Associations of dietary and lifestyle oxidative balance scores with mortality risk among older women: the Iowa Women's Health Study

Antioxidant Diets and Lifestyles Could Mitigate the Risk of Sarcopenia with Low Muscle Mass in Women: A Retrospective Study

Background: Sarcopenia is characterized by a loss of muscle mass, strength, and function. At present, there are no effective methods available for prevention or treatment. Oxidative Balance Score (OBS) has been shown to be significantly correlated with a decreased risk of sarcopenia. Nevertheless, gender-specific studies still exhibit certain limitations. Methods: Individuals who completed dual-energy X-ray absorptiometry and the diet and lifestyle questionnaires from the National Health and Nutrition Examination Survey were enrolled. OBSs were calculated according to dietary or lifestyle variables and physical activity. Sarcopenia with low muscle mass (SLM) was identified based on the ratio of appendicular skeletal muscle mass to body mass index. A logistic regression analysis investigated the association between OBS and the risk of SLM in different gender groups. Kaplan-Meier survival and subgroup analyses and Cox regression analyses were used to explore the relationship between OBS and mortality in individuals with SLM in each gender subgroup. Results: The level of OBS in the SLM group was lower (20.40 vs. 17.07, p < 0.05). A multivariate logistic regression analysis showed that the OR between individual dietary nutrients and lifestyle and the risk of SLM exhibition was gender-specific. Stratified analyses revealed that total OBS, as well as diet and lifestyle OBS were negatively associated with the risk of SLM within each gender subgroup (all p < 0.05, all trends p < 0.05). Furthermore, a restriction cubic spline regression analysis showed that diet and lifestyle OBSs were negatively correlated with the risk of SLM in females (nonlinear p = 0.0469, nonlinear p = 0.0254). The KM curve showed that OBS was not significantly associated with all-cause mortality in the male and female subgroups (female, p = 0.064, male, p = 0.53). Conclusions: This study establishes a significant negative correlation between OBS and the risk of SLM, particularly among females. Consequently, adopting an antioxidant diet and lifestyle may prove to be more advantageous for females.

Interactive and joint effects of toxic metals and oxidative balance score on the risk of mortality in adults with NAFLD

BACKGROUND

High oxidative balance score (OBS) may mitigate inflammation levels and thereby alleviate the adverse health effects induced by toxic metals. We assessed the independent, joint effects as well as their interactions of toxic metals and OBS on mortality among individuals with non-alcoholic fatty liver diseases (NAFLD).

METHODS

Participants with NAFLD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were included. Mortality and underlying causes of death were certain by National Death Index records through 31 December 2019. Cox regression models were used to estimate hazard ratios (HRs) for all-cause and disease-specific mortality. Additionally, we assessed multiplicative and additive interactions of OBS and toxic metals on mortality.

RESULTS

Among 5263 patients with NAFLD, 1097 deaths occurred during a mean follow-up of 10.27 years. Compared with those in the OBS tertile 1, participants in tertile 3 had lower risk of all-cause mortality (HR=0.79, 95 %CI: 0.64, 0.96). Compared with individuals in the lowest lead concentration in blood, those in the highest had an increased risk of mortality, with the HRs (95 %CIs) being 1.23 (1.01, 1.51), 1.53(1.06, 2.20) and 1.94(1.25, 3.01) for all-cause, CVD and cancer mortality, respectively. Similar results were also found for blood cadmium level. Joint associations analyses found that individuals with low lead and high-OBS levels had the lowest risk of all-cause, CVD and cancer mortality, with the HRs(95 %CIs) being 0.58(0.40, 0.85), 0.45(0.21, 0.93) and 0.35(0.15, 0.81), respectively. Multiplicative interactions between OBS and blood cadmium on all-cause death (HR=0.87, 95 %CI: 0.78, 0.97) and CVD death (HR=0.81, 95 %CI: 0.67, 0.99) were found.

CONCLUSIONS

High OBS and low exposure to toxic metals were associated with lower risk of mortality among participants with NAFLD. Adopting anti-oxidative lifestyle could alleviate the harmful effects of toxic metals in NAFLD patients. Comprehensive strategies are essential to decrease the risk of mortality and potentially mitigate the overall burden of NAFLD.

Association of oxidative balance score with incident cardiovascular disease in patients with type 2 diabetes: findings of the UK Biobank study

BACKGROUND & AIMS

To clarify how dietary and lifestyle factors work on diabetes-related cardiovascular disease (CVD), we investigated whether the increased risk of CVD in patients with type 2 diabetes mellitus (T2DM) could be offset by an increase in diet and/or lifestyle with antioxidant potential.

RESEARCH DESIGN AND METHODS

A total of 7,658 individuals from UK Biobank (UKB) with T2DM but no diagnosed CVD were included in this study. We screened combinations of 16 nutrients and/or 4 lifestyles to calculate the Oxidative Balance Score (OBS), dietary OBS (DOBS), and lifestyle OBS (LOBS). Cox proportional hazards (CPH) regression models and mediation statistical models were performed.

RESULTS

After adjusting for covariates, CPH regression models showed inverse associations between both OBS and LOBS and CVD. The highest tertile of LOBS was significantly associated with a lower risk of CVD compared to the lowest tertile, with hazard ratios and 95% CIs as follows: Atherosclerotic Cardiovascular Disease (ASCVD) 0.81 (0.68-0.97), Coronary Artery Disease (CAD) 0.79 (0.67-0.93), Atrial Fibrillation (AF) 0.56 (0.45-0.70) and CVD mortality 0.67(0.51-0.88). Correspondingly, the results of associations between the highest tertile of OBS and risks of CVDs above were ASCVD 0.80 (0.64-0.99), CAD 0.83(0.68-1.01), AF 0.73 (0.57-0.92) and CVD mortality 0.68 (0.50-0.92). No associations between DOBS and CVDs were observed [ASCVD 0.83 (0.66-1.05), CAD 0.86 (0.70-1.05), AF 0.77 (0.60-1.00), and CVD mortality 0.79 (0.57-1.10)]. These results were consistent in stratified analyses. Additionally, we identified a mediating role for C-reactive protein (CRP) and white blood cell count (WBC) in the observed relations, with indirect effect and mediation estimates as follows: CRP - 0.003 6.0% (OBS and CAD), -0.008 17.2%, -0.003 11.7%, and - 0.010 14.5% (OBS/DOBS/LOBS and CVD mortality); WBC - 0.006 14.3%, -0.006 12.6%, -0.006 13.4%, -0.005 23.3% (OBS and CVDs), -0.008 11.8%, -0.008 11.9%, -0.008 11.8%, and - 0.005 5.3% (LOBS and CVDs).

CONCLUSION

Sustained adherence to diets and lifestyles with high antioxidant potential may significantly reduce the risk of CVD in individuals with T2DM.

Association of oxidative balance score with all-cause and cardiovascular mortality in overweight and obese

Background

The oxidative balance score (OBS) combines diverse dietary components with lifestyle factors to comprehensively evaluate oxidative stress. The investigation focuses on the link between the OBS and mortality outcomes, including cardiovascular and all-cause deaths, in overweight and obese individuals.

Methods

The analysis utilized data from the National Health and Nutrition Examination Survey (NHANES), covering the period from 1999 to 2018. Mortality information, categorized into all-cause and cardiovascular deaths, was gathered from the National Death Index (NDI). Kaplan-Meier survival analysis, along with multivariate Cox regression and restricted cubic spline (RCS) modeling, were utilized to explore the link between OBS and mortality risks. Subgroup analysis and sensitivity analysis were used to assess the robustness of the results and possible effect modifiers. Mediation analysis identifies pathways through which the independent variable affects the dependent variable.

Results

In this study, 26,219 participants with overweight or obesity were enrolled, with an average age of 49.8 ± 17.4 years. During a median follow-up duration of 115 months, 2,239 participants (8.5%) died, including 837 (3.2%) from cardiovascular disease. According to Kaplan-Meier analysis, mortality was highest among participants in the lowest OBS quartile (Q1) and lowest among those in the highest quartile (Q4). Participants in the fourth OBS quartile experienced a 21.7% decrease in the risk of mortality from all causes and a 29.5% decrease in cardiovascular mortality risk, according to fully adjusted results, compared to those in the first quartile. These results were validated through subgroup analyses. The analysis of RCS revealed a notable inverse association between OBS and mortality outcomes. Mediation analysis indicates that white blood cell count (WBC) and gamma-glutamyl transferase (GGT) serve as significant mediators in the association between OBS and mortality risk.

Conclusion

Elevated levels of OBS were strongly linked to reduced potential for both cardiovascular and all-cause mortality among individuals who are overweight or obese.

Oxidative balance score and its association with chronic inflammatory airway diseases and mortality: a population-based study

Objective

The aim of this research was to explore the possible connection between combined Oxidative Balance Score (OBS) and the prevalence of chronic inflammatory airway diseases (CIAD), including asthma, chronic obstructive pulmonary disease (COPD), and chronic bronchitis, along with the mortality rate among individuals with CIAD.

Methods

Data were gathered from the National Health and Nutrition Examination Survey (NHANES) 2013-2018 cycles. The Oxidative Balance Score (OBS) was calculated using 16 different nutrients and 4 different lifestyles, which was then categorized into four groups. The CIAD included individuals with self-reported asthma, chronic bronchitis, or COPD. Mortality data up to December 31, 2019, was obtained from the National Death Index. In cross-sectional studies, the association between OBS and the prevalence of total and specific CIAD was examined using multiple logistic regressions. Dose-response relationships were analyzed through restricted cubic spline regression (RCS). In prospective cohort studies, cumulative survival rates were determined using the Kaplan-Meier method and compared with log-rank tests. Multiple COX regressions were conducted to evaluate the relationship between OBS and all-cause as well as respiratory diseases mortality among participants with CIAD.

Results

A total of 12,458 adults were enrolled in this study. The demographic characteristics of the study population revealed a mean age of 52.25 ± 15.8 years, 47.73% being male, and the majority identified as Non-Hispanic White (66.87%). We found that 20.26% of the participants were suffered from CIAD, followed by asthma (15.41%), chronic bronchitis (6.10%) and COPD (3.80%), respectively. The median OBS levels were 20.98 with a standard deviation of 0.17. After adjusting for all confounders, we found that the highest quartile of OBS was significantly associated with lower prevalence of total CIAD (OR = 0.71, 95% CI 0.64-0.81), asthma (OR = 0.62, 95% CI 0.52-0.73), chronic bronchitis (OR = 0.64, 95% CI 0.44-0.92), and COPD (OR = 0.48, 95% CI 0.31-0.77) compared to the lowest quartile. Additionally, a linear and inverse relationship was found between OBS and the incidence of various respiratory disorders. Kaplan-Meier survival analysis showed that individuals in the highest quartile of OBS had the lowest risk of both all-cause mortality (log-rank test p = 0.017) and respiratory diseases mortality (log-rank test p < 0.001). Furthermore, after adjusting for multiple factors, individuals in the fourth quartile continued to show a significantly reduced risk of all-cause mortality (HR = 0.71, 95% CI 0.55-0.93) and respiratory diseases mortality (HR = 0.53, 95% CI 0.43-0.74) in comparison to those in the lowest quartile of OBS levels.

Conclusion

The findings revealed that a higher OBS was significantly linked to a decreased prevalence of total and specific CIAD, including asthma, chronic bronchitis, and COPD. Higher OBS levels were also associated with reduced mortality from both all causes and respiratory diseases among CIAD patients. These findings offer valuable information on the role of diet and lifestyle in preventing CIAD.

Association of oxidative balance score with cardiovascular disease and all-cause and cardiovascular mortality in American adults with type 2 diabetes: data from the National Health and Nutrition examination survey 1999-2018

Background

Oxidative stress has an important role in type 2 diabetes (T2D). Oxidative balance score (OBS) is an emerging assessment of dietary and lifestyle oxidative balance. We aimed to explore the association of OBS with cardiovascular disease (CVD) and all-cause and CVD mortality in the T2D population through NHANES 1999-2018.

Methods

OBS integrated 16 dietary components and 4 lifestyle components. T2D was diagnosed according to the American Diabetes Association criteria. Multivariate logistic regression and multivariate Cox proportional hazards regression analyses were used to explore the association of OBS with CVD and mortality in T2D, respectively.

Results

3801 adult T2D participants were included. In fully adjusted models, OBS, dietary OBS, and lifestyle OBS were all negatively associated with the prevalence of CVD (odds ratios of 0.98, 0.98, and 0.85, respectively). Higher OBS and lifestyle OBS (p for trend 0.016 and <0.001, respectively) rather than dietary OBS (p for trend = 0.06) were associated with significantly lower odds of CVD. Higher OBS, dietary OBS, and lifestyle OBS were all negatively associated with all-cause mortality (hazard ratios [HR] of 0.98, 0.98, and 0.92, respectively; p for trend of 0.002, 0.009, and 0.035, respectively). Higher OBS and dietary OBS were negatively associated with CVD mortality (HR 0.96 and 0.95, respectively; p for trend both <0.001), whereas lifestyle OBS was not. Restricted cubic spline analysis suggested that most associations were linear. Stratified analyses showed that these associations were influenced by some demographic variables and disease status.

Conclusions

Adherence to higher OBS was associated with reduced CVD prevalence and mortality risk in T2D. Antioxidant diet and lifestyle had more significant associations with mortality and CVD prevalence, respectively. However, as these findings are merely associations and do not allow causal inferences to be drawn, future validation in high-quality randomized controlled trials is needed.

Association of oxidative balance score with all-cause mortality among individuals with chronic kidney disease: a cohort study

BACKGROUND

The Oxidative Balance Score (OBS) is employed for evaluating the body's overall level of oxidative stress. This study aimed to investigate the association between OBS and mortality in individuals with chronic kidney disease (CKD) using a cohort study design.

METHODS

We used data from adult participants(≥ 20 years old) in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. CKD is diagnosed based on the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. OBS, which consists of 16 dietary factors and 4 lifestyle factors, categorized into pro-oxidants and antioxidants, with a total score range of 0 to 40 .The OBS was divided into four quartiles (Q1 to Q4), with Q1 (5-12), Q2 (13-18), Q3 (19-24), and Q4 (25-36). We excluded patients with missing data on OBS, CKD, and key covariates.Cox regression analysis were used to examine the relationship between OBS and all-cause mortality in CKD patients. Sensitivity analyses included subgroup analysis and multiple imputation.

RESULTS

We included a total of 3,984 patients with CKD. During an average follow-up period of 103 months, 1,263 cases (31.7%) of all-cause mortality were recorded. In the fully adjusted model, compared to Q1 the hazard ratios (HRs) and 95% confidence intervals (CIs) for Q4 were as follows: OBS 0.80 (0.68, 0.95) (p = 0.012), dietary OBS 0.78 (0.66, 0.92) (p = 0.003), and lifestyle OBS 0.83 (0.70, 0.99) (p = 0.038). Our sensitivity analyses further confirmed the robustness of these results.

CONCLUSIONS

Higher OBS was negatively correlated with all-cause mortality risk in American adults with CKD.

Unintentional fall mortality by place, sex, and age group among older Chinese adults, 2010-21

Background

Unintentional falls are known to be a leading cause of injury mortality among older Chinese adults, yet we lack data on the most recent trends in related mortality. To address this, we used the latest nationally representative data from China to examine trends in elderly unintentional fall mortality by place (urban/rural), sex (men/women), and age group (65-69, 70-74, 75-79, 80-84, and ≥85 years) from 2010 to 2021.

Methods

We retrieved mortality data from the Chinese Health Statistical Yearbook (2010-21) and population data from the Chinese Population Census (2010, 2020). Using line graphs, we examined mortality trends over time. We fitted a joinpoint regression model to detect periods experiencing significant changes and calculated the average and specific annual percentage change of mortality rates to quantify significant changes in the mortality of the elderly due to unintentional falls.

Results

Between 2010 and 2021, the age-standardised mortality rate from unintentional falls increased from 45.7 to 67.8 per 100 000 population among Chinese adults aged 65 years and older. Subgroup analyses by sex and place showed similar changing patterns to the overall mortality trends. The joinpoint regression identified certain recent periods that saw significant increases in mortality among adults aged 65-69, 70-74, 75-79, and 80-84 years. During the study period, men and individuals living in rural areas generally had higher unintentional fall mortality rates than women and people living in urban areas (mortality rate ratios: 1.09-1.21 for men vs. women and 1.01-1.27 for rural areas vs. urban areas). Notably, the differences between urban and rural areas, and those between men and women, were consistent across the three younger age groups (65-69, 70-74, and 75-79 years) studied, but reduced in the two oldest age groups (80-84 and ≥85 years).

Conclusions

The age-standardised mortality rate from unintentional falls increased between 2010 and 2021 among Chinese adults aged 65 years or older, with wide variations across years. Unintentional fall mortality has recently increased among adults aged 65 to 84 years. Differences between urban and rural areas, as well as between men and women, deserve the attention of injury researchers and policymakers.

Association between oxidative balance scores and all-cause and cardiovascular disease-related mortality in patients with type 2 diabetes: data from the national health and nutrition examination survey (2007-2018)

BACKGROUND

Oxidative Balance Scores (OBS) is composite measures that assess the balance between pro-oxidant and antioxidant factors in an individual's diet and lifestyle. Evidence on OBS and cardiovascular disease (CVD) in diabetic patients is scarce. This study investigates the potential association between OBS and CVD-prevalence and all-cause and CVD-related mortality in adult diabetic patients.

METHODS

Participants were selected from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. OBS-related data collection was initiated by linking the National Death Index to determine mortality due to all-cause and cardiovascular disease until December 31, 2019. Weighted logistic regression analyses explored the relationship between OBS and CVD. In addition, multivariable Cox proportional risk regression models and Kaplan-Meier curves were used to determine the correlation between OBS and mortality, with time to event as the time variable, as well as to estimate hazard ratios (HR) and 95% confidence interval (CI).

RESULTS

A total of 3491 participants were included in the final analysis. Weighted logistic regression analysis of the relationship between OBS and CVD prevalence found that higher OBS was not associated with CVD prevalence compared with lower levels after fully adjustment in model 3 (OR: 0.82, 95% CI: 0.51-1.31, P = 0.39). During 3,491 person-years of follow-up, 408 deaths were recorded, of which 105 deaths were attributed to CVD. In fully adjusted model 3, participants in the highest quartile of OBS had significant reductions in all-cause mortality of 53% [HR: 0.47, 95% CI: 0.29-0.77), Ptrend= 0.002] and in cardiovascular disease mortality of 78% [HR: 0.22, 95% CI: 0.08-0.56), Ptrend= 0.004], compared with the lowest quartile groups of OBS. The Kaplan-Meier analysis results showed that participants in the highest quartile of OBS had the lowest risk of all-cause and CVD-related mortality and were statistically different (P < 0.05). Subgroup analysis confirmed that P for interaction was significant only concerning the educational level attained and in individuals with a history of CKD (P < 0.05).

CONCLUSIONS

Although OBS wasn't very useful for assessing CVD prevalence outcomes, higher OBS was significantly associated with lower all-cause and CVD-related mortality, suggesting that maintaining adequate OBS may reduce mortality in patients with DM.

Relationship between dietary oxidative balance score, anthropometric measurements and socioeconomic factors in women at low risk of cardiovascular disease

INTRODUCTION

The aim of this study was to investigate the relationship between the dietary oxidative balance score (OBS), an indicator of oxidative stress, anthropometric measures and socioeconomic factors in women at low risk of cardiovascular disease.

METHODS

The participants' 3-day dietary intake, demographic information, anthropometric measurements and blood pressure values were recorded, and the Framingham Risk Score (FRS) and OBS values were determined. Oxidative balance score consists of prooxidant and antioxidant scores. Prooxidant scores were calculated from red meat consumption, total iron and polyunsaturated fatty acid intake, alcohol and cigarette consumption parameters, while antioxidant scores were calculated by assessing cruciferous consumption, dietary total vitamin C, vitamin E, β-carotene, β-cryptoxanthin, β-carotene, β-cryptoxanthin, lycopene, lutein+zeaxanthin and selenium intake.

RESULTS

A total of 145 women were included in the study. Education level was associated with anthropometric measurements, income status with antioxidant and prooxidant scores, and exercise status with OBS (p<0.05). Weight, waist, hip, BMI, waist/hip, and waist/height ratio were significantly lower in subjects with low prooxidant score (p<0.05); there was no significant relationship between age, systolic, diastolic, FRS (p>0.05).

CONCLUSION

The study, conducted in healthy women, showed that dietary oxidative balance scoring is promising in preventing the development of CVD and reducing the burden of disease, and that prospective cohort studies should be conducted in this area.

Association of oxidative balance score, cardiovascular, and all-cause mortality among patients with type 2 diabetes mellitus

Background

To investigate the association between oxidative balance score (OBS), cardiovascular mortality (CVM), and all-cause mortality (ACM) in type 2 diabetes mellitus (T2DM) patients.

Methods

We included 6,119 participants with T2DM from the 2005-2020 National Health and Nutrition Examination Surveys (NHANES). The status of CVM and ACM of participants was followed through December 31, 2019. Multivariable Cox regression models, Kaplan-Meier curves, log-rank test, restricted cubic spline regression, and subgroup analysis, were used to evaluate the relationship between OBS, CVM, and ACM.

Results

During a median of 100.9 months follow-up, 1,790 ACM cases had occurred, 508 of which were due to cardiovascular disease. The T2DM participants were divided into four groups based on the quartiles of OBS. Participants with Q4 tended to be younger, financially better-off, married, highly educated, had lower alcohol consumption rates, were non-smokers, and exhibited a lower likelihood of ACM and CVM. In multivariate Cox regression models, compared with the patients with Q4, those with Q1 had a 30% increased risk for ACM (Q1, reference; Q4, HR: 0.70, 95%CI: 0.58-0.86) and a 43% increased risk for CVM (Q1, reference; Q4, HR: 0.57, 95%CI: 0.36-0.88). The restricted cubic spline regression models have no nonlinear relationship between OBS, CVM, and ACM. Kaplan-Meier survival curves showed that patients with Q4 had a lower risk of ACM and CVM (log-rank P < 0.05).

Conclusions

We find that ACM and CVM increase with higher OBS in T2DM patients. Moreover, there are linear relationships between OBS, ACM, and CVM.

Interplay of sleep patterns and oxidative balance score on total cardiovascular disease risk: Insights from the National Health and Nutrition Examination Survey 2005-2018

Background

Unhealthy lifestyle and diet may contribute to the development of cardiovascular disease (CVD), but limited evidence exists regarding the association between sleep patterns, oxidative stress-related exposures to diet and lifestyle, and CVD risk.

Methods

We analysed data from 10 212 adults in the National Health and Nutrition Examination Survey (NHANES) database (2005-2018). Self-report questionnaires were used to collect data on sleep duration, sleepiness, and trouble sleeping, classified into three categories: healthy, intermediate, and poor sleep patterns. Healthy sleep was defined as sleeping seven to nine hours per night with no self-reported sleepiness or trouble sleeping, while intermediate and poor sleep patterns indicated one and two to three sleep problems, respectively. The oxidative balance score (OBS) was calculated based on twenty oxidative stress-related exposures to dietary and lifestyle factors, with a higher score indicating greater antioxidant exposure. Survey-based multivariable-adjusted regression analysis was conducted to examine the association of sleep patterns or OBS alone and combined with the total and specific CVD risk.

Results

Participants with poor sleep patterns had a higher likelihood of developing CVD (odds ratio (OR) = 1.76; 95% confidence interval (CI) = 1.26-2.45, P < 0.05), while an inverse association was found between OBS and CVD risk (quartile (Q) 4 vs Q1: OR = 0.67; 95% CI = 0.47-0.94, P = 0.02, P for trend <0.05). There was an interaction between sleep patterns and OBS (P for interaction = 0.03). Participants with unhealthy (intermediate and poor) sleep patterns and pro-oxidant OBS (Q1 and Q2) were significantly associated with increased risk of total CVD (OR = 2.31; 95% CI = 1.42-3.74, P < 0.05), as well as angina and congestive heart failure, but not coronary heart disease (CHD). Stratified analysis showed that among individuals without hyperlipidaemia, participants with both unhealthy sleep patterns and pro-oxidant OBS exhibited a higher risk of CHD compared to those with healthy sleep patterns and antioxidative OBS.

Conclusions

Unhealthy sleep patterns and reduced oxidative balance are positively associated with an increased risk of overall and specific CVD. Interventions that target healthy sleep habits and antioxidant-rich diets and lifestyles may be important for reducing the risk of CVD.

Association of dietary oxidative balance score and sleep duration with the risk of mortality: prospective study in a representative US population

OBJECTIVE

We investigated the association between dietary oxidative balance score (DOBS) and mortality and whether this association can be modified by sleep duration.

DESIGN

We calculated DOBS to estimate the overall oxidative effects of the diet, with higher DOBS reflecting more antioxidant intake and less pro-oxidant intake. Cox proportional hazards models were employed to examine the associations between DOBS and all-cause, CVD and cancer mortality in the general population and people with different sleep durations.

SETTING

Prospective analysis was conducted using data from the US National Health and Nutrition Examination Survey (NHANES, 2005-2015).

PARTICIPANTS

A total of 15 991 US adults with complete information on dietary intake, sleep duration and mortality were included.

RESULTS

During a median follow-up of 7·4 years, 1675 deaths were observed. Participants in the highest quartile of DOBS were significantly associated with the lower risk of all-cause mortality (hazard ratio (HR) = 0·75; 95 % CI 0·61, 0·93) compared with those in the lowest. Furthermore, we found statistically significant interactions between DOBS and sleep duration on all-cause mortality (P interaction = 0·021). The inverse association between DOBS and all-cause mortality was significant in short sleepers (HR = 0·66, 95 % CI 0·48, 0·92), but not in normal and long sleepers.

CONCLUSIONS

Our study observed that higher DOBS was associated with lower all-cause mortality, and this association appeared to be stronger among short sleepers. This study provides nutritional guidelines for improving health outcomes in adults, especially for short sleepers.

Association between an oxidative balance score and mortality: a prospective analysis in the SUN cohort

PURPOSE

We aimed to prospectively investigate the association of an overall oxidative balance score (OBS) with all-cause death and cause-specific mortality among participants in the Seguimiento Universidad de Navarra (SUN) Study, a Mediterranean cohort of Spanish graduates.

METHODS

Using baseline information on 12 a priori selected dietary and non-dietary lifestyle pro- and antioxidants exposures-vitamins C and E, β-carotenes, selenium, zinc, heme iron, polyphenols, total antioxidant capacity, body mass index, alcohol, smoking, and physical activity-we constructed an equally weighted OBS categorized into quartiles, with higher scores representing greater antioxidant balance. Cox proportional hazards models were fitted to evaluate the association between the OBS and mortality.

RESULTS

A total of 18,561 participants (mean [SD] age, 38.5 [12.4] years; 40.8% males) were included in the analysis. During a median follow-up of 12.2 years (interquartile range 8.3-14.9), 421 deaths were identified, including 80 deaths from cardiovascular disease (CVD), 215 from cancer, and 126 from other causes. After adjustment for potential confounders, the hazard ratios and 95% confidence interval (CIs) between the highest quartile (predominance of antioxidants) vs. the lowest quartile (reference category) were 0.35 (95% CI 0.22-0.54, P-trend < 0.001) for all-cause mortality, 0.18 (95% CI 0.06-0.51, P-trend = 0.001) for CVD mortality, 0.35 (95% CI 0.19-0.65, P-trend = 0.002) for cancer mortality, and 0.45 (95% CI 0.20-1.02, P-trend = 0.054) for other-cause mortality.

CONCLUSION

Our findings suggest a strong inverse association between the OBS and all-cause, CVD, and cancer mortality. Individuals exposed to both antioxidant dietary and lifestyle factors may potentially experience the lowest mortality risk.

STUDY REGISTRY NUMBER

Dynamic Mediterranean Prospective Cohort: the SUN Project; NCT02669602. https://clinicaltrials.gov/ct2/show/NCT02669602 . https://proyectosun.es.

Dietary patterns and survival to 100 + years: an empty systematic review of cohort and case–control studies

Background

Centenarians are used as a model of healthy ageing and longevity. Diet is a factor known to affect mortality in middle aged adults and elderly. However, it is unknown whether diet has an impact on survival to 100 + years. The aims of this systematic review were to summarize the evidence on (i) the association between dietary patterns in late adult life and survival to 100 + years and (ii) the common characteristics across dietary patterns that are shown to be positively associated with survival to 100 + years.

Methods

We performed a systematic literature search in MEDLINE and EMBASE, and a hand search at four longevity projects homepages up to 4 June 2021. We searched for cohort and case–control studies investigating the association between dietary patterns and all-cause mortality among individuals aged ≥ 65 years at enrolment regardless of their health status and residence. Studies were excluded if follow-up was performed too soon to allow the population or a subgroup of it to have become 100 + years of age.

Results

Of 3,685 identified records 108 reports were retrieved and full text screened. No studies met our inclusion criteria, thus the review process resulted in no eligible studies found. Hence, no risk of bias assessment and no synthesis of data was performed.

Conclusions

No studies have investigated dietary patterns in late adult life in relation to survival to 100 + years of age. We have observed that as of June 2021 published cohort studies exist investigating all-cause mortality risk from different dietary patterns among the oldest old, but follow-up has been performed before the cohort could have reached 100 years of age. However, cohorts do exist where data on dietary habits in adult life has been collected decades ago and where follow-up in 2022 will allow the participants to have become 100 + years old.

Registration

The review protocol is published at University of Southern Denmark’s Research Portal (Poulsen et al. Dietary Patterns and Survival to 100 + Years: Protocol for a Systematic Review of cohort and case–control studies University of Southern Denmark's Research Portal: University of Southern Denmark, 2021) available at https://portal.findresearcher.sdu.dk/en/publications/kostm%C3%B8nstre-og-overlevelse-til-100-%C3%A5r-protokol-for-en-systematisk. We have specified aim (i) of our research question in this report compared to the protocol, by adding “late” to “adult life”.

Lifestyle-based oxidative balance score and its association with cardiometabolic health of the community-dwelling elderly: A cross-sectional secondary analysis

Background

Cardiometabolic diseases, the main disease burden in older adults, are largely caused by oxidative stress resulting from lifestyle factors. This study investigated the relationship between lifestyle-based oxidative balance scores and cardiometabolic health among the community-dwelling elderly.

Methods

This work conducted a secondary analysis of previous cross-sectional research data and constructed a lifestyle-based oxidative balance score (LOBS) including 4 components (higher scores were considered more antioxidant). Linear regression models and logistic regression models were used to evaluate the associations with cardiometabolic biomarkers and the number of cardiometabolic risk factors. Besides, we investigated whether these associations differed by covariates.

Results

A total of 710 individuals (60.99% female, median age 70.0 years) were recruited. The inverse associations of LOBS with SBP and TG and the positive association with HDLC were statistically significant in both linear and logistic regression models. In contrast, an inverse association of LOBS with DBP was significant only in the linear regression model (all P < 0.05). The associations of LOBS with TG and HDLC were not affected by age, gender, or socioeconomic level. A significant inverse association was observed between LOBS and the number of cardiometabolic risk factors. Compared with the lowest LOBS, the ORs for more cardiometabolic risk factors in the second and third intervals were 0.577 (0.422, 0.788) and 0.460 (0.301, 0.703) (both P < 0.001).

Conclusion

In summary, this study shows that antioxidant-predominant lifestyle exposure yields a better cardiometabolic health status. We recommend that general practitioners should offer comprehensive healthy lifestyle management to community-dwelling elderly.