A Review of A Priori Defined Oxidative Balance Scores Relative to Their Components and Impact on Health Outcomes.

Ángela Hernández-Ruiz,Belén García-Villanova,Miguel Ruiz-Canela,Eduardo Guerra-Hernández,Esther Molina-Montes,Pilar Amiano

doi:10.3390/nu11040774

Abstract

Oxidative Balance Scores (OBSs) are tools that have emerged to evaluate the global balance of individuals’ oxidation—reduction status. The aim was to compare OBSs available in the literature regarding their characteristics and associations with chronic diseases in epidemiological studies. Studies that developed OBSs were searched in PubMed until August 2018. A total of 21 OBSs were identified. These OBSs presented different scoring schemes and different types of anti- and pro-oxidant components, including dietary factors (dietary intake and/or nutrient biomarkers), lifestyle factors, and medications. Most OBSs were based on over 10 components, and some included only dietary factors. Few considered weighted components in the score. Only three OBSs were validated as potential surrogates of oxidative balance through inflammation and OS-related biomarkers. Notably, all the OBSs were associated—to a varying degree—with a reduced risk of cardiovascular diseases, chronic kidney disease, colorectal adenomas, and different cancer types (colorectal and breast cancer), as well as with all-cause and cancer-related mortality. For other outcomes, e.g., prostate cancer, contradictory results were reported. In summary, there is a great heterogeneity in the definition of OBSs. Most studies are concordant in supporting that excessive OS reflected by a lower OBS has deleterious effects on health. Unified criteria for defining the proper OBSs, valuable to gauge OS-related aspects of the diet and lifestyle that may lead to adverse health outcomes, are needed.

Highlights

Oxidative stress (OS) is a multifactorial process caused by an imbalance between anti- and pro-oxidant components
This lack of consistency could be attributable to the complex interplay between the numerous endogenous enzymatic mechanisms and exogenous modifiable factors involving multiple pro- and antioxidant factors by which OS may trigger the development of diseases
Our aim was to analyze and compare the characteristics of Oxidative Balance Scores (OBSs) published in the literature and to review the association of these OBSs with different health outcomes, especially chronic disease related with OS

Summary

Introduction

Oxidative stress (OS) is a multifactorial process caused by an imbalance between anti- and pro-oxidant components. While a considerable body of evidence from basic science and animal studies support the role of OS as both an initiator and promoter of inflammation and disease occurrence [5], epidemiological studies have produced conflicting results regarding the impact that individual determinants of OS may have on health [6,7] This lack of consistency could be attributable to the complex interplay between the numerous endogenous enzymatic mechanisms and exogenous modifiable factors involving multiple pro- and antioxidant factors by which OS may trigger the development of diseases. Among dietary factors, certain nutrients are presumed to function as antioxidants (e.g., carotenoids and tocopherols, vitamin C, flavonoids, PUFAs, and minerals: zinc, selenium, copper) or pro-oxidants (e.g., saturated fat, iron) [8], while smoking is a recognized pro-oxidant factor. Such interactions and correlations between these factors makes it difficult to ascertain the independent effects of oxidant or antioxidant factors on disease risk

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