Association between the composite dietary antioxidant index and non-alcoholic fatty liver disease: evidence from National Health and Nutrition Examination Survey 2005–2016
ImportanceOxidative stress contributes to the progression of non-alcoholic fatty liver disease (NAFLD). Antioxidants from food can reduce NAFLD incidence, and the Composite Dietary Antioxidant Index (CDAI) measures total antioxidant capacity (TAC). However, the relationship between CDAI and NAFLD in...
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Frontiers Media S.A.
2025-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1473487/full |
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| author | Yidian Fu Yidian Fu Chao Jiang Zonglin Li Xiangyun Shi Peiyuan Lv Peiyuan Lv Jingbo Zhang |
| author_facet | Yidian Fu Yidian Fu Chao Jiang Zonglin Li Xiangyun Shi Peiyuan Lv Peiyuan Lv Jingbo Zhang |
| author_sort | Yidian Fu |
| collection | DOAJ |
| description | ImportanceOxidative stress contributes to the progression of non-alcoholic fatty liver disease (NAFLD). Antioxidants from food can reduce NAFLD incidence, and the Composite Dietary Antioxidant Index (CDAI) measures total antioxidant capacity (TAC). However, the relationship between CDAI and NAFLD in the US adult population remains unclear.ObjectiveTo assess whether CDAI is associated with NAFLD in US adults.Design, setting, and participantsThis population-based cross-sectional study used data on US adults from the National Health and Nutrition Examination Survey (NHANES) 2005–2016 cycles. Data were analyzed from January to February 2024.ExposuresCDAI obtained from the dietary intake questionnaire.Main outcomes and measuresThe main outcome was NAFLD which defined by the US fatty liver score (USFLI) ≥30. Sampling weights were calculated according to NHANES guidelines.ResultsAmong 9,746 adults included in this study [mean age, 48.3 years; 4,662 (47.6%) males], 3,324 (33.0%) were classified as having NAFLD using USFLI. In the fully adjusted of multivariable logistic regression, CDAI was negatively associated with NAFLD (odds ratio [OR], 0.95; 95% CI, 0.93–0.98). Furthermore, individuals in the highest quartile of CDAI were 34% less likely to have NAFLD compared to those in the lowest quartile (OR, 0.66; 95% CI, 0.52–0.85). In subgroup analyses, CDAI was inversely associated with NAFLD among participants with a BMI <25 (OR, 0.89; 95% CI, 0.83–0.95) and without metabolic syndrome (OR, 0.93; 95% CI, 0.91–0.96). The interaction tests revealed significant differences in these subgroups (P for interaction = 0.04 for BMI and 0.003 for metabolic syndrome). Sensitivity analyses confirmed this association using the hepatic steatosis index (HSI) to define NAFLD, applying unweighted logistic regression, adjusting for physical activity or after excluding non-Hispanic Black participants, and after excluding medications known for their potential hepatotoxic effects.Conclusions and relevanceIn this cross-sectional study based on six cycles (2005–2016) of the NHANES, CDAI was negatively associated with NAFLD in US adult population. This association highlights the potential for dietary interventions to reduce NAFLD incidence and underscores the need for future research, including clinical trials and mechanistic studies, to further explore the role of dietary antioxidants in NAFLD prevention and management. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-5ff317d38ba94d3898b7d09e428a86fd2025-01-23T05:10:25ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-01-011210.3389/fnut.2025.14734871473487Association between the composite dietary antioxidant index and non-alcoholic fatty liver disease: evidence from National Health and Nutrition Examination Survey 2005–2016Yidian Fu0Yidian Fu1Chao Jiang2Zonglin Li3Xiangyun Shi4Peiyuan Lv5Peiyuan Lv6Jingbo Zhang7Graduate School of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, ChinaDepartment of Psychosomatic Medicine, Hebei General Hospital, Shijiazhuang, Hebei, ChinaDepartment of Medical Laboratory, Liaocheng Hospital of Traditional Chinese Medicine, Liaocheng, Shandong, ChinaCollege of Geography and Resources, Sichuan Normal University, Chengdu, ChinaGraduate School of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, ChinaDepartment of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaImportanceOxidative stress contributes to the progression of non-alcoholic fatty liver disease (NAFLD). Antioxidants from food can reduce NAFLD incidence, and the Composite Dietary Antioxidant Index (CDAI) measures total antioxidant capacity (TAC). However, the relationship between CDAI and NAFLD in the US adult population remains unclear.ObjectiveTo assess whether CDAI is associated with NAFLD in US adults.Design, setting, and participantsThis population-based cross-sectional study used data on US adults from the National Health and Nutrition Examination Survey (NHANES) 2005–2016 cycles. Data were analyzed from January to February 2024.ExposuresCDAI obtained from the dietary intake questionnaire.Main outcomes and measuresThe main outcome was NAFLD which defined by the US fatty liver score (USFLI) ≥30. Sampling weights were calculated according to NHANES guidelines.ResultsAmong 9,746 adults included in this study [mean age, 48.3 years; 4,662 (47.6%) males], 3,324 (33.0%) were classified as having NAFLD using USFLI. In the fully adjusted of multivariable logistic regression, CDAI was negatively associated with NAFLD (odds ratio [OR], 0.95; 95% CI, 0.93–0.98). Furthermore, individuals in the highest quartile of CDAI were 34% less likely to have NAFLD compared to those in the lowest quartile (OR, 0.66; 95% CI, 0.52–0.85). In subgroup analyses, CDAI was inversely associated with NAFLD among participants with a BMI <25 (OR, 0.89; 95% CI, 0.83–0.95) and without metabolic syndrome (OR, 0.93; 95% CI, 0.91–0.96). The interaction tests revealed significant differences in these subgroups (P for interaction = 0.04 for BMI and 0.003 for metabolic syndrome). Sensitivity analyses confirmed this association using the hepatic steatosis index (HSI) to define NAFLD, applying unweighted logistic regression, adjusting for physical activity or after excluding non-Hispanic Black participants, and after excluding medications known for their potential hepatotoxic effects.Conclusions and relevanceIn this cross-sectional study based on six cycles (2005–2016) of the NHANES, CDAI was negatively associated with NAFLD in US adult population. This association highlights the potential for dietary interventions to reduce NAFLD incidence and underscores the need for future research, including clinical trials and mechanistic studies, to further explore the role of dietary antioxidants in NAFLD prevention and management.https://www.frontiersin.org/articles/10.3389/fnut.2025.1473487/fullcomposite dietary antioxidant indexnon-alcoholic fatty liver diseaseNHANESUS fatty liver indexhepatic steatosis index |
| spellingShingle | Yidian Fu Yidian Fu Chao Jiang Zonglin Li Xiangyun Shi Peiyuan Lv Peiyuan Lv Jingbo Zhang Association between the composite dietary antioxidant index and non-alcoholic fatty liver disease: evidence from National Health and Nutrition Examination Survey 2005–2016 Frontiers in Nutrition composite dietary antioxidant index non-alcoholic fatty liver disease NHANES US fatty liver index hepatic steatosis index |
| title | Association between the composite dietary antioxidant index and non-alcoholic fatty liver disease: evidence from National Health and Nutrition Examination Survey 2005–2016 |
| title_full | Association between the composite dietary antioxidant index and non-alcoholic fatty liver disease: evidence from National Health and Nutrition Examination Survey 2005–2016 |
| title_fullStr | Association between the composite dietary antioxidant index and non-alcoholic fatty liver disease: evidence from National Health and Nutrition Examination Survey 2005–2016 |
| title_full_unstemmed | Association between the composite dietary antioxidant index and non-alcoholic fatty liver disease: evidence from National Health and Nutrition Examination Survey 2005–2016 |
| title_short | Association between the composite dietary antioxidant index and non-alcoholic fatty liver disease: evidence from National Health and Nutrition Examination Survey 2005–2016 |
| title_sort | association between the composite dietary antioxidant index and non alcoholic fatty liver disease evidence from national health and nutrition examination survey 2005 2016 |
| topic | composite dietary antioxidant index non-alcoholic fatty liver disease NHANES US fatty liver index hepatic steatosis index |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1473487/full |
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