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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health and Nutrition
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1393119

The Independent and Joint Relationships Between Dietary Antioxidant Intake with Risk of Chronic Obstructive Pulmonary Disease and All-Cause Mortality: Insights from NHANES

Provisionally accepted
Yifeng Xu Yifeng Xu 1*Zhaoqi Yan Zhaoqi Yan 1Keke Li Keke Li 1Liangji Liu Liangji Liu 2Lei Xu Lei Xu 2*
  • 1 Jiangxi University of Traditional Chinese Medicine, Nanchang, China
  • 2 Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China

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

    Background: Numerous studies have indicated that a diet rich in antioxidants can prevent Chronic Obstructive Pulmonary Disease (COPD). However, the relationship between combined dietary antioxidant intake and the risk of COPD remains unclear. The Comprehensive Dietary Antioxidant Index (CDAI) is a composite score of various dietary antioxidants, including vitamins A, C, E, zinc, selenium, and carotenoids. In this study, we examined the independent and joint associations of CDAI with the risk of COPD and allcause mortality. Methods: The analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2013 to 2018. Multivariable weighted logistic and Cox regression models were employed to evaluate the correlations of CDAI (including vitamins A, C, E, zinc, selenium, and carotenoids) with the risk of COPD and all-cause mortality. Restricted cubic spline models were used to examine potential non-linear relationships. Sensitivity and stratified analyses were conducted to assess the robustness of the results. Results: In NHANES, compared to the lowest quartile, the highest quartile of CDAI levels was significantly negatively associated with the risk of COPD (Odds Ratio [OR]: 0.47; 95% Confidence Interval [CI]: 0.22-0.97), exhibiting a non-linear relationship. Additionally, vitamins A, C, E, zinc, selenium, and carotenoids were also negatively associated with the risk of COPD. Furthermore, dietary antioxidant zinc in the second quartile (Hazard Ratio [HR]: 0.25; 95% CI: 0.10-0.62) was associated with a reduced risk of all-cause mortality compared to the lowest quartile. Subgroup analysis results remained stable, and sensitivity analysis did not support the association between selenium and the risk of COPD, with no substantial changes in the remaining associations. Conclusion: Higher CDAI is inversely associated with the risk of COPD, and appropriate intake of the dietary antioxidant zinc may reduce all-cause mortality in COPD patients.

    Keywords: Comprehensive Dietary Antioxidant Index, COPD, NHANES, Oxidative Stress, Restricted cubic spline

    Received: 28 Feb 2024; Accepted: 25 Nov 2024.

    Copyright: © 2024 Xu, Yan, Li, Liu and Xu. 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:
    Yifeng Xu, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
    Lei Xu, Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.