Relative Validity of Dietary Total Antioxidant Capacity for Predicting All-Cause Mortality in Comparison to Diet Quality Indexes in US Adults.

Kyungho Ha,Ock K Chun,Junichi R Sakaki,Kijoon Kim

doi:10.3390/nu12051210

Kyungho Ha, Ock K Chun + Show 2 more

Open Access

https://doi.org/10.3390/nu12051210

Copy DOI

Journal: Nutrients	Publication Date: Apr 25, 2020
Citations: 27	License type: CC BY 4.0

Affiliation: University of Connecticut, Sookmyung Women's University

Abstract

While traditionally diet quality index scores (DQIS) as noted later in this abstract have been used to predict health outcomes, dietary total antioxidant capacity (TAC), a useful tool for assessing total antioxidant power in the diet, may also be a novel predictor. This study evaluated the associations between dietary TAC and DQIS and all-cause mortality. Based on the National Health and Nutrition Examination Survey (NHANES) 1988–1994 and 1999–2006, 23,797 US adults were followed-up until 2015. Dietary TAC and DQIS including the Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH) were calculated using a 1-day 24 h dietary recall. US adults in the highest quintiles of DQIS had lower rates of all-cause mortality compared to those in the lowest quintiles (HEI-2015 hazard ratio (HR): 0.87, 95% confidence interval (CI): 0.77–0.98; AHEI-2010 HR: 0.84, 95% CI: 0.74–0.94; aMED HR: 0.79, 95% CI: 0.69–0.90; DASH HR: 0.80, 95% CI: 0.70–0.92). Similarly, those in the highest quintile of dietary TAC also had a lower all-cause mortality than those in the lowest quintile (HR: 0.88, 95% CI: 0.79–0.98). These findings suggest that dietary TAC might be a relatively valid predictor of all-cause mortality in the US population compared to the DQIS.

Highlights

Poor diet quality is thought to be a leading risk factor for reduced quality of life as well as increased mortality [1]
The proportion of the participants who had sufficient physical activity level and who never smoked and smoked in the past but quit for ≥3 years was higher in the highest quintiles of diet quality index scores (DQIS) and dietary
Based on a large sample of nationally representative US adults, the present study found that dietary total antioxidant capacity (TAC) was positively associated with the DQIS including HealthyEating Index (HEI)-2015, Alternative Healthy Eating Index (AHEI)-2010, alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH) and people in the highest quintile of dietary TAC had a lower rate of all-cause mortality than those in the lowest quintile, similar to the trends observed with DQIS

Summary

Introduction

Poor diet quality is thought to be a leading risk factor for reduced quality of life as well as increased mortality [1]. Eating Index (HEI), Alternative Healthy Eating Index (AHEI), alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH) have been widely used to evaluate American diets [2]. These diet quality indexes have been used in epidemiologic studies to reflect risk gradients for major diet-related diseases [4]; the methods for measuring diet indexes are complicated and their relationships with disease risk vary across studies [5,6,7], making it difficult to formulate public health recommendations for a healthy diet and guidelines for self-assessment of diet quality. The endogenous antioxidant defensive system in our body can regulate the Nutrients 2020, 12, 1210; doi:10.3390/nu12051210 www.mdpi.com/journal/nutrients

Objectives

Methods

Results

Conclusion