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Associations of cumulative average dietary total antioxidant capacity and intake of antioxidants with metabolic syndrome risk in Korean adults aged 40 years and older: a prospective cohort study (KoGES_CAVAS)
Ji-Sook Kong, Jiseon Lee, Youngjun Kim, Hye Won Woo, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim
Epidemiol Health. 2023;45:e2023067.   Published online July 28, 2023
DOI: https://doi.org/10.4178/epih.e2023067
  • 4,208 View
  • 122 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Limited and inconsistent prospective evidence exists regarding the relationship of dietary total antioxidant capacity (dTAC) and antioxidant intake with metabolic syndrome (MetS) risk. We evaluated the associations of the cumulative averages of dTAC and antioxidant intake (in 5 classes: retinol, vitamin C, vitamin E, carotenoids, and flavonoids, as well as 7 flavonoid subclasses) with the risk of MetS.
METHODS
This study included 11,379 participants without MetS, drawn from the Korean Genome and Epidemiology Study_CArdioVascular disease Association Study (KoGES_CAVAS). The cumulative average consumption was calculated using repeated food frequency questionnaires. Incidence rate ratios were estimated using a modified Poisson regression model with a robust error estimator.
RESULTS
The median follow-up period was 5.16 years, and 2,416 cases of MetS were recorded over 58,750 person-years. In men, significant inverse associations were observed in all 5 antioxidant classes, except for the highest quartile of dTAC. In women, dTAC and total flavonoids were not significantly associated with MetS; however, significant L-shaped associations were found for the remaining 4 antioxidant classes. Of the 7 flavonoid subclasses, only flavones in the highest quartile for men and flavan-3-ols in women lacked significant associations with MetS. The inverse associations were not sex-specific, but they were particularly pronounced among participants with a body mass index (BMI) of 23 kg/m<sup>2</sup> or higher.
CONCLUSIONS
The findings suggest that most antioxidant classes and flavonoid subclasses, unlike dTAC, exhibit a clear beneficial association with MetS in an L-shaped pattern in both men and women, particularly those with a high BMI.
Summary
Korean summary
농촌코호트 조사 참여자를 대상으로 식이 총항산화능, 총항산화능 하위분류, 플라보노이드 하위분류와 대사증후군 발생 위험의 전향적 연관성을 평가한 결과, 대부분의 항산화물(5개항산화물 분류:4개 항산화 비타민과 플라보노이드; 플라보노이드 7개 하부분류)에서 대사증후군과 음의 상관성을 확인할 수 있었으며 총항산화능(남자와 여자)과 플라보노이드(여자)에서 약한 연관성을 보였다. 남녀간 유의한 상호작용은 없었고 특히 BMI가 높은 집단에서 두드러졌다. 이 연구의 결과는 특히 식이 총항산화능을 구성하는 하위 유형을 적절히 섭취하는 것이 특히 비만한 성인에서 대사증후군 위험을 낮추는 예방전략으로 효과가 있을 수 있음을 시사한다.
Key Message
We observed that the cumulative average of dietary antioxidant vitamins and most flavonoids may be have pivotal roles in prevention of MetS, although there may be weak associations of dTAC and flavonoids in women. Moreover, these inverse associations were more pronounced in high BMI individuals. Our results suggest that the consumption of antioxidants and flavonoid may mitigate the MetS risk, particularly in overweight/obese individuals at high risk of developing chronic diseases.

Citations

Citations to this article as recorded by  
  • The association of dietary total flavonoids and their subclasses with the risk of type 2 diabetes: a prospective cohort study
    Hye Won Woo, Mi Kyung Kim, Kong Ji-Sook, Jiseon Lee, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim
    European Journal of Nutrition.2024;[Epub]     CrossRef
  • A Systematized Review of the Relationship Between Obesity and Vitamin C Requirements
    Julia K Bird, Edith JM Feskens, Alida Melse-Boonstra
    Current Developments in Nutrition.2024; 8(5): 102152.     CrossRef
Gastric cancer risk is reduced by a predominance of antioxidant factors in the oxidative balance: a hospital-based case-control study in Korea
Jimi Kim, Jeonghee Lee, Il Ju Choi, Young-Il Kim, Jeongseon Kim
Epidemiol Health. 2022;44:e2022089.   Published online October 17, 2022
DOI: https://doi.org/10.4178/epih.e2022089
  • 4,145 View
  • 91 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Gastric carcinogenesis is linked to oxidative stress from both exogenous and endogenous exposures. This study aimed to determine the association between the risk of gastric cancer and the oxidative balance score (OBS), which comprises antioxidant and pro-oxidant factors, including diet and lifestyle.
METHODS
For this hospital-based case-control study, 808 controls and 404 patients with gastric cancer who had clinical records indicating <i>Helicobacter pylori</i> infection and the histological subtype of cancer were recruited. The OBS was determined based on diet and lifestyle factors obtained from a 106-item semiquantitative food frequency questionnaire and a constructed questionnaire. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
A higher OBS was associated with a reduced gastric cancer risk (OR, 0.49; 95% CI <sub>T3 vs. T1,</sub> 0.33 to 0.71; p for trend <0.001). In a subgroup analysis, antioxidant factors showed inverse associations with gastric cancer risk (OR, 0.53; 95% CI <sub>T3 vs. T1,</sub> 0.35 to 0.79; p for trend=0.003). A stronger association with antioxidant factors was observed in patients with intestinal gastric cancer (OR, 0.34; 95% CI <sub>T3 vs. T1,</sub> 0.19 to 0.62; p for trend<0.001) and those with <i>H. pylori</i> infection (OR, 0.57; 95% CI <sub>T3 vs. T1,</sub> 0.37 to 0.88; p for trend=0.014).
CONCLUSIONS
A predominance of antioxidant factors compared to pro-oxidant factors from diet and lifestyle reduced the risk of gastric cancer. The combined effect of oxidative stress, which involves an altered balance between antioxidants and pro-oxidants, is important for modulating the risk of gastric cancer.
Summary
Korean summary
본 연구에서는 한국인 암 발생의 상위권을 차지하는 위암 발병률에 대해 영양소, 식품, 생활습관 등 항산화와 산화촉진 요인으로 구성된 산화 균형 점수(Oxidative Balance Score)와의 연관성을 비교 분석하였습니다. 산화촉진 요인에 비해 항산화 관련 요인에서 위암 발생의 위험이 유의하게 감소함을 나타냈습니다.
Key Message
The aim of this study was to determine the association between the risk of gastric cancer and the oxidative balance score comprising antioxidant and pro-oxidants factors, including diet and lifestyle. We found that predominantly antioxidants from diet and lifestyle, in contrast to pro-oxidants, reduce the risk of gastric cancer.

Citations

Citations to this article as recorded by  
  • Association between oxidative balance score and prostate specific antigen among older US adults
    Jintao Li, Chao Yang, Kui Xiang
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • The systemic oxidative stress score has a prognostic value on gastric cancer patients undergoing surgery
    Xinyu Wang, Limin Zhang
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • An oxidative stress biomarkers predict prognosis in gastric cancer patients receiving immune checkpoint inhibitor
    Guiming Deng, Hao Sun, Rong Huang, Hongming Pan, Yanjiao Zuo, Ruihu Zhao, Zhongze Du, Yingwei Xue, Hongjiang Song
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • Oxidative balance score and risk of cancer: a systematic review and meta-analysis of observational studies
    Motahareh Hasani, Seyedeh Parisa Alinia, Maryam Khazdouz, Sahar Sobhani, Parham Mardi, Hanieh-Sadat Ejtahed, Mostafa Qorbani
    BMC Cancer.2023;[Epub]     CrossRef

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