Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)

Abstract

BackgroundThe Composite Dietary Antioxidant Index (CDAI), a composite score of multiple dietary antioxidants (including vitamin A, C, and E, selenium, zinc, and carotenoids), represents an individual’s comprehensive dietary antioxidant intake profile. CDAI was developed based on its combined effect on pro-inflammatory markers Tumor Necrosis Factor-α (TNF-α) and anti-inflammatory effects of Interleukin-1β (IL-1β), which are associated with many health outcomes, including depression, all-cause mortality, colorectal cancer, etc. Handgrip strength is used as a simple measure of muscle strength, not only is it highly correlated with overall muscle strength, but also serves as a diagnostic tool for many adverse health outcomes, including sarcopenia and frailty syndromes.PurposeThe association between CDAI and Handgrip strength (HGS) is currently unclear. This study investigated the association between CDAI (including its components) and HGS in 6,019 American adults.MethodThe research data were selected from the 2011–2014 National Health and Nutrition Survey (NHANES), and a total of 6,019 American adults were screened and included. A weighted generalized linear regression model was used to evaluate CDAI (including its components) and HGS.Results(1) CDAI was significantly positively correlated with HGS (β = 0.009, 0.005∼0.013, P < 0.001), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.084, 0.042∼0.126, P = 0.002) and significant in trend test (P for trend < 0.0100). Gender subgroup analysis showed that male CDAI was significantly positively correlated with HGS (β = 0.015, 0.007∼0.023, P = 0.002), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.131, 0.049∼0.213, P = 0.006) and the trend test was significant (P for trend < 0.0100). There was no correlation between female CDAI and HGS, and the trend test was not statistically significant (P > 0.05). (2) The intake of dietary vitamin E, Zinc and Selenium showed a significant positive correlation with HGS (β = 0.004, 0.002∼0.007, P = 0.006; β = 0.007, 0.004∼0.009, P < 0.001; β = 0.001, 0.001∼0.001, P < 0.001), vitamin A, vitamin C and carotenoid were significantly associated with HGS in the Crude Model, but this significant association disappeared in the complete model with the increase of control variables. Gender subgroup analysis showed that in model 3, male dietary intake levels of vitamin E, Zinc, and Selenium were significantly positively correlated with HGS (β = 0.005, 0.002∼0.009, P = 0.011; β = 0.007, 0.004∼0.011, P = 0.001; β = 0.001, 0.001∼0.001, P = 0.004), the rest of the indicators had no significant correlation with HGS. Among the female subjects, dietary zinc intake was significantly positively correlated with HGS (β = 0.005, 0.001∼0.008, P = 0.008), and there was no significant correlation between other indicators and HGS (P > 0.05).ConclusionThere was an association between the CDAI and HGS, but there was a gender difference, and there was an association between the CDAI and HGS in male, but the association was not significant in female. Intake of the dietary antioxidants vitamin E, selenium, and zinc was associated with HGS in male, but only zinc was associated with HGS among dietary antioxidants in female.

A Mendelian randomization study to examine the causal associations of circulating micronutrient levels with frailty risk

“…Lewis et al examined the relationship between dietary and circulating vitamin C with skeletal muscle mass, and found a positive correlation between vitamin C with skeletal muscle mass ( 39 ). In addition, from a study analyzing the association between the NHANES cohort’s dietary antioxidant and grip strength, vitamin E intake was found to be positively associated with grip strength in men ( 40 ). In contrast, a study conducted in Switzerland demonstrated that the supplementation of vitamins C and E neither improved nor prevented low grip strength over a five years ( 41 ).…”

Composite dietary antioxidant index is associated with reduced prevalence of metabolic syndrome but not mortality in metabolic syndrome: Results from NHANES 2001–2018

“…We obtained the mean intake of vitamin A, vitamin C, vitamin E, zinc, selenium, and carotenoids from the CDAI (excluding intake from dietary supplements, medications, or plain drinking water). The CDAI was derived according to the validated method from previous studies ( Wu et al, 2023a , Yu et al, 2022 ), which is to subtract the mean intake of each antioxidant from its intake, normalize by dividing by the standard deviation, and then combine all the figures. The CDAI was calculated as follows (where x represents the intake of individual dietary antioxidants, mean represents the average intake of each component, and SD represents the standard deviation of the mean): …”

Association of obstructive sleep apnea symptoms with all‐cause mortality and cause‐specific mortality in adults with or without diabetes: A cohort study based on the NHANES

“…Smoking status was divided into three categories as follows: never (<100 cigarettes in a lifetime), former (>100 cigarettes in a lifetime but no longer smoke), and current (>100 cigarettes in a lifetime and smoke at times or daily). 16 Drinking status was categorized as (a) never drinking, (b) former drinking (having drunk before and not drinking in the last 12 months), (c) mild alcohol user (<2 drinks per day for females, <3 drinks per day for males, or excessive drinking <2 days per month), (d) current moderate drinking (≥2 drinks per day for females, ≥3 drinks per day for males, or excessive drinking ≥2 days per month), and (e) current heavy drinking (≥3 drinks per day for females, ≥4 drinks per day for males, or excessive drinking more than 5 days per month). 17 Asthma and chronic obstructive pulmonary disease (COPD) were diagnosed through a combination of patient self-report, medical history, medication use, and age.…”