovascular mortality risk (HR 0.960, 95 % CI 0.949-0.970, p < 0.0001). Compared to Q1, those in Q4 had significantly lower all-cause mortality (HR 0.719, 95 % CI 0.643-0.804, p < 0.0001, p for trend <0.0001) and cardiovascular mortality (HR 0.567, 95 % CI 0.455-0.705, p < 0.0001, p for trend <0.0001). These findings were consistent across subgroups. RCS curves showed a negative correlation between OBS and both mortality types.

CONCLUSION

Higher OBS is linked to reduced all-cause and cardiovascular mortality in diabetes and prediabetes patients.

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 of the oxidative balance score and chronic kidney disease: insights from the national health and nutrition examination survey 2009-2018

Introduction

Oxidative stress plays a pivotal role in the pathogenesis of chronic kidney disease (CKD). The oxidative balance score (OBS) was devised to quantify the overall oxidative state, integrating pro-oxidant and antioxidant influences from both dietary intake and lifestyle practices. The aim of this study was to delve into the relationship between the OBS and CKD within the adult population of the United States.

Methods

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2009-2018, we derived the OBS from 16 dietary and four lifestyle factors. We employed weighted multivariate regression to probe the link between OBS and CKD. Additionally, we undertook subgroup analyses and applied Restricted Cubic Spline Regression (RCS) for further data analyses.

Results

This study encompassed 19,444 participants. Logistic regression analysis consistently demonstrated a protective effect of higher OBS on CKD. In Model 3, each unit increase in OBS was associated with a 2% reduction in the risk of CKD (95% CI: 0.97-0.99, p < 0.001) and a 4% reduction in the risk of reduced estimated glomerular filtration rate (eGFR) (95% CI: 0.95-0.98, p < 0.001). The highest OBS quintile (Q4) also showed significant reductions in the risk of CKD (OR: 0.66, 95% CI: 0.53-0.82, p < 0.001) and reduced eGFR (OR: 0.51, 95% CI: 0.37-0.69, p < 0.001) in Model 3. RCS analysis revealed a linear relationship between OBS and CKD. Subgroup analyses indicated significant associations between OBS and CKD in most subgroups, except for those without hypertension or with cardiovascular disease. Additionally, interaction analyses demonstrated that age, hypertension, and diabetes significantly modify the association between OBS and CKD risk.

Conclusion

An elevated OBS, reflecting a predominance of antioxidants, correlates with a diminished CKD risk in the American adult demographic. These insights emphasize the potential influence of oxidative equilibrium on the development of CKD.

Relationship between dietary oxidative balance score, anthropometric measurements and socioeconomic factors in women at low risk of cardiovascular disease

INTRODUCTION

The aim of this study was to investigate the relationship between the dietary oxidative balance score (OBS), an indicator of oxidative stress, anthropometric measures and socioeconomic factors in women at low risk of cardiovascular disease.

METHODS

The participants' 3-day dietary intake, demographic information, anthropometric measurements and blood pressure values were recorded, and the Framingham Risk Score (FRS) and OBS values were determined. Oxidative balance score consists of prooxidant and antioxidant scores. Prooxidant scores were calculated from red meat consumption, total iron and polyunsaturated fatty acid intake, alcohol and cigarette consumption parameters, while antioxidant scores were calculated by assessing cruciferous consumption, dietary total vitamin C, vitamin E, β-carotene, β-cryptoxanthin, β-carotene, β-cryptoxanthin, lycopene, lutein+zeaxanthin and selenium intake.

RESULTS

A total of 145 women were included in the study. Education level was associated with anthropometric measurements, income status with antioxidant and prooxidant scores, and exercise status with OBS (p<0.05). Weight, waist, hip, BMI, waist/hip, and waist/height ratio were significantly lower in subjects with low prooxidant score (p<0.05); there was no significant relationship between age, systolic, diastolic, FRS (p>0.05).

CONCLUSION

The study, conducted in healthy women, showed that dietary oxidative balance scoring is promising in preventing the development of CVD and reducing the burden of disease, and that prospective cohort studies should be conducted in this area.

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.

Association between oxidative balance score and female infertility from the national health and nutrition examination survey 2013-2018

Background

The correlation between oxidative stress and female infertility pathogenesis was established, and the oxidative balance score (OBS) can serve as a measure of overall oxidative stress burden within an individual. Prior reports have not addressed the relationship between OBS and female infertility. This study endeavors to investigate the association between infertility risk in female and OBS.

Methods

The analysis focused on data from the National Health and Nutrition Examination Survey 2013-2018. OBS was determined from 16 dietary components and 4 lifestyle components. Multivariate logistic regression was employed to investigate the relationship between OBS and female infertility. Further stratified analysis was conducted to examine the associations across various subgroups. To elucidate the dose-response relationship between infertility risk in female and OBS, a restricted cubic spline function was employed.

Results

The study included a total of 1410 participants. Through weighted multivariable logistic regression analysis, we observed a consistent inverse correlation between OBS and the risk of female infertility [OR (95% CI) = 0.97 (0.95, 0.99), p = 0.047]. When participants were segregated into quartiles based on OBS, those in the highest quartile had a 61% [OR (95% CI) = 0.39 (0.2, 0.79), p = 0.01] reduced risk of infertility compared to those in the lowest quartile of OBS. A trend test assessing OBS by quartile also revealed the relationship between OBS and female infertility. This correlation remained constant across both dietary and lifestyle OBS. Additionally, lifestyle OBS and female infertility exhibited a nonlinear association. A sensitivity analysis verified the consistency of our findings.

Conclusion

The study found that a higher OBS is associated with a lower prevalence of female infertility. These results emphasized the potential role of oxidative homeostasis in the pathogenesis of infertility and highlighted the importance of follow-up studies and prevention strategies.

Association between the oxidative balance score and kidney stones in adults

OBJECTIVES

This study was to investigate the correlation between oxidative balance score (OBS) and the prevalence of kidney stones in the general adult population.

MATERIALS AND METHODS

We conducted an analysis using data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES) project, including 17,988 participants. The OBS was computed based on previous research, combining 16 dietary factors and 4 lifestyle factors. Multiple logistic regressions and restricted cubic spline (RCS) regressions were utilized to explore the associations between OBS and kidney stone prevalence.

RESULTS

Our analysis included 1,622 adults with kidney stones and 16,366 adults without kidney stones. The average age of participants was 46.86 ± 0.27 years, with 50.72% being male. The median OBS was 22.00 (17.00, 27.00). After adjusting for all covariates, each one-unit increase in OBS was associated with a 3% decrease in kidney stone prevalence (odds ratio [OR] = 0.97 [0.96-0.98], P < 0.001). Moreover, compared to the first quartile, the fourth quartile of OBS (OR = 0.65 [0.50-0.84], P = 0.001) exhibited a negative association with kidney stone prevalence after adjusting for multiple variables. Furthermore, we observed a non-linear negative relationship between OBS and kidney stone prevalence, with inflection points at 18.2 (P for nonlinearity = 0.048). Stratified analysis did not identify any variables significantly affecting the results.

CONCLUSION

Our findings indicate that a higher OBS is associated with a decreased prevalence of kidney stones in the general adult population.

Assessing the role of antioxidant and pro-oxidant balance in mediating the relationship between vitamin K intake and depressive symptoms in adults

Background

Growing evidence suggests a link between vitamin K (VK) intake and depression, although the underlying mechanisms remain unclear. We aimed to investigate whether oxidative balance scores (OBS) mediate the association between VK intake and depression in participants from the National Health and Nutrition Examination Survey (NHANES) 2007-2018.

Methods

We analyzed data from 30,408 individuals. Dietary VK intake served as the independent variable, depression symptoms as the outcome variable, and OBS as the mediator. Multivariable logistic regression and restricted cubic splines assessed the associations. Mediation analysis was conducted to evaluate the potential mediating role of OBS.

Results

Higher dietary VK intake was associated with lower depression risk in the multivariate model. Compared to the lowest log2 VK quartile, those in the higher quartiles had significantly lower depression odds (Q3: OR 0.66, 95% CI 0.55-0.78; Q4: OR 0.64, 95% CI 0.52-0.78). Additionally, a 1-unit increase in log2 VK intake was associated with a 15% decrease in depression odds (OR 0.85, 95% CI 0.81-0.90). Restricted cubic splines revealed a non-linear relationship between log2 VK and depression (p for non-linearity <0.001). Notably, OBS mediated 26.09% (p < 0.001) of the association between log2 VK and depression.

Conclusion

Higher VK intake is associated with reduced depression risk, potentially mediated by oxidative balance. Further research is warranted to confirm causality and elucidate the underlying mechanisms.

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.

Associations between oxidative balance score and chronic kidney disease events in US adults: a population-based study

Oxidative Balance Scores (OBS) are utilized to assess an individual's antioxidant status, encompassing both dietary and lifestyle factors that contribute to oxidative balance. This study investigates the relationship between OBS and chronic kidney disease (CKD) prevalence among U.S. adults, utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. The study involved a cross-sectional analysis of 13,373 individuals from NHANES, focusing on adults aged 20 years or older. OBS was calculated using 20 components, including dietary and lifestyle factors. CKD was identified based on albumin-to-creatinine ratio and estimated glomerular filtration rate, with patients stratified into mild, moderate, and high-risk groups. Statistical analysis included logistic regression models and restricted cubic splines to explore the OBS-CKD relationship. Our findings indicate a statistically significant negative correlation between OBS and CKD prevalence, particularly in mild and moderate-risk groups. Higher OBS quartiles were associated with a decreased likelihood of CKD (OR 0.70; 95% CI 0.53-0.92; P = 0.013). Restricted cubic splines indicated a non-linear, inverse association between OBS and CKD odds for the overall population (P for nonlinearity = 0.017). For mild and moderate CKD risk groups, the relationships were less pronounced (P for nonlinearity = 0.053 and 0.184, respectively), suggesting variability in the OBS-CKD link across different risk levels. The study highlights the potential of elevated OBS as a primary prevention measure for CKD, particularly in individuals with mild to moderate risk. These findings underscore the importance of antioxidant status in CKD risk management and encourage further research into the role of dietary and lifestyle factors in CKD prevention.

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.

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.

Association of the oxidative balance score with sarcopenia among young and middle-aged adults: findings from NHANES 2011-2018

Background

Sarcopenia is associated with oxidative stress. The Oxidative Balance Score (OBS) is commonly used to assess dietary and lifestyle exposure to oxidative stress. However, few studies in the literature have assessed the correlation between sarcopenia and OBS.

Aim

This study aimed to assess the association between OBS and sarcopenia among young and middle-aged adults in the United States using data from the National Health and Nutrition Examination Survey (NHANES).

Method

Weighted logistic regression analysis was used to investigate the association between OBS and sarcopenia based on data from NHANES 2011-2018. Subgroup analyses were performed to observe the consistency of the outcomes, and the stability of the results was tested using sensitivity analyses.

Result

The final sample included 5,525 young and middle-aged American adults. A higher OBS was associated with a lower risk of sarcopenia. In the fully adjusted model, the second (odds ratio [OR]: 0.62, 95% confidence interval [CI]: 0.41, 0.94; p = 0.023), third (OR: 0.50; 95% CI: 0.34, 0.74; p < 0.001), and highest quartiles (OR: 0.18; 95% CI: 0.11, 0.28; p < 0.001) of the OBS were associated with higher risks of sarcopenia when compared to the lowest quartile. This association was consistent across both dietary and lifestyle OBS scores. Our subgroup analysis revealed no significant differences between the subgroups of variables included in the interaction analysis. Sensitivity analyses revealed similar results.

Conclusion

Our study showed that higher antioxidant and lower antioxidant exposure may decrease the risk of developing sarcopenia. Higher OBS scores may indicate greater protection against sarcopenia; however, further clinical studies are warranted to confirm these findings.

The cross-sectional correlation between the oxidative balance score and cardiometabolic risk factors and its potential correlation with longitudinal mortality in patients with cardiometabolic risk factors

BACKGROUND

This study analyzes the correlation between oxidative balance score (OBS), cardiometabolic risk factors (CMRFs), and mortality in individuals with CMRFs.

METHODS

Data were chosen from the National Health and Nutrition Examination Survey. The survey-weighted multivariable logistic regression models were implemented to explore the relationship between OBS and the risk of CMRFs. Then, Cox proportional hazard models were employed to estimate the impact of OBS on mortality in individuals with CMRFs.

RESULTS

Following multivariate adjustment, the subjects in the highest quartile exhibited a 46% reduction in the risk of CMRFs, a 33% reduction in the risk of diabetes, a 31% reduction in the risk of hypertension, and a 36% reduction in the risk of hyperlipidemia, compared with those in the lowest quartile. Furthermore, each 1-unit increase in OBS was remarkably negatively correlated with the prevalence of CMRFs, diabetes, hypertension, and hyperlipidemia. The correlation between OBS and CMFRs was found to be mediated by serum γ-glutamyltransferase (GGT) and white blood cells (WBC), and the mediation effect of GGT levels and WBC, accounting for 6.90% and 11.51%, respectively. Lastly, the multivariate Cox regression model revealed that elevated OBS, irrespective of whether it was treated as a categorical or continuous variable, exhibited a significant association with decreased mortality from all causes, cardiovascular disease, and cancer.

CONCLUSIONS

An increased OBS might reflect a lower risk of CMRFs and a favorable prognosis for individuals with CMRFs. Moreover, WBC and GGT may play a potential mediating role between OBS and CMRFs.

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.

Association between oxidative balance score and hearing loss: a cross-sectional study from the NHANES database

Aim

The oxidative balance score (OBS), a composite score of dietary nutrients and lifestyles, reflects an individual's oxidative and antioxidant status. Evidence showed that oxidative stress levels were related to hearing loss. The relationship between OBS and hearing loss remains unclear. This study was to explore the association between OBS and hearing loss in adults.

Methods

In this cross-sectional study, data of participants aged 20-69 years who received hearing tests were extracted from the National Health and Nutrition Examination Survey (NHANES) database (2011-2012, 2015-2016). Hearing loss was defined as hearing threshold >25 dB in either ear. The OBS was composed of 16 dietary nutrients and 4 lifestyles. The covariates were screened using the backward stepwise regression analysis. The association of OBS and hearing loss was assessed with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroups of age, gender, occupational noise exposure, recreational noise exposure, firearm noise exposure, and veteran status were further evaluated the associations. The importance ranking of OBS components was analyzed by the weighted random forest model.

Results

Of the total 3,557 adults, 338 (9.5%) suffered from hearing loss. High OBS levels were associated with lower odds of hearing loss (OR = 0.58, 95%CI: 0.41-0.82), after adjusting age, gender, race, hypertension, tinnitus, recreational noise exposure, and occupational noise exposure. Similar results were discovered in individuals aged50-59 years old (OR = 0.47, 95%CI: 0.24-0.93), aged 60-69 years old (OR = 0.31, 95%CI: 0.16-0.61), with female (OR = 0.44, 95%CI: 0.20-0.96), without occupational noise exposure (OR = 0.31, 95%CI: 0.16-0.62), recreational noise exposure (OR = 0.48, 95%CI: 0.30-0.76), firearm noise exposure (OR = 0.38, 95%CI: 0.19-0.77), and veteran status (OR = 0.57, 95%CI: 0.39-0.82). In OBS components, vitamin B12, total fat and physical activity were important for hearing loss.

Conclusion

Elevated OBS may be associated with hearing health in adults. Appropriate vitamin B12 supplementation, reduction of total fat intake, and increased physical activity may be beneficial to the prevention of hearing loss.

Nonlinear relationship between oxidative balance score and hyperuricemia: analyses of NHANES 2007-2018

BACKGROUND

Limited data regarding the correlation between oxidative balance score (OBS) and hyperuricemia highlights the necessity for thorough investigations. This study aims to examine the link between OBS, which incorporates dietary and lifestyle factors, and the occurrence of hyperuricemia.

METHODS

We conducted a cross-sectional study involving 13,636 participants from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). The oxidative balance score (OBS) was determined based on four lifestyle factors and sixteen dietary nutrients. We assessed the levels of serum uric acid (SUA) and the occurrence of hyperuricemia as outcomes. Weighted logistic regression and linear models were used for statistical analysis, using Restricted Cubic Splines (RCS) to examine potential nonlinear associations. Subgroup analysis and sensitivity assessments were performed to identify any variations and ensure the robustness of the findings.

RESULTS

Higher OBS was consistently correlated with decreased SUA levels and a reduced prevalence of hyperuricemia. RCS highlighted a significant negative nonlinear association, particularly in females. Subgroup analysis revealed gender-based differences and interactive correlation, providing additional insights regarding OBS and hyperuricemia relationship.

CONCLUSION

This study underscores a robust negative correlation between OBS and SUA levels as well as the incidence of hyperuricemia, emphasizing the importance of dietary and lifestyle factors. Incorporating RCS, subgroup analysis, and sensitivity assessments enhances the depth of our findings, providing valuable insights for further research.

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.

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 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.

Association between oxidative balance score and self-reported severe headache or migraine based on NHANES 1999 to 2004 data: A cross-sectional study

Purpose

The pathophysiological mechanisms underlying migraine remain elusive, with oxidative stress hypothesized as a potential etiological factor. The Oxidative Balance Score (OBS) is a comprehensive tool for assessing the impact of diet and lifestyle on oxidative stress, thereby gauging an individual's overall antioxidant capacity. In this cross-sectional study, we explored the correlation between OBS and migraine prevalence among a cohort of US adults.

Methods

We analyzed data from 6195 participants aged 20 years and above, drawn from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2004. We employed multiple logistic regression, coupled with sensitivity analyses, to investigate the relationship between OBS and migraine. Subsequent subgroup analyses and interaction tests were performed to assess the consistency of this association across the population.

Results

Multiple logistic regression revealed an inverse relationship between OBS and the likelihood of experiencing migraines. Specifically, individuals in the highest OBS quartile exhibited a significantly reduced migraine risk compared to those in the lowest quartile (OR = 0.98, 95% Confidence Interval (CI): 0.97-0.99, P = 0.0001). Furthermore, restricted cubic spline curves indicated a non-linear association between dietary OBS and migraine incidence (non-linear P = 0.0258).

Discussion

Our findings suggest that adherence to an antioxidant-rich diet may be an effective strategy for mitigating migraine, potentially by influencing oxidative balance.

Association between oxidative balance score and prostate specific antigen among older US adults

Objective

Oxidative Balance Score (OBS) is an index affecting the oxidative stress of dietary and lifestyle factors. We aimed to explore the association of OBS with prostate specific antigen (PSA) among older males.

Methods

A total of 5,136 samples were collected in this study to investigate the relationship between OBS and PSA from the National Health and Nutrition Examination Survey. Logistic regression models and restricted cubic spline were used to assess the associations between OBS and PSA.

Results

Compared with the Q1 group, the odds ratios for the association between OBS and PSA were 1.005 (1.003, 1.009), 1.003 (1.001, 1.006), and 1.001 (0.978, 1.022) for Q2, Q3, and Q4, respectively. In the age-specific analyses, the association was significant among individuals aged 65 years old and over: the odds ratios for the association between OBS and PSA were 1.019 (1.005, 1.028), 1.028 (1.018, 1.039), and 1.038 (1.022, 1.049) for Q2, Q3, and Q4, respectively. But it was not significant among individuals aged less than 65 years old: the odds ratios for the association between OBS and PSA were 1.016 (0.995, 1.026), 1.015 (0.985, 1.022), and 0.988 (0.978, 1.016) for Q2, Q3, and Q4, respectively. The restricted cubic splines also indicated a nonlinear relationship between OBS and PSA among individuals aged 65 years old and over (Poverall = 0.006, Pnonlinear = 0.021).

Conclusion

Our findings provide evidence that OBS is positively associated with higher levels of PSA among older adults. Further large-scale prospective cohort studies are needed to verify our findings.

Association between dietary and behavioral-based oxidative balance score and phenotypic age acceleration: a cross-sectional study of Americans

OBJECTIVES

In light of the rise in the global aging population, this study investigated the potential of the oxidative balance score (OBS) as an indicator of phenotypic age acceleration (PhenoAgeAccel) to better understand and potentially slow down aging.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey collected between 2001 and 2010, including 13,142 United States adults (48.7% female and 51.2% male) aged 20 and above, OBS and PhenoAgeAccel were calculated. Weighted generalized linear regression models were employed to explore the associations between OBS and PhenoAgeAccel, including a sex-specific analysis.

RESULTS

The OBS demonstrated significant variability across various demographic and health-related factors. There was a clear negative correlation observed between the higher OBS quartiles and PhenoAgeAccel, which presented sex-specific.

RESULTS

the negative association between OBS and PhenoAgeAccel was more pronounced in male than in female. An analysis using restricted cubic splines revealed no significant non-linear relationships. Interaction effects were noted solely in the context of sex and hyperlipidemia.

CONCLUSIONS

A higher OBS was significantly associated with a slower aging process, as measured by lower PhenoAgeAccel. These findings underscore the importance of OBS as a biomarker in the study of aging and point to sex and hyperlipidemia as variables that may affect this association. Additional research is required to confirm these results and to investigate the biological underpinnings of this relationship.

Association between Oxidative Balance Score and Severe Headache or Migraine among American Adults A Cross-Section Study

BACKGROUND

Migraine is implicated in oxidative stress. The oxidative balance score (OBS) assesses the combined impact of diet and lifestyle on oxidative and antioxidant balance in diseases. However, the association between OBS and migraine remains underexplored.

OBJECTIVE

We aimed to examine the relationship between OBS and severe headaches or migraines among American adults.

METHODS

This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004, defining severe headaches or migraine via self-reports and calculating OBS from 16 diaries and 4 lifestyle factors. Multivariable weighted logistic regression models were used to explore the OBS-migraine relationship, with stratified analysis for result validation.

RESULTS

The study included 6,653 participants (average age 45.6, 52.1% male), and 19.1% reported severe headaches or migraines. There was a significant inverse association between OBS and severe headache or migraine, with an adjusted odds ratio (OR) of 0.97 (95% [confidence interval] CI: 0.96, 0.98, p < 0.001). The highest OBS tertile had an adjusted OR of 0.58 (95% CI: 0.47, 0.73) compared to the lowest. This pattern was consistent across sexes, with an adjusted OR of 0.98 (0.95, 1.00) in males and 0.97 (0.95, 1.00) in females. The adjusted OR for migraine was 0.61 (0.44, 0.87) and 0.54 (0.37, 0.79) in the highest tertile for males and females, respectively.

CONCLUSION

The study highlights a significant association between OBS and severe headaches or migraines, suggesting the potential role of oxidative stress in these conditions. The findings emphasize the importance of a balanced, antioxidant-rich diet and lifestyle in managing severe headaches or migraine.

Interaction between the oxidative balance score and serum per- and poly-fluoroalkyl substances (PFASs) on liver health: analysis of the NHANES 2007-2018 dataset

BACKGROUND

Per- and poly-fluoroalkyl substances (PFASs) are pervasive synthetic compounds, prompting investigations into their intricate interactions with lifestyle factors and health indicators because of their enduring environmental presence and bioaccumulation. This study aimed to explore the effects of the oxidative balance score (OBS) and PFAS on liver-related indices.

METHODS

Twenty dietary and lifestyle factors were used to calculate the OBS. The serum concentrations of PFASs were measured, and their sum was calculated for analysis. The levels of liver markers were also evaluated. Linear regression models and interaction analyses were used to assess the associations between OBS, PFAS concentrations, and liver indices.

RESULTS

The results revealed an inverse association between high OBS and perfluorooctane sulfonic acid concentration, as well as the sum of PFAS concentrations. OBS was positively associated with liver markers. The PFAS concentrations were positively associated with total bilirubin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels. Interaction analyses revealed significant interactions between OBS and specific PFASs for alkaline phosphatase (interaction P < 0.05). Possible interactions were also found between OBS and specific PFASs for ALT, and AST levels (interaction P < 0.10).

CONCLUSIONS

This study clarified the association between total PFAS and OBS. This association was significant mainly for diet-related OBS. PFAS and OBS are associated with liver-related indicators in the blood.

The impact of dietary nitrates and acrylamide intake on systemic redox status in healthy young adults

OBJECTIVES

The nitrogen-containing xenobiotics, such as nitrates and acrylamide may potentially influence systemic redox status and contribute to the generation of oxidative stress (OS) in the human body, but there is still a lack of studies that would evaluate the various parameters assessing the oxidative-antioxidant balance. The aim of this study was to evaluate the exposure to nitrates and acrylamide derived from daily diet and to analyze the impact of these nitrate-containing xenobiotics on the parameters of systemic redox status in healthy young adults.

MATERIAL AND METHODS

To assess nitrate and acrylamide intake in the study population, a semi-quantitative food frequency questionnaire was used. Systemic redox status was evaluated by measurement of a panel of biochemical parameters: enzymatic (glutathione S-transferase, glutathione reductase, glutathione peroxidase [GPx]) and non-enzymatic (uric acid, bilirubin and albumin), thiol/disulphide homeostasis parameters (total thiol, native thiol, and disulfide) and oxidative/ antioxidant balance indicators (total antioxidant status, total oxidant status, OS index).

RESULTS

The average consumption of nitrates and acrylamide in the study population was 1.24 mg/kg b.w./day and 0.23 μg/kg b.w./day, respectively, which is within the normal value range. Of 12 measured parameters, significant differences were revealed for disulfide and total thiol levels, which were increased in the subgroup with the highest daily intake of nitrates compared to the subgroup with the lowest intake; for GPx, which was highest in the subgroup of the lowest daily intake of acrylamide; and for native thiols in the subgroup with the highest daily intake.

CONCLUSIONS

The intake of nitrogen-containing xenobiotics within the range considered as normal does not markedly influence redox state parameters in healthy young adults. Some significant changes were revealed only for thiol/disulphide homeostasis parameters, which may be the first line of antioxidant defense, as well as for GPx activity. Compensative mechanisms in healthy young people are efficient enough to neutralize OS induced by slightly increased exposure to nitrogen-containing xenobiotics delivered with food. Int J Occup Med Environ Health. 2023;36(6):773-87.

Association between oxidative stress exposure and colorectal cancer risk in 98,395 participants: results from a prospective study

Background

The intricate role of oxidative stress (OS) in colorectal cancer (CRC) initiation is underscored by an imbalance between pro-oxidants and antioxidants. Utilizing the Oxidative Balance Score (OBS) as a metric, this study aims to investigate the association between OS exposure and CRC risk, while also examining potential sex-specific differences in a large U.S. cohort.

Methods

The study included 98,395 adults from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. To construct the OBS, 14 dietary and lifestyle factors intricately associated with oxidative stress were quantified. A higher OBS value indicated a more favorable oxidative balance pattern or diminished OS exposure. Due to sex-specific differences in OBS, associations were evaluated separately for men and women based on Cox regression analysis. Subgroup analyses were conducted to elucidate potential modifiers.

Results

During 867,963.4 person-years of follow-up, 1,054 CRCs occurred. The mean (SD) age and OBS were 65.52 (5.73) years and 14.09 (3.95) points, respectively. In the fully adjusted Cox model, we observed an inverse association between OBS and CRC incidence in women (HRQ5vsQ1: 0.72; 95% CI: 0.52, 0.99; P for trend = 0.018) but not men. Subgroup analyses revealed the inverse association was more pronounced among women without versus with a family history of CRC (HRQ5 vsQ1: 0.66, 95% CI: 0.47-0.93; P for trend = 0.001; P for interaction = 0.001). The results remained robust after several sensitivity analyses.

Conclusion

Higher OBS was associated with lower CRC risk in women but not men; this inverse association was stronger among women without a family history of CRC. These findings suggest exposure to OS may confer sex-specific CRC risk effects, especially for women without a family history of CRC.

Association between oxidative balance score and kidney stone in United States adults: analysis from NHANES 2007-2018

Purpose: To investigate the relationship between the Oxidative Balance Score (OBS) and kidney stone risk using NHANES 2007-2018 data, and to explore potential mechanisms and population-specific effects. Materials and methods: Data from the NHANES 2007-2018 were analyzed. OBS was calculated based on 16 dietary components and 4 lifestyle components. Multivariate logistic regression was employed to investigate the relationship between OBS and kidney stone. Further stratified analyses were conducted to examine the associations across different subgroups. Results: A total of 19,799 participants were included in the study. There was a consistent inverse association between OBS and the risk of kidney stones (OR = 0.97; 95% CI: 0.96-0.99). After dividing the participants into quartiles based on OBS, compared to the lowest quartile of OBS, the risk of kidney stones in the highest quartile of OBS was reduced by 33% (95% CI 0.50-0.89; p = 0.002). This association was consistent across both dietary and lifestyle OBS scores. The protective effect of OBS was notably pronounced among Non-Hispanic white and Other race groups, and among individuals with a higher level of education. However, the association was not significant among individuals with diabetes. Conclusion: A higher OBS, indicating a balance skewed towards antioxidants, is associated with a reduced risk of kidney stones, especially among specific population subgroups. These findings underscore the potential role of oxidative balance in kidney stone pathogenesis and highlight the importance of considering individual and population-specific factors in future research and preventive strategies.

Association between oxidative balance score and urinary incontinence in females: results from the national health and nutrition examination survey in 2005-2018

PURPOSE

Oxidative stress plays a crucial role in the pathogenesis of urinary incontinence (UI). This study aimed to assess the association between the oxidative balance score (OBS) and UI in adult females in the United States.

METHODS

The study utilized data from the National Health and Nutrition Examination Survey database, spanning from 2005 to 2018. Weighted multivariate logistic regression, subgroup analyses, and restricted cubic spline regression were conducted to determine the odds ratio (OR) and 95% confidence intervals (95% CI) regarding the association between OBS and UI. Sensitivity analyses were performed to assess the robustness of the findings.

RESULTS

A total of 7304 participants were enrolled in this study. After adjusting for potential confounders, participants with lower OBS were found to have a higher likelihood of experiencing stress, urge, and mixed incontinence (OR, 0.986; 95% CI 0.975-0.998; p = 0.022; OR, 0.978; 95% CI 0.963-0.993; p = 0.004; and OR, 0.975; 95% CI 0.961-0.990; p = 0.001). Lifestyle factors were strongly associated with the prevalence and frequency of UI. The results remained consistent, and no significant interaction effects were observed in the subgroup analyses. The prevalence of three types of UI exhibited a nonlinear inverted U-shaped trend with increasing in OBS and dietary OBS (p for nonlinear < 0.05).

CONCLUSION

Among females, the higher the OBS, the lower the prevalence of UI. Therefore, dietary and lifestyle-related antioxidant therapy for females with UI should receive attention and be subject to further investigation.

Association of the Oxidative Balance Score and Cognitive Function and the Mediating Role of Oxidative Stress: Evidence from the National Health and Nutrition Examination Survey (NHANES) 2011-2014

BACKGROUND

Oxidative stress is possibly related to cognitive function decline. The oxidative balance score (OBS) that combines pro- and antioxidant components from diet and lifestyle has been reported to be associated with age-related diseases.

OBJECTIVES

We aimed to investigate the association between OBS and cognitive function in older adults and explore whether oxidative stress mediated this relationship.

METHODS

A total of 1745 adults aged ≥60 y were included in the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Cognitive function was measured using 4 tests: the immediate recall test, delayed recall test, animal fluency test (AFT), and digital symbol substitution test (DSST). Weighted multivariate linear regression and restricted cubic splines (RCS) analyses were used to evaluate the association between OBS and cognitive function, and mediation analysis was used to test the indirect effect of oxidative stress indicators on the association.

RESULTS

The OBS was positively associated with AFT, DSST, and global cognitive function in older adults, and the beta estimates (95% CI) were 0.015 (0.008, 0.034), 0.009 (0.002, 0.025), and 0.030 (0.024, 0.074), moreover, RCS results suggested an approximately linear dose-response relationship between the OBS and these 3 tests. The highest quartiles of these 3 tests were also significantly correlated with OBS. Albumin, uric acid, and serum 25(OH)D concentrations were significant mediators of the relationship between OBS and cognitive function, and the overall mediation effect proportion was 36% when included in 1 model.

CONCLUSIONS

OBS was positively correlated with cognitive function in older adults, and albumin, uric acid, and serum 25(OH)D concentrations could be the driving mediators of the association. The findings emphasize the importance of a healthy, antioxidant diet and lifestyle that contribute to cognitive function. J Nutr 20xx;x:xx.

Association between Hypertension and Stroke Recurrence as Modified by Pro-oxidant-Antioxidant Balance: A Multi-Center Study

BACKGROUND

Hypertension and oxidative stress are involved in the pathophysiological mechanism of stroke. We aimed to investigate the modification impact of the pro-oxidant-anti-oxidant balance (PAB) on the association between hypertension and stroke recurrence (SR).

METHODS

A cross-sectional design was conducted from December 2019 to December 2020 in 951 stroke patients in six hospitals across Vietnam. Hypertension was defined using antihypertensive medication or systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg. PAB was estimated using weighting methods based on smoking, drinking, and overweight/obesity with pro-oxidant capacity, diet quality, fruit intake, vegetable intake, and physical activity with antioxidant capacity. The higher PAB scores indicated a beneficial balance shifting toward antioxidant dominance. SR was diagnosed by neurologists. Moreover, sociodemographic and health conditions were included as covariates. Multiple logistic regression analyses were used to explore the associations and interactions.

RESULTS

The hypertension and SR proportions were 72.8% and 17.5%, respectively. hypertension was associated with an increased SR likelihood (odds ratio (OR) = 1.93; p = 0.004), whereas a higher PAB score was associated with a lowered SR likelihood (OR = 0.87; p = 0.003). Moreover, hypertension interacting with every one-point increment of PAB was associated with a lowered SR likelihood (OR = 0.83; p = 0.022).

CONCLUSIONS

The harmful impact of hypertension on SR could be alleviated by PAB. The interplay of health behaviors should be highlighted in the intervention strategies for stroke prevention.

Oxidative balance scores and depressive symptoms: Mediating effects of oxidative stress and inflammatory factors

BACKGROUND

Few studies have examined the combined effects of dietary and lifestyle factors on depressive symptoms. This study aimed to evaluate the association between oxidative balance score (OBS) and depressive symptoms and the underlying mechanisms.

METHODS

A total of 21,283 adults from the 2007 to 2018 National Health and Nutrition Examination Survey (NHANES) were included. Depressive symptoms were defined as a total score of ≥10 on the Patient's Health Questionnaire (PHQ-9). Twenty dietary and lifestyle factors were selected to calculate the OBS. Multivariable logistic regression analyses were used to evaluate the association between OBS and depression risk. Mediation analyses were conducted to explore the roles of oxidative stress and inflammatory markers.

RESULTS

In multivariate model, a significant negative association was found between OBS and depression risk. Compared with those in OBS tertile 1, participants in tertile 3 had lower odds of developing depressive symptoms (OR:0.50; 95 % CI:0.40-0.62; P < 0.001). Restricted cubic splines showed a linear relationship between OBS and depression risk (P for nonlinearity = 0.67). Moreover, higher OBS was found to be associated with lower depression scores (β = -0.07; 95 % CI:-0.08, -0.05; P < 0.001). GGT concentrations and WBC counts mediated the association between OBS and depression scores by 5.72 % and 5.42 %, respectively (both P < 0.001), with a joint mediated effect of 10.77 % (P < 0.001).

LIMITATIONS

This study was a cross-sectional design making it difficult to infer a causal association.

CONCLUSIONS

OBS is negatively associated with depression, which may be mediated in part by oxidative stress and inflammation.

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

PURPOSE

We aimed to prospectively investigate the association of an overall oxidative balance score (OBS) with all-cause death and cause-specific mortality among participants in the Seguimiento Universidad de Navarra (SUN) Study, a Mediterranean cohort of Spanish graduates.

METHODS

Using baseline information on 12 a priori selected dietary and non-dietary lifestyle pro- and antioxidants exposures-vitamins C and E, β-carotenes, selenium, zinc, heme iron, polyphenols, total antioxidant capacity, body mass index, alcohol, smoking, and physical activity-we constructed an equally weighted OBS categorized into quartiles, with higher scores representing greater antioxidant balance. Cox proportional hazards models were fitted to evaluate the association between the OBS and mortality.

RESULTS

A total of 18,561 participants (mean [SD] age, 38.5 [12.4] years; 40.8% males) were included in the analysis. During a median follow-up of 12.2 years (interquartile range 8.3-14.9), 421 deaths were identified, including 80 deaths from cardiovascular disease (CVD), 215 from cancer, and 126 from other causes. After adjustment for potential confounders, the hazard ratios and 95% confidence interval (CIs) between the highest quartile (predominance of antioxidants) vs. the lowest quartile (reference category) were 0.35 (95% CI 0.22-0.54, P-trend < 0.001) for all-cause mortality, 0.18 (95% CI 0.06-0.51, P-trend = 0.001) for CVD mortality, 0.35 (95% CI 0.19-0.65, P-trend = 0.002) for cancer mortality, and 0.45 (95% CI 0.20-1.02, P-trend = 0.054) for other-cause mortality.

CONCLUSION

Our findings suggest a strong inverse association between the OBS and all-cause, CVD, and cancer mortality. Individuals exposed to both antioxidant dietary and lifestyle factors may potentially experience the lowest mortality risk.

STUDY REGISTRY NUMBER

Dynamic Mediterranean Prospective Cohort: the SUN Project; NCT02669602. https://clinicaltrials.gov/ct2/show/NCT02669602 . https://proyectosun.es.

Association between the Oxidative Balance Score and Incident Chronic Kidney Disease in Adults

Oxidative stress is a novel risk factor for chronic kidney disease (CKD). The oxidative balance score (OBS) was developed to represent the overall oxidative balance based on dietary and lifestyle pro-oxidant and antioxidant components. The aim of this study is to verify the relationship between the OBS and the incidence of CKD. Data from 5795 participants without CKD at the baseline survey of the Korean Genome and Epidemiology Study were analyzed. Participants were classified into sex-specific OBS tertiles. During the mean follow-up period of 13.6 years, 286 men and 382 women newly developed CKD. The Cox proportional hazard spline curve revealed an inverse dose-response association between the OBS and incident CKD in both men and women. Multiple Cox proportional hazard regression analysis revealed that the adjusted hazard ratios (95% confidence intervals) for sex-specific highest (T3) and middle (T2) OBS tertile groups were 0.80 (0.59-1.08) and 0.70 (0.51-0.95), respectively, in men and 0.76 (0.59-0.98) and 0.73 (0.55-0.96), respectively, in women, with the sex-specific lowest OBS tertile group (T1) as the reference. These results suggest that a healthy diet and lifestyle that increases the OBS may help prevent CKD in both men and women.

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

Background

Oxidative stress is associated with outcomes of chronic lung disease. The oxidative stress-related exposures of diet and lifestyle can be evaluated by the oxidative balance score (OBS), and higher OBS scores indicate more significant antioxidant exposures. But the relationship between OBS and lung health is unknown.

Purpose

The aim of this study was to explore the association between OBS and lung health (respiratory symptoms, chronic lung disease, and lung function).

Methods

A series of models, including weighted linear models, weighted logistic regression, and weighted multinomial logistic regression, were performed to assess the associations of OBS with respiratory symptoms, chronic lung disease, and lung function. The models adjusted by age, race/ethnicity, gender, educational background, poverty-to-income ratio, and dietary energy were also performed.

Results

Cross-sectional data of 5,214 participants from the National Health and Nutrition Examination Survey for the years 2007-2012 were analyzed. For every one-unit increase in OBS, the odds of wheezing/chronic bronchitis decreased by 6%. Increased OBS was associated with higher percent-predicted forced expiratory volume in one second (FEV1) (adjusted mean difference (MD), 0.21%; 95% CI: 0.10-0.32) and percent-predicted forced vital capacity (FVC) (adjusted MD, 0.15%; 95% CI: 0.07-0.24). A significantly lower risk of wheezing/chronic bronchitis was found in participants in the second/third/fourth OBS quartile compared to those in the first OBS quartile (all P for trend < 0.05). Moreover, higher percent-predicted FEV1 and FVC were also found in the third quartile and fourth quartile (all P for trend < 0.05). Furthermore, both dietary and lifestyle components were tightly related to pulmonary outcomes. Many associations were maintained after stratified by sex or after sensitivity analyses.

Conclusion

Oxidative balance score was negatively correlated with the diagnosis of chronic bronchitis/wheezing/restrictive spirometry pattern and positively correlated with percent-predicted FVC and FEV1. It seems that the higher the OBS score, the better the pulmonary outcomes. The findings highlight the importance of adherence to an antioxidant diet and lifestyle and that it contributes to lung health.