The Association Between Dietary Antioxidant Micronutrients and Cardiovascular Disease in Adults in the United States: A Cross-Sectional Study.

Ting Yin,Xu Zhu,Haifeng Zhang,Yuan Tang,Xinyi Lu,Dong Xu,Xinli Li,Mengsha Shi,Huapeng Lin,Wenming Yao,Yanli Zhou

doi:10.3389/fnut.2021.799095

Abstract

Background: Antioxidant micronutrients represent an important therapeutic option for the treatment of oxidative stress-associated cardiovascular diseases (CVDs). However, few studies have evaluated the relationship between the levels of multiple dietary antioxidants and CVDs.Objective: The study therefore aimed to evaluate associations between dietary antioxidants and total and specific CVDs among a nationally representative sample of adults in the US.Design: In total, 39,757 adults (>20 years) were included in this cross-sectional study from the 2005–2018 National Health and Nutrition Examination Survey. We analyzed dietary recall of 11 antioxidant micronutrients in this population. Multivariate logistic and weighted quantile sum (WQS) regression were both applied to examine the relationships between these antioxidants, alone and in combination, with the prevalence of all CVDs and specific CVDs. The linearity of these correlations was also explored using restricted cubic spline (RCS) regression.Results: Multivariate logistic models showed that, compared with the lowest quartile, the levels of 11 antioxidants in the highest quartile were independently associated with decreased total CVD (all P < 0.05). The WQS index showed that, when considered together, the 11 micronutrients were negatively correlated with total CVD (P < 0.001) and five specific CVDs (all P < 0.05), and selenium had the strongest association (weight = 0.219) with total CVD. Moreover, the RCS model demonstrated that iron, zinc and copper were all negatively and non-linearly correlated with total CVD, while the eight other micronutrients had non-significant, linear, negative relationships with total CVD (P for non-linearity >0.05). A piecewise binary logistic regression analysis showed that the inflection points in the relationships between CVD and iron, zinc and copper were 7.71, 6.61, and 0.74 mg/day, respectively.Conclusions: Our findings suggested that high levels of combined dietary antioxidant micronutrients are associated with decreased prevalence of CVDs, and that selenium has the greatest contribution to this association.

Highlights

Cardiovascular disease (CVD) is the leading cause of death and disability in both developed and developing countries, and has become a serious public health problem [1, 2]
Study Population Characteristics According to Total CVD Status
The results showed significant protective correlation existed between 11 antioxidant micronutrients and total CVD

Summary

Introduction

Cardiovascular disease (CVD) is the leading cause of death and disability in both developed and developing countries, and has become a serious public health problem [1, 2]. Numerous studies have been published on CVD risk factors in recent decades; these have established that aging, smoking, obesity, cholesterol levels, poor dietary habits, educational level, blood pressure, diabetes, and genetics, all affect risk [3]. 43.9% of the US adult population is still projected to have some form of CVD by 2030 [4]. Antioxidant micronutrients represent an important therapeutic option for the treatment of oxidative stress-associated cardiovascular diseases (CVDs). Few studies have evaluated the relationship between the levels of multiple dietary antioxidants and CVDs

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Discussion

Conclusion