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)
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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/m2 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.
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/m2 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.
참고문헌 (49)
- Alberti KG, "Harmonizing the metabolic syndrome : a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity", Circulation, 120, pp.1640~1645 (2009)
- Saklayen MG, "The global epidemic of the metabolic syndrome", Curr Hypertens Rep, 20, pp.12~ (2018)
- Grundy SM, "Metabolic syndrome update", Trends Cardiovasc Med, 26, pp.364~373 (2016)
- Gregório BM, "The potential role of antioxidants in metabolic syndrome", Curr Pharm Des, 22, pp.859~869 (2016)
- Puchau B, "Dietary total antioxidant capacity : a novel indicator of diet quality in healthy young adults", J Am Coll Nutr, 28, pp.648~656 (2009)
- Pellegrini N, "Twenty-five years of total antioxidant capacity measurement of foods and biological fluids : merits and limitations", J Sci Food Agric, 100, pp.5064~5078 (2020)
- Parohan M, "Dietary total antioxidant capacity and mortality from all causes, cardiovascular disease and cancer : a systematic review and dose-response meta-analysis of prospective cohort studies", Eur J Nutr, 58, pp.2175~2189 (2019)
- Floegel A, "Development and validation of an algorithm to establish a total antioxidant capacity database of the US diet", Int J Food Sci Nutr, 61, pp.600~623 (2010)
- Mozaffari H, "Dietary total antioxidant capacity and cardiovascular disease risk factors : a systematic review of observational studies", J Am Coll Nutr, 37, pp.533~545 (2018)
- Kim SA, "Dietary pattern, dietary total antioxidant capacity, and dyslipidemia in Korean adults", Nutr J, 18, pp.37~ (2019)
- Tan LJ, "Dietary antioxidant consumption and the risk of type 2 diabetes in South Korean adults : a prospective cohort study based on the Health Examinees study", BMJ Open, 12, pp.e065073~ (2022)
- Rasaee S, "Does total antioxidant capacity affect the features of metabolic syndrome? A systematic review", Nutr Food Sci, 51, pp.100~113 (2020)
- Hosseini A, "Quercetin and metabolic syndrome : a review", Phytother Res, 35, pp.5352~5364 (2021)
- Kong JS, "Prospective Associations between cumulative average intake of flavonoids and hypertension risk in the CArdioVascular Disease Association Study(CAVAS)", Nutrients, 15, pp.1186~ (2023)
- Kim Y, "Cohort profile : the Korean Genome and Epidemiology Study(KoGES)Consortium", Int J Epidemiol, 46, pp.e20~ (2017)
- Lorenzo C, "The National Cholesterol Education Program-Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes", Diabetes Care, 30, pp.8~13 (2007)
- Lee SY, "Appropriate waist circumference cutoff points for central obesity in Korean adults", Diabetes Res Clin Pract, 75, pp.72~80 (2007)
- Ahn Y, "Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study", Eur J Clin Nutr, 61, pp.1435~1441 (2007)
- "Food values" (2009)[URL]
- "Food and nutrient databases" (2020)[URL]
- "National nutrient database for standard reference, release 28 (slightly revised)"[URL]
- Watanabe T, "Advances in food composition tables in Japan-Standard Tables of Food Composition in Japan-2015-(seventh revised edition)", Food Chem, 238, pp.16~21 (2018)
- "USDA database for the flavonoid content of selected foods, release 3.3"[URL]
- "USDA database for the isoflavone content of selected foods release 2.1"[URL]
- "USDA database for the proanthocyanidin content of selected foods, release 2.1"[URL]
- "Phenol-Explorer 3.6. database on polyphenol content in food"[URL]
- Kim DO, "Comprehensive study on vitamin C equivalent antioxidant capacity(VCEAC)of various polyphenolics in scavenging a free radical and its structural relationship", Crit Rev Food Sci Nutr, 44, pp.253~273 (2004)
- Hu FB, "Dietary fat and coronary heart disease : a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements", Am J Epidemiol, 149, pp.531~540 (1999)
- Zou G, "A modified poisson regression approach to prospective studies with binary data", Am J Epidemiol, 159, pp.702~706 (2004)
- Pérez-Martínez P, "Lifestyle recommendations for the prevention and management of metabolic syndrome : an international panel recommendation", Nutr Rev, 75, pp.307~326 (2017)
- Djoussé L, "Diet and metabolic syndrome", Endocr Metab Immune Disord Drug Targets, 10, pp.124~137 (2010)
- Woodward M, "Epidemiology : study design and data analysis", pp.452~459 (2013), CRC Press
- Kleinbaum DG, "Applied regression analysis and other multivariable methods", pp.358~371 (2013), Cengage Learning
- Jun S, "Estimation of dietary total antioxidant capacity of Korean adults", Eur J Nutr, 57, pp.1615~1625 (2018)
- Kim K, "Greater total antioxidant capacity from diet and supplements is associated with a less atherogenic blood profile in U. S. adults", Nutrients, 8, pp.15~ (2016)
- "An overview of global flavonoid intake and its food sources" (2017)[URL]
- Grosso G, "Dietary polyphenols are inversely associated with metabolic syndrome in Polish adults of the HAPIEE study", Eur J Nutr, 56, pp.1409~1420 (2017)
- Kim S, "Total antioxidant capacity from dietary supplement decreases the likelihood of having metabolic syndrome in Korean adults", Nutrients, 9, pp.1055~ (2017)
- Bahadoran Z, "Dietary total antioxidant capacity and the occurrence of metabolic syndrome and its components after a 3-year follow-up in adults: Tehran Lipid and Glucose Study", Nutr Metab, 9, pp.70~ (2012)
- Colafella KM, "Sex-specific differences in hypertension and associated cardiovascular disease", Nat Rev Nephrol, 14, pp.185~201 (2018)
- Powles J, "Global, regional and national sodium intakes in 1990 and 2010 : a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide", BMJ Open, 3, pp.e003733~ (2013)
- Lenda DM, "Effect of a high-salt diet on oxidant enzyme activity in skeletal muscle microcirculation", Am J Physiol Heart Circ Physiol, 282, pp.H395~H402 (2002)
- Jin S, "The association of dietary flavonoids, magnesium and their interactions with the metabolic syndrome in Chinese adults : a prospective cohort study", Br J Nutr, 126, pp.892~902 (2021)
- Zhang Y, "Associations of dietary and circulating vitamin e level with metabolic syndrome. a meta-analysis of observational studies", Front Nutr, 8, pp.783990~ (2021)
- Beydoun MA, "Carotenoids, vitamin A, and their association with the metabolic syndrome : a systematic review and meta-analysis", Nutr Rev, 77, pp.32~45 (2019)
- Guo H, "Vitamin C and metabolic syndrome : a meta-analysis of observational studies", Front Nutr, 8, pp.728880~ (2021)
- Parmenter BH, "An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk", Food Funct, 11, pp.6777~6806 (2020)
- García-Barrado MJ, "Role of flavonoids in the interactions among obesity, inflammation, and autophagy", Pharmaceuticals(Basel), 13, pp.342~ (2020)
- Grosso G, "The effect of dietary polyphenols on vascular health and hypertension : current evidence and mechanisms of action", Nutrients, 14, pp.545~ (2022)
