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

Jia Zhang; Xueqin Lu; Ruifeng Wu; Hanchen Ni; Lingli Xu; Wenjuan Wu; Cheng Lu; Jiayi Feng; Yongmei Jin

doi:10.3389/fnut.2023.1214875

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

Front Nutr. 2023 Aug 10:10:1214875. doi: 10.3389/fnut.2023.1214875. eCollection 2023.

Authors

Jia Zhang¹, Xueqin Lu², Ruifeng Wu³, Hanchen Ni⁴, Lingli Xu⁵, Wenjuan Wu⁶, Cheng Lu¹, Jiayi Feng¹, Yongmei Jin⁴

Affiliations

¹ Department of Cardiovascular Medicine, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
² Department of Nutrition, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
³ Department of Pediatrics, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
⁴ Department of Nursing, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
⁵ Intensive Care Unit, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
⁶ Department of Gastrointestinal Diagnosis and Treatment, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Abstract

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.

Keywords: American; National Health and Nutrition Examination Survey; adults (MeSH); atherosclerotic cardiovascular disease; composite dietary antioxidant index.