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BackgroundThe potential beneficial health effects of dietary antioxidants have been reported. However, the association of a composite dietary antioxidant index (CDAI) with fatty liver index (FLI) remains unclear. This study aims to assess whether CDAI (including its components) is associated with FLI among US adults.MethodsThis population-based cross-sectional study used data on US adults from the National Health and Nutrition Examination Survey (NHANES) 2007–2018 cycles. Weighted generalized linear regression models were used to analyze the association between CDAI (including vitamin A, C, E, zinc, selenium, and carotenoids) and FLI, which was calculated by using body mass index (BMI), waist circumference and levels of γ-glutamyl transferase and triglycerides.ResultsWeighted generalized linear regression models showed an inverse association between CDAI and FLI in the total population (β, −0.40; 95% CI, −0.59, −0.21), in women (β, −0.56; 95% CI, −0.94, −0.18), and in men (β, −0.32; 95% CI, −0.54, −0.10) after adjusting for various confounders. The restricted cubic splines showed the negative linear dose–response associations between CDAI and FLI (all P non_linear >0.05). The dietary selenium intake in women has an inverse U-shaped relationship with FLI, with an inflection point value of 110 μg. In model 3, intake of dietary antioxidants Vitamins A, C, E, and carotenoids were significantly negatively associated with FLI in female but only were vitamins A and E negatively associated with FLI in male. In subgroup analysis, CDAI showed a significantly negative relation to FLI among those aged 60 years or older (β, −0.57; 95% CI, −0.81, −0.33), among those who engaged in active physical activity (β, −0.46; 95% CI, −0.63, −0.29), among those without metabolic syndrome (β, −0.43; 95% CI, −0.62, −0.24), and those without hyperuricemia (β, −0.43; 95% CI, −0.60, −0.26). Additionally, CDAI was significantly negatively associated with male FLI, regardless of whether they had diabetes or not.ConclusionIn conclusion, our results indicate that higher CDAI may be associated with a lower FLI.

BackgroundThe relationship between CDAI and suicidal ideation is unclear. This study investigates the relationship between CDAI and suicidal ideation and examines the association between CDAI and all-cause mortality (ACM) or cardiovascular disease mortality (CVM) among participants with and without suicidal ideation.MethodsData from seven NHANES cycles (2005–2018) were analyzed using cross-sectional and prospective cohort studies. Weighted multivariable logistic regression models, restricted cubic spline (RCS) plots, and subgroup analyses explored the association between CDAI and suicidal ideation. Kaplan–Meier (KM) curves, weighted multivariable Cox proportional hazards models, and RCS assessed the relationship between CDAI and CVM or ACM.ResultsAmong 30,976 participants aged over 20, 1,154 (3.72%) had suicidal ideation. Higher CDAI levels (Quartile 4) were associated with a 28% reduction in suicidal ideation compared to lower levels (Quartile 1). Over an average follow-up of 89 months, 3,267 participants (7.6%) died, including 808 (1.8%) from cardiovascular causes. Higher CDAI levels were linked to a 30, 68, and 28% reduction in ACM in the total population, those with suicidal ideation, and those without, respectively. CVM was reduced by 40% in the total population and by 41% in those without suicidal ideation.ConclusionCDAI is negatively associated with suicidal ideation and correlated with reduced ACM and CVM among participants with and without suicidal ideation.

ObjectiveThe objective of this study is to assess the correlation between composite dietary antioxidant index (CDAI) with all-cause mortality and cause-specific mortality in adults with hypertension.MethodsThe cohort study comprised adult participants with hypertension from the NHANES database, spanning 9 cycles from 2001 to 2018. Follow-up was conducted until December 31, 2019. Multi-variable Cox regression analysis was utilized to ascertain hazard ratios (HR) and their corresponding 95% confidence intervals, evaluating the relationship between CDAI and the risks of all-cause and cause-specific mortality. To further investigate the association between CDAI and mortality rates in adults with hypertension, Kaplan–Meier survival curves, restricted cubic splines (RCS), subgroup analyses and sensitivity analyses were employed.ResultsThe analysis included 16,713 adults with hypertension (mean age 56.93 ± 0.23 years, 8,327 [49.61%] male). During the mean follow-up time 102.11 ± 1.22 months, with 3,908 (18.08%) all-cause mortality occurred, 1,082 (4.84%) cardiovascular mortality and 833 (3.80%) cancer mortality. Compared to the lowest quartile of CDAI, the weighted multivariate hazard ratios of participants in the highest quartile was 0.77 (95% CI, 0.68–0.87) for all-cause mortality, 0.83 (95% CI, 0.67–1.04) for cardiovascular mortality, and 0.64 (95% CI, 0.50–0.82) for cancer mortality. RCS analysis demonstrated a nonlinear association of CDAI with all-cause and cancer mortality, and a linear association between CDAI and cardiovascular mortality. The results were robust in subgroup analyses and sensitivity analyses.ConclusionHigher CDAI is associated with reduced all-cause mortality, cardiovascular mortality, and cancer mortality in hypertensive adults. Our findings highlight the importance of an antioxidant diet in improving outcomes in adults with hypertension.

BackgroundThe dietary inflammatory index (DII) and composite dietary antioxidant index (CDAI) were developed as tools for use when seeking to assess the potential inflammatory and antioxidant activity of a given diet, respectively. The associations between these indices and gallstone incidence remain largely unexplored.ObjectiveThe present study sought to clarify how both the DII and the CDAI are related to gallstone incidence and age at first gallbladder surgery among adults in the USA.MethodsCross-sectional data from the 2017–2020 cycles of the National Health and Nutrition Examination Survey (NHANES) pertaining to 12,426 individuals were used to conduct the present study. Data from 2 days with 24-h dietary recall were employed when calculating DII and CDAI scores. Relationships between dietary indices and the incidence of gallstones were assessed through logistic regression analyses, while linear regression analyses were employed to characterize how these indices are associated with the age at first gallbladder surgery.ResultsHigher DII scores and lower CDAI scores, which, respectively, denote diets with greater inflammatory potential and reduced antioxidant potential, were found to be associated with higher gallstone incidence even following adjustment for potential confounding factors. Smooth curve fitting suggested that the association between DII and gallstones was nearly linear, whereas that between CDAI and gallstone incidence was nonlinear. Higher DII values were also related to first gallbladder surgery at an earlier age (β = −0.64, 95% CI: −1.26, −0.02).ConclusionThese results emphasize the benefits of anti-inflammatory diets rich in antioxidants, which may help reduce gallstone incidence among adults in the USA. Higher DII scores may also predict the need for gallbladder surgery at a younger age.

BackgroundThere is growing evidence that antioxidant-rich diets may prevent hyperlipidemia. However, the relationship between the Composite Dietary Antioxidant Index (CDAI) and hyperlipidemia is unclear. The CDAI is a composite score reflecting the antioxidant content of an individual’s diet, and this study aimed to investigate the relationship between CDAI and hyperlipidemia.MethodsThe study used the 2003–2018 National Health and Nutrition Examination Survey (NHANES) database for cross-sectional analyses and included 27,626 participants aged 20 years and older. The CDAI, which includes vitamins A, C, and E, zinc, selenium, and carotenoids, was calculated based on dietary intake reported in a 24-h recall interview. Hyperlipidemia was defined by the National Cholesterol Education Program (NCEP). Covariates included age, sex, race, education, marriage, household poverty-to-income ratio (PIR), glomerular filtration rate (eGFR), body mass index (BMI), energy, carbohydrates, total fat, cholesterol, smoking, alcohol consumption, hypertension, diabetes mellitus, coronary heart disease, and lipid-lowering medications. The association between CDAI and hyperlipidemia was explored through multiple logistic regression analyses and smoothed curve fitting. We also performed subgroup analyses and interaction tests to verify the relationship’s stability.ResultsAfter adjusting for potential confounders, CDAI was negatively associated with the risk of developing hyperlipidemia (OR 0.98, 95% CI 0.96–0.99, p

Background: The potential beneficial health effects of dietary antioxidants have been reported. However, the association of a composite dietary antioxidant index (CDAI) with fatty liver index (FLI) remains unclear. This study aims to assess whether CDAI (including its components) is associated with FLI among US adults., Methods: This population-based cross-sectional study used data on US adults from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 cycles. Weighted generalized linear regression models were used to analyze the association between CDAI (including vitamin A, C, E, zinc, selenium, and carotenoids) and FLI, which was calculated by using body mass index (BMI), waist circumference and levels of γ -glutamyl transferase and triglycerides., Results: Weighted generalized linear regression models showed an inverse association between CDAI and FLI in the total population ( β , -0.40; 95% CI, -0.59, -0.21), in women (β, -0.56; 95% CI, -0.94, -0.18), and in men (β, -0.32; 95% CI, -0.54, -0.10) after adjusting for various confounders. The restricted cubic splines showed the negative linear dose-response associations between CDAI and FLI (all P non_linear >0.05). The dietary selenium intake in women has an inverse U-shaped relationship with FLI, with an inflection point value of 110 μg. In model 3, intake of dietary antioxidants Vitamins A, C, E, and carotenoids were significantly negatively associated with FLI in female but only were vitamins A and E negatively associated with FLI in male. In subgroup analysis, CDAI showed a significantly negative relation to FLI among those aged 60 years or older ( β , -0.57; 95% CI, -0.81, -0.33), among those who engaged in active physical activity ( β , -0.46; 95% CI, -0.63, -0.29), among those without metabolic syndrome (β, -0.43; 95% CI, -0.62, -0.24), and those without hyperuricemia (β, -0.43; 95% CI, -0.60, -0.26). Additionally, CDAI was significantly negatively associated with male FLI, regardless of whether they had diabetes or not., Conclusion: In conclusion, our results indicate that higher CDAI may be associated with a lower FLI., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zheng, Li, Fu, Bai and Dong.)

Background: The relationship between CDAI and suicidal ideation is unclear. This study investigates the relationship between CDAI and suicidal ideation and examines the association between CDAI and all-cause mortality (ACM) or cardiovascular disease mortality (CVM) among participants with and without suicidal ideation., Methods: Data from seven NHANES cycles (2005-2018) were analyzed using cross-sectional and prospective cohort studies. Weighted multivariable logistic regression models, restricted cubic spline (RCS) plots, and subgroup analyses explored the association between CDAI and suicidal ideation. Kaplan-Meier (KM) curves, weighted multivariable Cox proportional hazards models, and RCS assessed the relationship between CDAI and CVM or ACM., Results: Among 30,976 participants aged over 20, 1,154 (3.72%) had suicidal ideation. Higher CDAI levels (Quartile 4) were associated with a 28% reduction in suicidal ideation compared to lower levels (Quartile 1). Over an average follow-up of 89 months, 3,267 participants (7.6%) died, including 808 (1.8%) from cardiovascular causes. Higher CDAI levels were linked to a 30, 68, and 28% reduction in ACM in the total population, those with suicidal ideation, and those without, respectively. CVM was reduced by 40% in the total population and by 41% in those without suicidal ideation., Conclusion: CDAI is negatively associated with suicidal ideation and correlated with reduced ACM and CVM among participants with and without suicidal ideation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Huang, Zhao, Choi and Gong.)

Objective: The objective of this study is to assess the correlation between composite dietary antioxidant index (CDAI) with all-cause mortality and cause-specific mortality in adults with hypertension., Methods: The cohort study comprised adult participants with hypertension from the NHANES database, spanning 9 cycles from 2001 to 2018. Follow-up was conducted until December 31, 2019. Multi-variable Cox regression analysis was utilized to ascertain hazard ratios (HR) and their corresponding 95% confidence intervals, evaluating the relationship between CDAI and the risks of all-cause and cause-specific mortality. To further investigate the association between CDAI and mortality rates in adults with hypertension, Kaplan-Meier survival curves, restricted cubic splines (RCS), subgroup analyses and sensitivity analyses were employed., Results: The analysis included 16,713 adults with hypertension (mean age 56.93 ± 0.23 years, 8,327 [49.61%] male). During the mean follow-up time 102.11 ± 1.22 months, with 3,908 (18.08%) all-cause mortality occurred, 1,082 (4.84%) cardiovascular mortality and 833 (3.80%) cancer mortality. Compared to the lowest quartile of CDAI, the weighted multivariate hazard ratios of participants in the highest quartile was 0.77 (95% CI, 0.68-0.87) for all-cause mortality, 0.83 (95% CI, 0.67-1.04) for cardiovascular mortality, and 0.64 (95% CI, 0.50-0.82) for cancer mortality. RCS analysis demonstrated a nonlinear association of CDAI with all-cause and cancer mortality, and a linear association between CDAI and cardiovascular mortality. The results were robust in subgroup analyses and sensitivity analyses., Conclusion: Higher CDAI is associated with reduced all-cause mortality, cardiovascular mortality, and cancer mortality in hypertensive adults. Our findings highlight the importance of an antioxidant diet in improving outcomes in adults with hypertension., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Qin, Shen and Xu.)

Background: The dietary inflammatory index (DII) and composite dietary antioxidant index (CDAI) were developed as tools for use when seeking to assess the potential inflammatory and antioxidant activity of a given diet, respectively. The associations between these indices and gallstone incidence remain largely unexplored., Objective: The present study sought to clarify how both the DII and the CDAI are related to gallstone incidence and age at first gallbladder surgery among adults in the USA., Methods: Cross-sectional data from the 2017-2020 cycles of the National Health and Nutrition Examination Survey (NHANES) pertaining to 12,426 individuals were used to conduct the present study. Data from 2 days with 24-h dietary recall were employed when calculating DII and CDAI scores. Relationships between dietary indices and the incidence of gallstones were assessed through logistic regression analyses, while linear regression analyses were employed to characterize how these indices are associated with the age at first gallbladder surgery., Results: Higher DII scores and lower CDAI scores, which, respectively, denote diets with greater inflammatory potential and reduced antioxidant potential, were found to be associated with higher gallstone incidence even following adjustment for potential confounding factors. Smooth curve fitting suggested that the association between DII and gallstones was nearly linear, whereas that between CDAI and gallstone incidence was nonlinear. Higher DII values were also related to first gallbladder surgery at an earlier age ( β  = -0.64, 95% CI: -1.26, -0.02)., Conclusion: These results emphasize the benefits of anti-inflammatory diets rich in antioxidants, which may help reduce gallstone incidence among adults in the USA. Higher DII scores may also predict the need for gallbladder surgery at a younger age., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Jiang and Shao.)

Background: There is growing evidence that antioxidant-rich diets may prevent hyperlipidemia. However, the relationship between the Composite Dietary Antioxidant Index (CDAI) and hyperlipidemia is unclear. The CDAI is a composite score reflecting the antioxidant content of an individual's diet, and this study aimed to investigate the relationship between CDAI and hyperlipidemia., Methods: The study used the 2003-2018 National Health and Nutrition Examination Survey (NHANES) database for cross-sectional analyses and included 27,626 participants aged 20 years and older. The CDAI, which includes vitamins A, C, and E, zinc, selenium, and carotenoids, was calculated based on dietary intake reported in a 24-h recall interview. Hyperlipidemia was defined by the National Cholesterol Education Program (NCEP). Covariates included age, sex, race, education, marriage, household poverty-to-income ratio (PIR), glomerular filtration rate (eGFR), body mass index (BMI), energy, carbohydrates, total fat, cholesterol, smoking, alcohol consumption, hypertension, diabetes mellitus, coronary heart disease, and lipid-lowering medications. The association between CDAI and hyperlipidemia was explored through multiple logistic regression analyses and smoothed curve fitting. We also performed subgroup analyses and interaction tests to verify the relationship's stability., Results: After adjusting for potential confounders, CDAI was negatively associated with the risk of developing hyperlipidemia (OR 0.98, 95% CI 0.96-0.99, p  < 0.01). The results of weighted regression models stratified by quartiles of CDAI (-8.664 ≤ Q1 ≤ -2.209, -2.209 < Q2 ≤ -0.002, -0.002 < Q3 ≤ 2.774, 2.774 < Q4 ≤ 124.284), fully adjusted for confounding variables, indicated that compared with the bottom quartile (Q1) of the CDAI, Q2, Q3, and Q4 of participants had a lower advantage ratio (Q2: OR 0.91, 95% CI 0.78-1.06, p  < 0.21; Q3: OR 0.85, 95% CI 0.73-1.00, p  < 0.05; and Q4: OR 0.77, 95% CI 0.64-0.94, p  < 0.01), which was confirmed by a test for trend ( p  < 0.05). Smoothed curve fit analysis showed linearity (p for non-linear = 0.0912). In summary, there is a linear negative relationship between CDAI and the risk of developing hyperlipidemia. Subgroup analyses by age, sex, ethnicity, education level, marriage, tobacco status, alcoholic drinking, body mass index (BMI), hypertension, and diabetes did not indicate strong interactions., Conclusion: In this large cross-sectional study, there was a linear negative association between CDAI and hyperlipidemia among US adults. Therefore increase antioxidant rich foods in your life as a prevention of hyperlipidemia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhou, Li, Li, Zheng, Yang and Zhuang.)