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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1526532
This article is part of the Research Topic Preventative Medicine: Nutritional and Lifestyle Interventions for Healthy Ageing and Chronic Diseases View all 31 articles

Associations of Comprehensive Dietary Antioxidant Index with Postmenopausal Femur Bone Mineral Density and Osteoporosis: Data from the National Health and Nutrition Examination Survey

Provisionally accepted
Jianbo Sun Jianbo Sun 1Jie Wang Jie Wang 1Wu Hu Wu Hu 1He Huang He Huang 2Hongmou Zhao Hongmou Zhao 1*
  • 1 Department of Foot and Ankle Surgery, Xi'an Honghui Hospital, Xi’an, Shaanxi, China
  • 2 Department of Orthopaedics, Tongyong Medical Xi'an Hospital, Xi'an, China

The final, formatted version of the article will be published soon.

    Objectives: The study aimed to explore associations of the comprehensive dietary antioxidant index (CDAI) with femur bone mineral density (BMD) and risk of osteoporosis in American postmenopausal women. Methods: A total of 2862 participants from the National Health and Nutrition Examination Survey were included in this study. The relationship between the CDAI and femur BMD was assessed via weighted multivariate linear regression model. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between the CDAI and the risk of osteoporosis was assessed by weighted logistic regression model. Moreover, the nonlinear relationship was also characterized by smooth curve fitting and weighted generalized additive model. The two-piecewise linear regression models and a recursive algorithm were used to find the inflection points.Results: After adjusting all covariates, the weighted multivariable linear regression models demonstrated that the CDAI was positively correlated with femur BMD. Moreover, there were nonlinear relationships between CDAI and risk of osteoporosis. In the age below 70 years, the risk of osteoporosis decreased to 60.6% and 92.2% with each unit increase in CDAI value before and after the inflection point (-2.268), respectively. In the 70 years or older, the risk of osteoporosis decreased to 80.4% with each unit increase in CDAI value before the inflection point (-1.479). The weighted logistic regression model demonstrated that compared to the first tertile of CDAI, the highest tertile of CDAI was significantly associated with a lower risk of osteoporosis, with ORs of 0.375 (95% CI 0.284, 0.495) for individuals under the age of 70, and 0.626 (95% CI 0.481, 0.814) for individuals aged 70 or above.The present study indicated that postmenopausal women with higher CDAI scores have a lower risk of osteoporosis. In addition, there is a non-linear relationship between CDAI and the risk of osteoporosis. This finding suggests that the adoption of a comprehensive antioxidant dietary structure represented by high CDAI scores may have a positive impact on the prevention and management of osteoporosis in postmenopausal women. Particularly for those with lower CDAI scores, early screening and intervention for osteoporosis may be necessary.

    Keywords: Comprehensive dietary antioxidant index1, antioxidant2, Bone mineral density3, osteoporosis4, American postmenopausal women5

    Received: 11 Nov 2024; Accepted: 10 Jan 2025.

    Copyright: © 2025 Sun, Wang, Hu, Huang and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hongmou Zhao, Department of Foot and Ankle Surgery, Xi'an Honghui Hospital, Xi’an, Shaanxi, China

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